子宫癌UterineCancer妇科八年制教学.pptxVIP

Uterine Cancer;General Description;General Description;Classification(pathogenetic,biologic behavior ); Estrogen independent type; Risk Factors;Risk Factors;Risk Factors;Risk Factors;Five histological subtypes;Five histological subtypes--Endometrioid Adenocarcinoma;Five histological subtypes --Mucinous carcinoma; Five histological subtypes --Serous adenocarcinoma ;Five histological subtypes--Clear cell carcinoma;Five histological subtypes--other rare subtypes;Clinical Features--Symptoms;Clinical Features--Signs;Special Examination;Ultrasonography Useful adjuvant method Significances Size of lesion Invasion of endometrium or cervix Resistant index of new vessels;Endometrial carcinoma in a 58-year-old woman with substantial postmenopausal bleeding. (A) Sagittal transvaginal US scan shows the endometrium with a thickness of 44 mm and a large area of mixed echogenicity suggestive of a mass. (B) Transverse sonohysterogram shows a 50-mm-diameter polypoid mass protruding into the endometrial cavity (calipers indicate the stalk of the mass). Histopathologic findings indicated poorly differentiated endometrial carcinoma.;Hysteroscopy Significance -Direct observation -Taking sample correctly -Identifying polyps and submucous myoma ;Pap test -Unreliable diagnostic test -30%-50% abnormal pap test results Others -MRI, CT, chest x-ray, IV urography, cystoscopy, sigmoidoscopy, ;Diagnosis;Differential Diagnosis;Metastasis Route ;Clinical Stage(FIGO 1971);Clinical Stage(FIGO 1971);Surgical pathologic staging (FIGO 1988);Surgical pathologic staging (FIGO 2000);Stage Ia* Tumor limited to the endometrium Stage Ib* Invasion to less than half of the myometrium Stage Ic* Invasion equal to or more than half of the myometrium;Stage IIa* Endocervical glandular involvement onlyStage IIb* Cervical stromal invasion;Stage IIIa* Tumor invades the serosa of the corpus uteri and/or adnexae and/or positive cytological findingsStage IIIb* Vaginal metastases Stage IIIc* Meta