子宫癌（Uterine Cancer）-妇科八年制教学课件.pptVIP

子宫癌（Uterine Cancer）-妇科八年制教学课件 General DescriptionUterine cancer is one of the most common malignancy of female genital tract.The incidence is increasing worldwide in recent years.Overall,2%-3% of women develop uterine cancer during their lifetime. General DescriptionA malignant epithelial disease that occurs in endometrial gland of uterusAlso called endometrial cancer Classification(pathogenetic,biologic behavior )Estrogen dependent typehave a history of exposure to unopposed estrogen (either endogenous or exogenous).Hyperplastic endometriumBetter differentiafedER(+),PR(+)Mere favorable prognesis Estrogen independent type-- Have no source of estrogen stimulation of endometrium.--Arising in background of atrophic endemetrium--Less differentiated--ER(-)PR(-)--Poor prognosis Risk Factors1. Medical conditionsa. Diabetes mellitus, hypertension.b. Overweight---obesity (excess estrogen as a result of peripheral conversion of adrenally derived androstenedione by aromatization in fat).c. Late menopause. Risk Factors2. Some gynecologic diseases ( Long-term endogenous estrogen exposure ) - polycystic ovary syndrome - functioning ovarian tumors - anovulating dysfunctional bleeding - Infertility, Nulliparity. Risk Factors3. Prolonged Use of estrogena. Prolonged menopausal estrogen replacement therapy without progestogen.b. Prolonged use of the antiestrogen tamoxifen for breast cancer. Risk Factors4. Genetic factors and other factorsa. Endometrial and ovarian cancer are the simultaneously occurring with other genital malignancy ,reported incidence (1.4~3.8%).b. Family history of tumor is higher.(12-28%) Five histological subtypesEndometrioid adenocarcinomaMucinous carcinomaSerous adenocarcinomaClear cell carcinomaOther rare subtypes Five histological subtypes--Endometrioid AdenocarcinomaAccount for about 80~90%.Well differentiated.Prognosis is better. Five histological subtypes --Mucinous carcinomaRare (about 5%)a. Most of them is a well differentiate