[Efficiency of ultrasound study in the diagnosis of cholangiocellular carcinoma].

OBJECTIVE: To evaluate the efficiency of ultrasound diagnosis in detecting and staging cholangiocellular carcinoma. MATERIAL AND METHODS: An ultrasound study (USS) was conducted in 120 patients aged 19 to 84 years with cholangiocellular carcinoma. The patients were divided into 3 groups by the location of a tumor process: 1) 47 (39.2%) patients with intrahepatic tumor; 2) 49 (40.8%) with portal duct or Klatskin's tumor; 3) 24 (20%) with distal one. Ninety (75%) patients were operated on; the others underwent minimally invasive X-ray surgical interventions as percutaneous transhepatic cholangiostomies. The data of ultrasound diagnosis were compared with the results of other studies, intraoperative assessment and morphological examination of a removed gross specimen. RESULTS: A tumor was detectable by USS only in 90 (75%) patients; its sensitivity was 100% for intrahepatic cholangiocellular carcinoma; 69.4 and 37.5% for portal duct and distal ones, respectively. It is most difficult to diagnose distal carcinomas of the common bile duct. USS reveals no semiotic signs of intrahepatic cholangiocellular carcinoma, which could distinguish the latter from other liver cancers. The specific features of the infiltrative growth of a bile duct tumor, such as hyperechoic infiltration along the external outlines of the ducts or hypoechoic infiltration during thickening of the duct walls, were ascertained. The sensitivity of intraoperative USS in identifying intrahepatic and portal duct cholangiocarcinoma was 100%. That of USS in detecting lymph node metastases was 61%; developed the semiotics of altered metastatic lymph nodes. CONCLUSION: The findings have indicated the high informative value of ultrasound diagnosis in determining the dilatation of the bile ducts and the spread of a tumor to the liver and lymph nodes. It is recommended that the indications for intraoperative USS should be expanded in intrahepatic cholangiocellular carcinoma to define the extent of duct carcinoma.

[Results of a 5-year screening for prostatic cancer]. / Itogi 5-letnego skrininga raka predstatel'noi zhelezy.

The results of 5-year screening (1996-2000) for prostatic cancer in 1129 males 40 to 80 years of age are presented. The examination included: measurement of blood levels of prostate-specific antigen (PSA), finger rectal examination, transrectal ultrasonic examination (TRUE) and, on demand, biopsy of the prostatic gland. Prostatic cancer was diagnosed in 1.5, 2.2 and 16% patients having PSA levels of 0-4.0, 4.0-10.0 and 10.0-30.0% ng/ml, respectively. At finger rectal examination prostatic cancer was suspected in 8% examinees, only in 33% of them the diagnosis was verified morphologically. By TRUE evidence 7% examinees were suspected and in 44.3% of them prostatic cancer was confirmed. Thus, biopsy proved necessary in 172 cases of 1129 examinees. In 64 (5.7%) males prostatic cancer was diagnosed and confirmed. Early prostatic cancer in the screened men and those consulted in the outpatient department of the National Cancer Research Center was detected in 77.7 and 22% men, respectively. The conclusion is made that men over 50 years of age should undergo prophylactic examination of the prostatic gland once a year.

[An analysis of preliminary results in screening for prostatic cancer]. / Analiz predvaritel'nykh rezul'tatov skrininga raka predstatel'noi zhelezy.

450 males aged over 50 years free of urological symptoms were screened for prostatic cancer using three techniques; finger rectal examination (FRE), transrectal ultrasound investigation (TUI), assay for prostatic specific antigen in the serum (SPSA). SPSA quantities under 4 ng/ml, 4-10 ng/ml, 10-20 ng/ml, over 20 ng/ml were registered in 206(45.8%), 135(30%), 69(15.4%) and 40(8.8%) patients, respectively. Detectability of prostatic cancer increases by 33,37.9, 45.5, 69.2% due to TUI, FRE, TUI + FRE, all the three methods, respectively. Prostatic biopsy was needed in 102 (22.7%) cases. From the 450 examinees, prostatic cancer was diagnosed in 25 (5.6%). SPSA was high in all of them, higher than 10 ng/ml in 92%. 20 (80%) of 25 patients with cancer had early stages of the disease (TI-2). The study is going on.