讲课肺癌英文培训ppt课件

本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。What is Lung Cancer?Begins when cells in the lung grow out of control and form a tumorWhat is Lung Cancer?Begins whe1本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Etiology and pathogenesisCigarette smokingOther factors include air pollutions Nowadays It is reported that tuberculosis is associated with the incidence of lung cancer Etiology and pathogenesisCigar2本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。ClassificationsAccording to anatomy:(1)Central lung (2)peripheral lung cancerClassificationsAccording to an3本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件4本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。According to histologic classification:Small cell lung cancer(SCLC)and Non-small cell lung cancer(NSCLC).NSCLC includes Squamous cell carcinoma,large cell carcinoma,adenocarcinoma,adenosquamous carcinoma.According to histologic classi5本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Small cell lung cancer(SCLC)Oat-cell carcinoma SCLC grows very rapidly and is very aggressive.Soon after the original cell becomes cancerous,it quickly multiplies to form a tumor.These cells swiftly spread to distant sites in the bodySCLC belongs in a group of tumors derived from neuroendocrine cells that are responsible for the production and secretion of specific peptide product.they may related to paraneoplastic syndrome.Small cell lung cancer(SCLC)O6本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Cells are oval or vaguely spindle-shaped,have scant cytoplasmCells are oval or vaguely spin7本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件8本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Squamous cell carcinomathe most frequent form of the tumor(30-50 percent of all casesbronchial epithelium and growth in situIt is related to cigarette smokingCavitation can occure in the distal to the obstructing massCentral location Squamous cell carcinomathe m9本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Intercellular bridges and cellular pleomorphismIntercellular bridges and cell10本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件11本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。squamous cell carcinoma usually occurs near the bronchi,the tumor can cause cough(sometimes a cough that is tinged with blood),shortness of breath,wheezing,and pneumonia in the area between the tumor and the edge of the lungit causes symptoms early in the disease squamous cell carcinoma usuall12本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。adenocarcinomaareas of scarring is associated with the occurrence of adenocarcinoma.Peripheral adenocarcinomas are usually well-circumscribed,grey-white masses that rarely cavitate.It arises from the submucosal glands,located in peripheral airways and alveoliFemale adenocarcinomaareas of scarrin13本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件14本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件15本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。large cell carcinomalarge cell carcinoma16本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。large nuclei,prominent nucleoli,abundant cytoplsmalarge nuclei,prominent nucleol17本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。usually located peripherallycan be quite large and not infrequently cavitateusually located peripherally18本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。the Symptoms of Lung CancerF Fa at ti ig gu ue e (t ti ir re ed dn ne es ss s)C Co ou ug gh h S Sh ho or rt tn ne es ss s o of f b br re ea at th h C Ch he es st t p pa ai in n L Lo os ss s o of f a ap pp pe et ti it te e C Co ou ug gh hi in ng g u up p p ph hl le eg gmm H He emmo op pt ty ys si is s (c co ou ug gh hi in ng g u up p b bl lo oo od d)I If f c ca an nc ce er r h ha as s s sp pr re ea ad d,s sy ymmp pt to omms s i in nc cl lu ud de e b bo on ne e p pa ai in n,d di if ff fi ic cu ul lt ty y b br re ea at th hi in ng g,a ab bd do ommi in na al l p pa ai in n,h he ea ad da ac ch he e,w we ea ak kn ne es ss s,a an nd d c co on nf fu us si io on nthe Symptoms of Lung CancerFat19本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Due to primary lesions:cough,dyspnea,hemoptysis,sputum,wheezing,weight loss,fever,pneumoniaDue to local extension:chest pain,hoarseness,superior vena cava syndrome,horners syndrome,dysphagia,pericardial effusion,pleural effusion,diaphragm paralysisOnly 5-15 percent of patients are asymptomatic when discovered to have bronchogenic carcinoma.Due to primary lesions:20本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Regionnal spread to hilar and mediastinal nodes may cause dysphagia due to esophageal compression horseness due to recurrent laryngeal nerve compression horners syndrome due to sympathetic nerve involvement elevation of the hemidiaphragm from phrenic nerve compression.Regionnal spread to hilar and21本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Superior sulcus,or pancoasts tumor may involve the brachial plexus,resulting in a c7-t2 neuropathy with pain,numbness,and weakness of the arm.Cardiac involvement is seen in About 20-25 percent of patients Superior sulcus,or pancoast22本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Extrapulmonary manifestations.Including metastasis to other organs,such