精品子宫内膜增生_1课件.ppt

子宫内膜增生与子宫内膜癌前病变;子宫内膜增生 （endometrial hyperplasia，EH） ;国际妇科病理协会分期(ISGP,1987) （International Society of Gynecology Pathology）;This is the microscopic appearance of normal proliferative endometrium in the menstrual cycle. The proliferative phase is the variable part of the cycle. In this phase, tubular glands with columnar cells and surrounding dense stroma are proliferating to build up the endometrium following shedding with previous menstruation.;This is normal secretory phase endometrium. Note the larger tortuous glands with secretions. The secretory phase follows a set 14 day course leading to either implantation of a fertilized ovum or menstruation.; 单纯增生 （simple hyperplasia）; 复合增生 （complex hyperplasia） ;非典型增生（atypical hyperplasia）;This is endometrial cystic hyperplasia in which the amount of endometrium is abnormally increased and not cycling as it should. The glands are enlarged and irregular with columnar cells that have some atypia. Simple endometrial hyperplasias can cause bleeding, but are not thought to be premalignant. However, adenomatous hyperplasia is premalignant.;非典型增生（atypical hyperplasia）;非典型增生（atypical hyperplasia）;非典型增生（atypical hyperplasia）; 临床表现;临床表现;临床表现;临床表现;临床表现;诊断;分段诊断性刮宫; 鉴别诊断; 治疗 ;子宫内膜单纯增生或复合增生的治疗生育年龄 者（≤40岁）;子宫内膜单纯增生或复合增生的治疗围绝经或绝经者（40岁）;非典型增生的治疗（生育年龄者）;非典型增生的治疗（围绝经或绝经者）; 预后;非典型增生与癌变率;非典型增生癌变的相关因素;子宫内膜癌 ;子宫内膜癌（ endometrial carcinoma ）;年龄分布;年龄分布;子宫内膜癌的高危因素; 子宫内膜癌发病的高危因素;子宫内膜癌的家族遗传 （遗传性子宫内膜癌)(1);子宫内膜癌的家族遗传 （遗传性子宫内膜癌)(2); 病理特点 大体表现（1）; 病理特点 大体表现（2）;局限型 弥漫型;This adenocarcinoma of the endometrium is more obvious. Irregular masses of white tumor are seen over the surface of this uterus that has been opened anteriorly. The cervix is at the bottom of the picture. This enlarged uterus was no doubt palpable on physical examination. Such a neoplasm often present w