EndometrialCarcinoma子宫内膜癌培训课件

,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,EndometrialCarcinoma子宫内膜癌,*,EndometrialCarcinoma子宫内膜癌,EndometrialCarcinoma子宫内膜癌,corpus uteri子宫体,cervix,子宫颈,Structure of uterus,endometrium,myometrium,Serous layer,EndometrialCarcinoma子宫内膜癌,2,corpus uteri子宫体cervix 子宫颈Struc,Prevalence,fourth most malignancy in women（,女性恶性肿瘤中第四位,）,ranks third in the malignant tumors of female reproductive system（,女性生殖系统恶性肿瘤中第3位,）,EndometrialCarcinoma子宫内膜癌,3,PrevalenceEndometrialCarcinoma,Epidemiology,55-69 years,75%postmenopausal 绝经后,25%pre-menopausal 绝经前,(5%50%,EndometrialCarcinoma子宫内膜癌,14,G1G2G3With solid component End,Serous,Clear-cell,EndometrialCarcinoma子宫内膜癌,15,Serous Clear-cell Endometria,Spread Patterns,转移方式,Direct extension（直接蔓延）,Lymphatic spread（淋巴转移）,Hematogenous spread（血行播散）,Transtubal passage of exfoliated cells,（脱落细胞经输卵管转移）,EndometrialCarcinoma子宫内膜癌,16,Spread Patterns转移方式 Direct e,Direct extension,Cervical involvement,宫颈受累,Myometrium invasion,肌层浸润,EndometrialCarcinoma子宫内膜癌,17,Direct extensionCervical invol,EndometrialCarcinoma子宫内膜癌培训课件,Clinical Findings,Vaginal bleeding（,阴道流血,）,Esp.,postmenopausal bleeding,（,绝经后阴道流血,）,Uterine enlargement,EndometrialCarcinoma子宫内膜癌,19,Clinical Findings Vaginal ble,Diagnosis,1.Fractional dilation and curretage,（分段诊刮）,扩张棒,刮匙,EndometrialCarcinoma子宫内膜癌,20,Diagnosis1.Fractional dilation,Diagnosis,-,Fractional dilation,&currettage,1,2,Establish the diagnosis,Help identify cervical involvement,Limit,Missed diagnosis,False positive cervical involvement,EndometrialCarcinoma子宫内膜癌,21,Diagnosis-Fracti,E,ndometrial,S,ampler,Diagnosis,-,Endometrial sampling,*Simple,non-traumatic procedure.,*Moldability permits easy insertion,into a markedly anteverted(,前屈,),or,retroverted(,后屈,),uterus.,*No cervical dilation necessary in most,cases.,*Less discomfort,bleeding,tissue,abrasion than D&C method.,EndometrialCarcinoma子宫内膜癌,22,Endometrial Diagnosis-Endo,Normal,endometrium,Hyperplasia,Hyperplasia with atypia,Endometrial carcinoma,Diagnosis-,endometrial cytology,EndometrialCarcinoma子宫内膜癌,23,Normal HyperplasiaHyperpla,Diagnosis-,endometrial assessment sonographically,Normal endometrium stripe,正常子宫内膜线,5mm,EndometrialCarcinoma子宫内膜癌,24,Diagnosis-end,Diagnosis-,hysteroscopy,Endometrial Carcinoma,Simple hyperplasia,Complex hyperplasia,Normal endometrium,Atrophic endometrium,EndometrialCarcinoma子宫内膜癌,25,Diagnosis-hysteroscopyEndo,Normal endometrium,EMCa Ia,EMCa Ib,EMCa II,Diagnosis-MRI,EndometrialCarcinoma子宫内膜癌,26,Normal endometriumEMCa IaEMCa,Differentiation Diagnosis,Cervical Cancer,postcoital bleeding,EndometrialCarcinoma子宫内膜癌,27,Differentiation DiagnosisCervi,Staging,Clinical Staging（临床分期）,pre-treatment evaluation,Surgically pathological staging,（手术病理分期）,EndometrialCarcinoma子宫内膜癌,28,Staging Clinical Staging（临床分期,Clinical Staging,Stage,Characteristics,_,I,Confined to the corpus（限于宫体）,IA,Uterine cavity8cm,IB,Uterine cavity 8cm,II,Involvement of,cervix（宫颈受累）,_,EndometrialCarcinoma子宫内膜癌,29,Clinical Staging Stage,Stage Characteristics,_,III,Extends outside the uterus but not outside the,true pelvis,may involve parametrium,IV,Extends outside the true pelvis or involves,the bladder or rectum,_,EndometrialCarcinoma子宫内膜癌,30,Stage,Surgical-pathological staging,Stage Characteristics,_,IA,limited to the endometrium,限于内膜,IB Invasion,1/2,the myometrium 肌层浸润1/2,the myometrium 肌层浸润1/2,IIA Endocervical,gland involvement,only,IIB Cervical,stromal invasion,_,EndometrialCarcinoma子宫内膜癌,31,Surgical-pathological staging,Stage Characteristics,_,IIIA Tumor invades serous and/or adnexes,and/or,positive peritoneal cytology,IIIB Vaginal metastases,IIIC Metastases to pelvic and/or paraaortic,lymph nodes,IVA Tumor invasion of bladder and/or rectum,IVB Distant metastases,including intra-,abdominal and/or inguinal nodes,_,EndometrialCarcinoma子宫内膜癌,32,Stage Charac,Treatment,1.,operation,Stage,I,total abdominal hysterectomy,经腹全子切除）+,bilateral salpingo-oophorectomy,双侧输卵管卵巢切除,Stage,II,radical hysterectomy,广泛子宫切除,+,lymphonode sampling,淋巴结取样(,pelvic,paraaortic,盆腔淋巴结及腹主动脉淋巴结),EndometrialCarcinoma子宫内膜癌,33,Treatment EndometrialCarcinoma,2.radiation therapy,3.chemotherapy,EndometrialCarcinoma子宫内膜癌,34,2.radiation therapyEndometria,Thanks,EndometrialCarcinoma子宫内膜癌,35,ThanksEndometrialCarcinoma子宫内膜,