肺癌英文课件.ppt

* * Lung cancer Definition Background Malignant neoplasm arising from bronchial epithelium Historical note 100 years ago 200 cases reported 1895 Roentgen diagnosis possible 1904 Sauerbruch negative-pressure cabin 1912 Davies first lung lobectomy 1941 Zhang Jizheng pneumonectomy Epidemiology Morbidity 19th century rare disease Before 1950s be rising Recent 50 years increased sharply leading cause of cancer death Etiology Occupational exposure Lung cancer Air pollution Lung infection Genetic factors Smoking C-erbB2 EGFR nm23 TGF-α Protein tyrosine phosphatase-γ Growth factor rb c-jun 3p Myc family p53 K-ras Tumor suppressor Dominant Oncogenes and Tumor suppressor genes Return Pathology Lung carcinogenesis Anatomic location Histological classification Invasion and Metastasis TNM staging Lung carcinogenesis columnar epithelium squamous metaplasia carcinoma in situ metastatic carcinoma infiltrating carcinoma Injury Risk factors Return Anatomic location Right Central Peripheral Left Upper Middle lower Upper lower Return 1% Rare 4% Carcinoids 20% SCC 10% Large Cell carcinoma 30% Squamous cell carcinoma 35% Adenocarcinoma 75% NSC Percentage Classification Histological classification of lung cancer Return Return Return Return Invasion and Metastasis Local infiltrate Bronchial lumen Direct extension Lymphatic metastasis Pulmonary hilum nodes Cervical nodes Mediastinum nodes Intrapulmonary nodes Distant metastasis Lung cancer Bone Brain Other Liver Pv Return TNM staging T-Primary Tumor N-Lymph node M-Metastasis Primary Tumor Primary Tumor Lymph node Metastasis M0—no distant metastasis M1—distant metastasis Ⅲb Ⅲb Ⅲb Ⅲb N3 Ⅲb Ⅲa Ⅲa Ⅲa N2 Ⅲb Ⅲa Ⅱb Ⅱa N1 Ⅲb Ⅱb Ⅰb Ⅰa N0 T4 T3 T2 T1 Return TNM staging Clinical presentation Early stage Advanced stage Paraneoplastic Syndromes Early stage No symptom Cough Pneumonic symptoms Hemoptysis Dyspnea Wheezing and Stridor Advanced stage Mediastinal invasion Pleural effusions Pancoast’s tumor Metastat