子宫内膜癌课件_6.pptVIP

Endometrial Carcinoma 子宫内膜癌 carcinoma of corpus uteri 子宫体癌 1 of 3 common malignant tumors of female reproductive system（女性生殖系统三大恶性肿瘤之一） Epidemiology（流行病学） age 58 -- 61 75% postmenopause （绝经后） 25% pre-menopause （绝经前） ( 5% age 40 ) Risk factors 1. Estrogen-dependent（雌激素依赖） (1) Exogenous（外源性）estrogen stimulation estrogen replacement therapy (ERT) Tamoxifen(它莫西芬) (2) Endogenous（内源性）estrogen stimulation polycystic ovary syndrome (PCOS) ovarian granulosa cell (颗粒细胞） tumor Risk factors 2. Diabetes (糖尿病) Obesity (肥 胖) Hypertension (高血压) 3. Estrogen-independent（非雌激素依赖） Genetics (遗传) factor family history ( 20% ) Endometrial Hyperplasia子宫内膜增生 Simple (cystic) hyperplasia 1% 单纯型（囊性）增生 Complex (adenomatous) hyperplasia 3% 复杂型（腺瘤性）增生 Atypical hyperplasia 1/3 不典型增生 Simple (cystic) Complex(adenomatous) hyperplasia hyperplasia  单纯型（囊性）增生 复杂型（腺瘤性）增生 Atypical hyperplasia 不典型增生 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 Gross Pathology（大体病理） Diffuse lesions （弥漫性病灶） Focal lesions （局限性病灶）: fundus（子宫底部） ，Esp. corner （子宫角部） Histological type