鼻咽癌专题知识讲座培训ppt课件

鼻咽癌专题知识讲座鼻咽癌专题知识讲座鼻咽癌专题知识讲座1一、概述(outline)1、发病有一定的地区性(more common in south-east Asia in the world,more common in southern China)我国头颈恶性肿瘤之冠(the top of the malignant tumor in head and neck)。某些高发区可能为全身恶性肿瘤之首，广东、广西、湖南和福建高发。鼻咽癌专题知识讲座2一、概述(outline)1、发病有一定的地区性(more l2、高发年龄（maximum age incidence)：4060岁（86.62%）l3、性别(sex)：男多于女(male to female is 2:1)鼻咽癌专题知识讲座32、高发年龄（maximum age incidence)：二、病因（etiology)(three possible causal factors)l1、遗传因素(genetic factors)l种族易感性l家族聚集性l(racial predilection,family tendency and HLA typing)鼻咽癌专题知识讲座4二、病因（etiology)(three possiblel2、病毒因素-Epstein-Barr virus EB病毒NPC患者血清中检测到EB病毒相关抗体(patients with NPC have high level of antibody against EBV(over 90%of patients)，NPC活组织的癌细胞中存在EBV DNA特异性mRNA或基因表达产物(expression of gene products，(but whether the relationship between the two is causal or incidental is still unknown)鼻咽癌专题知识讲座52、病毒因素-Epstein-Barr virus El3、环境因素(environment factors)微量元素(microelement)：镍(nickel)维生素缺乏(vitamin lack)性激素失调(hormonal factors)亚硝胺A combination of genetic,virus and environmental influences would best explain the occurrence of nasopharyngeal carcinoma)鼻咽癌专题知识讲座63、环境因素(environment factors)鼻咽癌病理学(pathology)l主要为低分化鳞癌。少见腺癌、肉瘤等 lOver 95%Squamous cell carcinoma(poorly differentiation)lAdenocarcinoma,sarcoma,鼻咽癌专题知识讲座7病理学(pathology)主要为低分化鳞癌。少见腺癌、好发部位most tumors arise on the posterosuperior wall or fossa of Rosenmuller l 图 咽隐窝 鼻咽顶后壁鼻咽癌专题知识讲座8好发部位most tumors arise on the 临床表现(clinical manifestations)1、鼻部症状:涕血或后吸涕带血，鼻塞。nasal symptoms such as epistaxis,bloodypostnasal discharge,nasal obstruction2、耳部症状：分泌性中耳炎Secretory otitis media:conductivedeafness,fluid in the middle ear,tympanic membrane indrawn 鼻咽癌专题知识讲座9临床表现(clinical manifestations)鼻咽癌专题知识讲座10鼻咽癌专题知识讲座10鼻咽癌专题知识讲座培训ppt课件11颈淋巴转移l图鼻咽癌专题知识讲座12颈淋巴转移图鼻咽癌专题知识讲座12鼻咽癌专题知识讲座13鼻咽癌专题知识讲座13l4、颅神经症状:（图）involved cranial nerves:fifth and sixth nerve are the most frequently involved,Headache,internal strabismus.4th,3rd and 2nd cranial nerves are next most commonly affected.9th,10th 11th and 12th may also be involved 鼻咽癌专题知识讲座144、颅神经症状:（图）involved cranial nel 舌下神经麻痹 外展神经麻痹 lHypoglossal paralysis abducens paralysis 鼻咽癌专题知识讲座15 舌下神经麻痹 外展神经麻痹 鼻咽癌专l5、远处转移：Distant metastases occur to bone,lung,liver and other sites 鼻咽癌专题知识讲座165、远处转移：Distant metastases occu诊断(Diagnosis)l1、病史、症状和体征lHistory,symptoms and signslEarly symptoms:bloody postnasal discharge fluid in the middle ear(unilateral)鼻咽癌专题知识讲座17诊断(Diagnosis)1、病史、症状和体征鼻咽癌专题知识2、鼻咽镜检查lThe posterior rhinoscopylFibreoptic nasopharyngoscopyl3、血清学检查lEBVCA-IgA,EBVEA-IgG鼻咽癌专题知识讲座182、鼻咽镜检查鼻咽癌专题知识讲座18l4、影象学检查lImaging CT,MRI鼻咽癌专题知识讲座194、影象学检查鼻咽癌专题知识讲座195、鼻咽活检确诊的方法lDefinitive diagnosis is made by biopsy鼻咽癌专题知识讲座205、鼻咽活检确诊的方法鼻咽癌专题知识讲座20鉴别诊断l图鼻咽癌专题知识讲座21鉴别诊断图鼻咽癌专题知识讲座21治疗(Treatment)l放射治疗:Radiotherapy is the method of choice.lPrognosis:the overall 5-year survival rate is about 50%ranging from 75%for early tumors to 15%for late tumors鼻咽癌专题知识讲座22治疗(Treatment)放射治疗:Radiotherapl手术：Surgeryl化疗 Chemotherapyl免疫治疗 Immnotherapy鼻咽癌专题知识讲座23手术：Surgery鼻咽癌专题知识讲座23 谢谢谢谢鼻咽癌专题知识讲座24 谢谢鼻咽癌专题知识讲座24