妇科学英文课件：Endometrial Carcinoma.ppt

Prognostic factors Advanced surgical stage Older age Histologic type: UPSC or clear cell adenocarcinoma Advanced tumor grade Presence of myometrial invasion Presence of lymphovascular space invasion Peritoneal cytology positive for cancer cells Increased tumor size High tumor expression levels of ER and PR UPSC = uterine papillary serous carcinoma (子宫乳头状浆液性腺癌). Post-treatment surveillance Acquiring medical history be followed by pelvic examination every 3 months for the first 2-3 years; twice yearly for an additional 2years ; once a year after 5 years; Serum CA125, vaginal cytology, chest X-ray Intermittent imaging using CT scanning or MRI * Endometrial Carcinoma Learning objectives To master: clinical manifestations, diagnosis and differential diagnosis of endometrial cancer. treatment principles of endometrial cancer. To be familiar with: risk factors and preventive measures of endometrial cancer. endometrial precancerous lesions To understand: the pathological changes and metastasis of endometrial cancer. the clinical stage and surgical-pathologic staging of endometrial cancer. Introduction Endometrial carcinoma (EC) is one of the three main gynecologic malignancy, which usually occurs between 58~61 years old. about 7% of all malignancies in women 5% occur in women under the age of 40 survival rate for all cases is about 75% Risk factors The following factors related to hormones increase the risk of EC Obesity Unopposed estrogen exposure (without progesterone) History of diabetes, hypertension Never being pregnant Menopause after the age of 55 Starting menstruation at an early age (12) Tamoxifen (drug used for breast cancer) Risk factors Days proliferative phase secretory phase mense ovary endometrium estrogen estrogen/progestrone ovulation Pathogenesis Feature Types I Type II Relation with estrogen Dependent Independent Unopposed estrogen Present Absent Endometrial hyperplasia Present Absent Menopausal status