as brain,central nervous system,skeleton system,liver,adrenal glands and lymph nodes ects.Paraneoplastic syndromes are remote effects of tumor.They lead to metabolic and neuromuscular disturbances unrelated to the primary tumor,metastases,or treatment.They may be the first sign of the tumor.They do not indicate that a tumor has spread.Extrapulmonary manifestations.23本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Physical examinationsUsually in early stage,most of the patients with lung cancer have no positive physical findings.General findings include abnormal percussion,breath sounds changes,moist rales(when pneumonia happens)Digital clubbing,superior vena cava syndrome,horners syndrome(unilaterally constricted pupil,enophthalmos,narrowed palpebral fissure and loss of sweating on the same side of the face.Physical examinationsUsually i24本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Physical examinationsEndobronchial obstruction may result in a localized wheezeLobar collapse may result in an area of decreased breath sounds and dullness to percussion.Physical examinationsEndobronc25本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。How is Lung Cancer Evaluated?B Be ec ca au us se e a al lmmo os st t a al ll l p pa at ti ie en nt ts s w wi il ll l h ha av ve e a a t tu ummo or r i in n t th he e l lu un ng g,a a c ch he es st t x x-r ra ay y o or r C CT T s sc ca an n o of f t th he e c ch he es st t i is s p pe er rf fo or rmme ed d T Th he e d di ia ag gn no os si is s mmu us st t b be e c co on nf fi ir rmme ed d w wi it th h a a b bi io op ps sy y T Th he e l lo oc ca at ti io on n(s s)o of f a al ll l s si it te es s o of f c ca an nc ce er r i is s d de et te er rmmi in ne ed d b by y a ad dd di it ti io on na al l C CT T s sc ca an ns s,P PE ET T (p po os si it tr ro on n e emmi is ss si io on n t to ommo og gr ra ap ph hy y)s sc ca an ns s,a an nd d MMR RI I (mma ag gn ne et ti ic c r re es so on na an nc ce e i imma ag gi in ng g)I It t i is s i immp po or rt ta an nt t t to o f fi in nd d o ou ut t i if f c ca an nc ce er r s st ta ar rt te ed d i in n t th he e l lu un ng g o or r s so omme ew wh he er re e e el ls se e i in n t th he e b bo od dy y.C Ca an nc ce er r a ar ri is si in ng g i in n o ot th he er r p pa ar rt ts s o of f t th he e b bo od dy y c ca an n s sp pr re ea ad d t to o t th he e l lu un ng g a as s w we el ll l How is Lung Cancer Evaluated?B26本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Chest X-ray It is the most important method to find lung cancerThe most frequent finding is a mass in the lung fieldChest X-ray It is the most imp27本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件28本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件29本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。On chest X-ray,secondary manifestations include lobar collapse,pleural effusion,pneumonitis,elevation of the hemidiaphragm,hilar and mediastinal adenopathy,and erosion of ribs or vertebrae due to metastases.On chest X-ray,secondary mani30本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件31本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件32本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Obstructive atelectasisObstructive atelectasis33本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Lung cancer on CT CT is the most useful in evaluating patients with pulmonary and mediastinal masses.It is also useful for detecting multiple metastases.CT can show a mass to be located in which lobe of lung field and the size of the mass.It also shows the nodule in the mediastinum.Sometimes,when a mass locate behind the heart,chest X-ray cant detect it.CT can detect some secret sites of lung cancer.Lung cancer on CT CT is the mo34本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件35本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。BronchoscopyBronchoscopy36本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Rigid and flexible scopeBiopsy and selective washingsLarger samples than flexible scopeExact locationLobectomyPneumonectomyUnresectableSleeveRigid and flexible scope37本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件38本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Transthoracic lung biopsy It may be utilized when tumor located in peripheral airway.Transthoracic needle with guidance by CT can be used to detect lesions located near the chest wall Transthoracic lung biopsy It 39本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件40本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Video Assisted Thoracic SurgeryDiagnosis of pleural diseaseWedge resection Video Assisted Thoracic Surger41本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件42本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Mediasteinoscopy&MediasteinotomyMediasteinoscopy&Mediasteino43本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件44本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Diagnoses unresectable diseaseEliminate N2 disease from surgical resectionDiagnoses unresectable disease45本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。