中英文本

Initial diagnosis. Two major categories of diagnostic problems are associated with the management of cancer ： obtaining the original diagnosis and correctly identifying the complications or intercurrent illnesses that may arise during the course of the disease. A tissue diagnosis, usually from the primary site, is required in order to allow the patient and physician the certainty to embark on a plan of treatment. Although for most patients with lung, breast, or colon cancer the initial diagnosis is straightforward, some patients may present with metastatic disease but with no apparent primary lesion, or the primary mass may not be easily accessible to needle biopsy. In these patients, identification of the primary lesion and its biopsy are mandatory steps in patient management. Indirect diagnostic techniques are not a substitute for a histologic or cytologic diagnosis of cancer. Rarely it may not be possible to obtain tissue for histologic diagnosis，e. g. , when there is a deep-seated brain tumor or when the patient’s general condition is so poor that the malignancy has little bearing on prognosis.
初步诊断Vf_x-,pgHm0bM%o8G#^。两大类诊断问题与癌症管理有关：进行入院诊断，并准确鉴别在疾病发展过程中可能出现的并发症或间发性疾病wJgxgqYTn(。必须进行原发部位的组织诊断，使病人和医生能够确定治疗方案oK@R8pV;PH*m92k。虽然多数患有肺癌、乳腺癌和结肠癌的病人的初步诊断都很直观，但是有些病人可能患有转移性癌，却没有明显的原发损害，或者针刺活检不容易接触到原置体McwSas1qCulp|o,HBD。对待这些病人，必须进行原发损害确诊及其活检，方便管理病人@Qb3-T9BaMhthp[CXYC2。间接诊断技术并不能代替组织学或细胞学癌症诊断#!r_^FSyh_y0%sya。在极少数情况下无法获得组织进行组织学诊断，例如，深层脑瘤或者病人的总体情况太过糟糕，使得恶性肿瘤与预后几乎没有关系fE!FY~;yyhQacR-M7%。

Physicians often face the diagnostic dilemma posed by the discovery of a metastatic lesion of unknown primary site. In searching for the primary, two rules apply： The clinician must consider the most common type of cancer in the given subject, taking into account age, sex, site of disease, and personal and family history, and must rule out the most treatable lesions, such as breast cancer in women and testicular cancer in young males. Special immunohistologic or electron microscopic studies may be required to rule out malignant melanoma or lymphoma. The finding of mediastinal, retroperitoneal, or lymph node involvement and high human chorionic gonadotropin or α-fetoprotein levels are indicative of germ-cell tumors. Cisplatin-based chemotherapy programs may cure such patients.
医生经常面临因发现未知原发部位的病灶转移而造成的诊断困境fwW95Z*by!MT[d9,~2wJ。为了寻找原发部位，要遵循两条规则：临床医生必须考虑病人最常见的癌症类型，考虑到年龄、性别、疾病位置、个人及家族史，并且必须排除最易治疗的病灶，比如女性的乳腺癌和年轻男性的睾丸癌^NYNVmQLsYO3scT-n。可能需要特殊的免疫组织学或电镜研究来排除恶性黑色素瘤或淋巴瘤.oeH%F@kfsyzOlOx。若发现纵隔、腹膜后或淋巴结转移和大量人体绒毛膜促性腺激素或者高含量的甲胎蛋白，则表明有生殖细胞肿瘤GpH,35|MoVrvvj!BnhG-。以铂类为基础的化学疗法可以治愈此类病人jPDkgs12Td,l9rCW7。

译文属可可英语原创，未经允许，不得转载p3P)PBUu1p。

重点讲解

1.embark on 从事，着手
例句：To diversify one's business is to embark on different kinds of commercial business.
多样化就是从事各式各样的商业经营0P]8~LFF+Sjrg3。
2.brain tumor 脑瘤
例句：The second scan revealed a brain tumor.
第二次扫描显示出一个脑瘤7[Y;VD*kmS=X。
3.rule out 排除，取消，反对，阻止
例句：We had to rule out the possibility of increased supplies.
我们只好排除了增加供应的可能性6XnrfNqs+_d。
4.be indicative of 暗示，表示
例句：His presence is indicative of his wish to help .
他的出现表明他愿意提供帮助d~!nO5[dTLQPt_。