Tumor(肿瘤).ppt

Tumor(肿瘤) Epidemiology 全球：1010余万人/年 我国：200万人/年，死亡约150余万人/年 城市：肺癌，胃癌，肝癌，肠癌，乳癌 农村：胃癌，肝癌，肺癌，食管癌，肠癌 Classification 分类的目的在于明确肿瘤的性质, 组织来源。 Classification 形态学及肿瘤对机体的影响---肿瘤的生物学行为: benign -- tumor malignant -- cancer Arising from epithelial - carcinoma Arising from mesodermal - sarcoma Classification 胚胎性肿瘤: blastoma Traditional: 瘤，病: 如恶性淋巴瘤，白血病 组织器官的来源部位：breast cancer，gastric cancer Etiology Environment: 1. Chemical factors 2. Physical factors 3. Biological factors Body factor: 1. Hereditary 2. Endocrine 3. Immune Pathology Generate and progress Proliferation cycle Differential Metastasis immunology Manifestation Local: Mass Pain Ulcer Bleeding Obstruction Infiltration and metastasis Manifestation Systemic: Anemia Lower fever Underweight Fatigue Diagnosis History: age,time,past history. Physical examination 1. Systemic 2. Local:site,character,regional LN. laboratory Serum: CA19-9,AKP Immunology:CEA,,AFP FCM Gene diagnosis:PCR Imaging X-ray: CT B-us MRI PET Endoscopic Pathology: cytology histology Staging TNM分期: T: Primary tumor N: Node M: Metastasis Prevention 一级预防：病因预防 二级预防：三早 三级预防：改善生存质量，对症治疗 Treatment Operation Prophylactic operation： 治疗癌前病变，防止其发生恶变或发展成进展期癌。如家族性结肠息肉病，粘膜白斑病等。 Diagnostic operation： 切除活检术，切取活检术，剖腹探查术。 Radical operation： 瘤切除术，广泛切除术，根治术及扩大根治术。 Operation Palliative operation：常用的有癌肿姑息切除，空腔脏器梗阻时行捷径转流或造口术，内分泌腺切除。 Reduction operation：当肿瘤体积较大，单靠手术无法根治的恶性肿瘤，作大部切除，术后继以其他非手术治疗。 肿瘤外科的原则： 1. 不切割原则: no incision 2. 整块切除原则: en block 3. 无瘤技术原则: non touch Chemotherapy Classification Side effect Molecular target  Radiotherapy Biological therapy TCM: traditional chinese medicine 常见体表肿瘤与肿块 Skin basal cell carcinoma melanoma lipoma schwannoma Hemangioma cyst * *