Colorectal cancer diagnostic study of choice: Difference between revisions
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There are no established criteria for the diagnosis of [disease name]. | There are no established criteria for the diagnosis of [disease name]. | ||
'''Colorectal Cancer Staging''' | |||
*Colorectal cancer staging is an estimate of the amount of penetration of the [[cancer]] | |||
*It is performed for [[diagnostic]] and [[research]] purposes, and to determine the best method of treatment | |||
*The systems for staging colorectal cancers largely depend on the extent of local invasion, the degree of [[Lymph node metastases|lymph node involvement]], and whether there is distant [[metastasis]] | |||
*Definitive staging can only be done after [[Colectomy|surgery]] has been performed and [[pathology]] reports have been reviewed | |||
*An exception to this principle would be after a [[colonoscopic]] [[polypectomy]] of a malignant [[Pedunculated|pedunculated polyp]] with minimal invasion | |||
*Preoperative staging of may be done with [[endoscopic ultrasound]] | |||
*Adjuncts to staging of metastasis include [[Medical ultrasonography|abdominal ultrasound]], [[Computed tomography|CT]], [[Positron emission tomography|PET scanning]], and other imaging studies | |||
'''Dukes Classification System''' | |||
Dukes classification was first proposed by Dr Cuthbert E. Dukes in 1932.<ref>Dukes CE. The classification of cancer of the rectum. ''Journal of Pathological Bacteriology'' 1932;35:323.</ref> | |||
The following table describes the Duke's classification stages. | |||
{| style="border:#c9c9c9 1px solid; margin: 1em 1em 1em 0; border-collapse: collapse;" cellspacing="0" cellpadding="4" {{table}} | |||
| style="background:#f0f0f0;" align="center" |'''Stage''' | |||
| style="background:#f0f0f0;" align="center" |'''Description''' | |||
|- | |||
| A||Tumor confined to the intestinal wall | |||
|- | |||
| B||Tumor invading through the intestinal wall | |||
|- | |||
| C||With lymph node(s) involvement | |||
|- | |||
| D||With distant metastasis | |||
'''TNM Classification System''' | |||
{{main|TNM}} | |||
The most common staging system is the [[TNM]] classification (tumors/nodes/metastases) system. The [[TNM]] classification system assigns a number<ref>{{cite book | |||
|author=Wittekind, Ch; Sobin, L. H. | |||
|title=TNM classification of malignant tumours | |||
|publisher=Wiley-Liss | |||
|location=New York | |||
|year=2002 | |||
|pages= | |||
|isbn=0-471-22288-7 | |||
|oclc= | |||
|doi= | |||
}}</ref>. | |||
The table below displays which TNM values represent which stage. | |||
{| style="border:#c9c9c9 1px solid; margin: 1em 1em 1em 0; border-collapse: collapse;" cellspacing="0" cellpadding="4" {{table}} | |||
| style="background:#f0f0f0;" align="center" |'''Stage''' | |||
| style="background:#f0f0f0;" align="center" |'''TNM Value''' | |||
|- | |||
| '''0'''||Tis, N0, M0 | |||
|- | |||
| '''I'''||T1, N0, M0; T2, N0, M0 | |||
|- | |||
| '''IIA'''||T3, N0, M0 | |||
|- | |||
| '''IIB'''||T4, N0, M0 | |||
|- | |||
| '''IIIA'''||T1, N1, M0; T2, N1, M0 | |||
|- | |||
| '''IIIB'''||T3, N1, M0; T4, N1, M0 | |||
|- | |||
| '''IIIC'''||Any T, N2, M0 | |||
|- | |||
| '''IV'''||Any T, Any N, M1 | |||
|} | |||
==References== | ==References== |
Revision as of 18:55, 22 January 2019
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Colorectal cancer diagnostic study of choice On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Diagnostic Study of Choice
Study of choice
[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
OR
The following result of [gold standard test] is confirmatory of [disease name]:
- [Result 1]
- [Result 2]
OR
[Name of the investigation] must be performed when:
- The patient presents with [symptom/sign 1], [symptom/sign 2], and [symptom/sign 3].
- A [name of test] is positive for [sign 1], [sign 2], and [sign 3] in the patient.
OR
[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
OR
The diagnostic study of choice for [disease name] is [name of the investigation].
OR
There is no single diagnostic study of choice for the diagnosis of [disease name].
OR
There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
OR
[Disease name] is primarily diagnosed based on the clinical presentation.
OR
Investigations:
- Among the patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
- Among the patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
- Among the patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
The comparison of various diagnostic studies for [disease name]
Test | Sensitivity | Specificity |
---|---|---|
Test 1 | ...% | ...% |
Test 2 | ...% | ...% |
[Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity
Diagnostic results
The following finding(s) on performing [investigation name] is(are) confirmatory for [disease name]:
- [Finding 1]
- [Finding 2]
Sequence of Diagnostic Studies
The [name of investigation] must be performed when:
- The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
- A positive [test] is detected in the patient, to confirm the diagnosis.
OR
The various investigations must be performed in the following order:
- [Initial investigation]
- [2nd investigation]
Name of Diagnostic Criteria
It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
[Disease name] is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
OR
There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
OR
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
[Disease name] may be diagnosed at any time if one or more of the following criteria are met:
- Criteria 1
- Criteria 2
- Criteria 3
OR
IF there are clear, established diagnostic criteria
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
OR
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
There are no established criteria for the diagnosis of [disease name].
Colorectal Cancer Staging
- Colorectal cancer staging is an estimate of the amount of penetration of the cancer
- It is performed for diagnostic and research purposes, and to determine the best method of treatment
- The systems for staging colorectal cancers largely depend on the extent of local invasion, the degree of lymph node involvement, and whether there is distant metastasis
- Definitive staging can only be done after surgery has been performed and pathology reports have been reviewed
- An exception to this principle would be after a colonoscopic polypectomy of a malignant pedunculated polyp with minimal invasion
- Preoperative staging of may be done with endoscopic ultrasound
- Adjuncts to staging of metastasis include abdominal ultrasound, CT, PET scanning, and other imaging studies
Dukes Classification System Dukes classification was first proposed by Dr Cuthbert E. Dukes in 1932.[1]
The following table describes the Duke's classification stages.
Stage | Description | ||||||||||||||||||
A | Tumor confined to the intestinal wall | ||||||||||||||||||
B | Tumor invading through the intestinal wall | ||||||||||||||||||
C | With lymph node(s) involvement | ||||||||||||||||||
D | With distant metastasis
TNM Classification System The most common staging system is the TNM classification (tumors/nodes/metastases) system. The TNM classification system assigns a number[2]. The table below displays which TNM values represent which stage.
References
|