Aim To discuss the diagnosis and treatment of xantho granulomatous pyelonephfitis, in order to reduce the misdiagnosis rate,and to improve the diagnosis and treatment. Methods Retrospective analysis was made of the clinical data of seven cases of xantho granulomatous pyelonephfitis. Among the seven patients who had undergone surgical treatment, four patients got nephrectomy, and the other three got renal radical resection. Results Among the seven cases, there was one case using intraoperative frozen section diagnosis, and the remaining six cases were confirmed pathologically, all the cases cured by surgical operation, and no recurrence after 1 to 4 years of follow-up. Conclusion The preoperative diagnosis of xantho granulomatous pyelonephfitis was difficult, often misdiagnosed as other kidney diseases. The characteristics of the disease was urine smearing with foam cells and of low density in CT film. The disease was diagnosed mainly by pathological examination. Using the rapid intra-operative frozen section examination had a guiding significance for those preoperative diagnosed renal cell carcinoma patients. According to the clinical stage and lesion of the disease, doctors could adopt the nephrectomy based treatment.%目的 探讨血清糖抗原 125 (CA125)、糖抗原 19-9(CA19-9)、癌胚抗原 (CEA) 检测在大肠癌诊断中的价值.方法 采用罗氏 Cobase 41601型电化学发光免疫分析仪测定 110例大肠癌患者、40例大肠良性病变患者、40例健康体检者血清中CA125、CA19-9、CEA的含量.结果 三项指标定量检测大肠癌组明显高于大肠良性病变组及对照组,其阳性率与肿瘤部位、大体病理类型、组织类型无显著性差异.三项指标的阳性率Dukes C+D期显著高于 Dukes A+B期;CA125、CA19-9、CEA三项指标灵敏度分别为34.55%、37.27%、34.55%,特异度分别为95%、97.5%、95%; 三项指标联合检测灵敏度为59.09%; 特异度为92.5%.而在Dukes C+D期三项指标联合检测灵敏度为89.58%,特异度为92.5%.结论 多种肿瘤标志物联合检测虽然可以提高诊断敏感性,也可以获得较好的特异性,但血清CA125、CA19-9、CEA检查用于大肠癌临床诊断的价值低.血清CA125、CA19-9、CEA三项指标联合检测在Dukes C+D期大肠癌病人诊断价值较高,有助于判断大肠癌病理分期并指导临床手术治疗.
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