Surgical Oncology详解.docVIP

Surgical Oncology Department of Surgery Shanghai Institute of Digestive Surgery Rui Jin Hospital Shanghai Second Medical University 肿瘤TUMOR Definition of Neoplasia a disorder of cell growth in which there is a permanent and inherited change in cells resulting in a pathological proliferation of tissue. The Etiology of Cancer ● Viruses(papilloma, Epstein-Barr, Hepatitis B, retroviruses,HIV) ● Radiation exposure ● Environmental industrial carcinogens ● Tobacco and alcohol consumption ● Genetic susceptibility syndromes Historical Observation of Chemical Carcinogens Date Observation Carcinogen 1761 Excessive use of Nitrosamines snuff lead to nasal polyps 1775 Scrotal cancer in soot chimney sweeps 1860s bladder cancer Aromatic amines 1915 Rabbit ears painted Benzpyrene with tar developed papillomas Cancer Mortality Behavior/environmental Factors Factor Percentage of cancer deaths Smoking 30 Diet 30 Infectious agents 5 Alcohol 3 Sedentary lifestyle 3 Ultraviolet 2 Air pollution 2 Smoking-related cancers ● Lung cancer ● Oropharyngeal cancer ● Stomach cancer ● Cervical cancer ● Pancreatic cancer ● Renal cancer ● Bladder cancer ● Liver cancer ● Leukemia Viruses Associated with Cancer Virus Cancer Hepatitis B, C Hepatocellular Cancer HIV Kaposi’s sarcoma Epstein-Barr virus Nasopharyngeal cancer Burkitt’s lymphoma Human Papilloma virus Cervical cancer Internal causes Hereditary susceptibility Endocrine factors Immune factors Prevention First step etiology Second step early detection and treatment Third step improve quality of life Major Genes in Development of Cancer ● Oncogenes ● Tumor suppressor genes ● DNA repair genes Oncogenes ● Growth factors EGF, TGF-α ● Growth factor receptors EGFR, PTK ● Intracellular transducers cAMP ● Transcription factors c-myc Multi-step natureof Colon Cancer Normal epithelium Modern Viewpoint of Cancer as a Long-term Process The c