ThoracotomyIf the methods mentioned above are not useful for detecting the cell type of lung cancer,thoracotomy may be usedThoracotomyIf the methods ment46本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Staging of lung cancerStaging is a way of describing a cancer,such as the size Staging is a way of describing a cancer,such as the size of the tumor and where it has spread of the tumor and where it has spread Staging is the most important tool doctors have to Staging is the most important tool doctors have to determine a patients prognosisdetermine a patients prognosis The type of treatment a person receives depends on the The type of treatment a person receives depends on the stage of the cancerstage of the cancerStaging is different for non-small cell lung cancer and Staging is different for non-small cell lung cancer and small cell lung cancersmall cell lung cancer Staging of lung cancerStaging 47本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Stage I Non-Small Cell Lung CancerCancer is found only Cancer is found only in the lung in the lung Surgical removal Surgical removal recommendedrecommendedRadiation therapy Radiation therapy and/or chemotherapy and/or chemotherapy may also be usedmay also be usedStage I Non-Small Cell Lung Ca48本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Stage II Non-Small Cell Lung CancerThe cancer has spread to The cancer has spread to lymph nodes in the lung lymph nodes in the lung Treatment is surgery to Treatment is surgery to remove the tumor and nearby remove the tumor and nearby lymph nodeslymph nodesChemotherapy Chemotherapy recommended;radiation recommended;radiation therapy sometimes given therapy sometimes given after chemotherapyafter chemotherapy Stage II Non-Small Cell Lung C49本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Stage III Non-Small Cell Lung Cancer The cancer has spread to the lymph The cancer has spread to the lymph nodes located in the center of the nodes located in the center of the chest,outside the lung chest,outside the lung Stage IIIA cancer has spread to lymph Stage IIIA cancer has spread to lymph nodes in the chest,on the same side nodes in the chest,on the same side where the cancer originatedwhere the cancer originated Stage IIIB cancer has spread to lymph Stage IIIB cancer has spread to lymph nodes on the opposite side of the nodes on the opposite side of the chest,under the collarbone,or the chest,under the collarbone,or the pleura(lining of the chest cavity)pleura(lining of the chest cavity)Surgery or radiation therapy with Surgery or radiation therapy with chemotherapy recommended for stage chemotherapy recommended for stage IIIA IIIA Chemotherapy and sometimes Chemotherapy and sometimes radiation therapy recommended for radiation therapy recommended for stage IIIBstage IIIB Stage III Non-Small Cell Lung 50本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Stage IV Non-Small Cell Lung Cancer The cancer has spread to The cancer has spread to different lobes of the lung different lobes of the lung or to other organs,such as or to other organs,such as the brain,bones,and liverthe brain,bones,and liver Stage IV non-small cell Stage IV non-small cell lung cancer is treated with lung cancer is treated with chemotherapychemotherapyStage IV Non-Small Cell Lung C51本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Small cell lung cancer has often metastasized at the time of diagnosis.TNM staging is not suited to small cell lung cancer.Small cell lung cancer has oft52本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。TreatmentIncluding:A:Surgery B:Chemotherapy C:Radiation therapy D:Some other therapy immunologic therapy,Chinese traditional therapyTreatmentIncluding:53本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。SurgeryNon-small cell lung cancer:patients with stage I and II are considered candidates for surgical resection,with stage III cancer may be candidates for surgery with postoperative radiation of the mediastinum.SurgeryNon-small cell lung can54本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件55本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。SurgeryWe must measure pulmonary function before surgical therapy.Forced vital capacity greater than 2 liters and a forced expiratory volume in the first second(FEV1)of greater than 50 percent of the forced vital capacity predict that a patient can tolerate the consequences of pneumonectomy.SurgeryWe must measure pulmona56本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件57本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。讲课肺癌英文培训ppt课件58本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。ChemotherapyNon-small cell lung cancerMVP:MMC 6-8mg/m2(1),VDS 3mg/m2NP:VP-16(d1,d8).DDP 100mg/m2(d1)GP Small-cell lung cancer it is highly responsive to chemotherapy.EP regimen VP-16 100mg/m2 d1d3.DDP 100mg/m2 d1.GPChemotherapyNon-small cell lun59本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。ChemotherapyAggressive chemotherapy produces complications and symptoms in all patients.All experience anemia,leukepenia and opportunistic infection other complications include nausea,vomiting possible cadiotoxicity,hemorrhagic cystitis and peripheral neuropathy.ChemotherapyAggressive chemoth60本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Radiation therapyIt is of proven benefit in controlling bone pain,spinal cord compression,superior vena cava syndrome and bronchial obstruction.Radiation therapyIt is of prov61本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Thank you62