第13周妇产科Endometrial Carcinoma.pptVIP

Endometrial Carcinoma 子宫内膜癌 carcinoma of corpus uteri 子宫体癌 Prevalence fourth most malignancy in women （女性恶性肿瘤中第四位） ranks third in the malignant tumors of female reproductive system（女性生殖系统恶性肿瘤中第3位） Epidemiology 55-69 years 75% postmenopausal 绝经后 25% pre-menopausal 绝经前 ( 5% 40years ) Risk factors *unopposed estrogen exposure endogenous ~ ovarian granulosa cell tumor exogenous ~ estrogen treatment *obesity hypertension endometrial cancer triad diabetes 子宫内膜癌三联症 *anovulation cycles 无排卵月经 Endometrial Hyperplasiaand Endometrial Cancer Simple hyperplasia with nuclear atypia without ~ Complex hyperplasia with nuclear atypia without ~ Simple hyperplasia Complex hyperplasia  单纯增生过长 复杂性增生过长 Nuclear Atypia (核异型性） Nuclear enlargement 核增大 Increase in nuclear/cytoplasm ratio 核/浆比例增大 Prominent nucleoli 核仁明显 Coarse abundant chromatin 染色体粗大 Risk of Hyperplasia toEndometrial Carcinoma ____________________________________________ Types of Hyperplasia Progressing to Cancer (%) __________________________________________ Simple(cystic) without atypia 1 Complex(adenomatous) without atypia 3 Simple with atypia 8 Complex with atypia 29 ___________________________________________ Pathology Histological types typeI estrogen-dependent Endometrioid adenocarcinoma （宫内膜样腺癌）80~90% , G1 typeII estrogen-independent high-grade endometrioid cancer ,G2/3 papillary serous carcinoma clear cell carcinoma Cell differentiation（细胞分化） G1（I级）: fairly good differentiation 分化较好 G2（II级）: moderate differentiation 中等