原发性支气管肺癌中英文对照课件.ppt

1 原发性支气管肺癌Primarybronchogeniccarcinoma 呼吸内科RespiratoryDepartment熊维宁Xiong Weining 2 定义Definition 原发性支气管肺癌简称肺癌 是起源于支气管粘膜或腺体的肿瘤 Primarybronchogeniccarcinomaisabbreviatedtolungcancer itderivesfrombronchimucosaorgland 3 Epidemiology LungCancerWorldwide mostcommoncancer2 000 000casesperyearChina firstleadingcauseofcancerdeathinurbanarea 15 5 yearsurvival 4 病因和发病机制Etiologyandpathogenesis 1吸烟1Smoking 5 LungCancer SmokingFacts Tobaccouseistheleadingcauseoflungcancer87 oflungcancersarerelatedtosmokingRiskrelatedto AmountsmokedAgeofsmokingonsetProductsmoked tar nicotinecontent filters DepthofinhalationGenderRiskgoesdownafter 5yrscessationAt15years 80 90 riskreductionNevergetsto neversmoker risk 6 20YearLag 7 Ifwhathappenedonyourinsidehappenedonyouroutside wouldyoustillsmoke 8 2职业致癌因子2Occupationcarcinogenicfactor Asbestos Radon3空气污染3Airpollution 1 室外大环境污染 1 Outdoorenvironmentpollution 2 室内小环境污染 2 Indoorenvironmentpollution4电离辐射4Ionizingradiation 9 5饮食与营养5DietandnutritionVITAMINA 10 6其他因素6Otherfactors7遗传因素7HereditaryfactorTumorsuppressorgenes p53Dominantoncogenes Kras Her 2 neu 11 病理和分类 Pathologyandclassification 12 解剖学分类Anatomyclassification 1中央型肺癌1Centrallungcancer 13 2周围型肺癌2Peripherallungcancer 14 组织学分类Histologyclassification 1小细胞肺癌1Smallcelllungcancer SCLC 1 燕麦细胞型 1 oatcelltype 2 中间细胞型 2 intermediatecelltype 3 混合型 3 mixedtype 15 SmallcellcarcinomaRareinnon smokersLargehilarmass70 presentwithovertmetastasisVerychemo responsive Worstprognosis 16 Smallcellcarcinoma 17 2非小细胞肺癌2Non smallcelllungcancer NSCLC 1 鳞状细胞癌 鳞癌 1 Squamouscellcarcinoma SCC 2 腺癌和支气管肺泡癌 2 Adenocarcinoma AC andbronchoalveolarcarcinoma 3 大细胞癌 3 Largecellcarcinoma 4 鳞腺癌 4 Adeno squamouscarcinoma 18 SquamouscellcarcinomaNow2ndmostcommon 1stinChina Stronglylinkedwithsmoking60 80 intheproximalairways centraltype CavitationTendencytospreadlocally regionallyPrognosisslightlybetterthanAdenocarcinoma 19 SquamousCellCarcinoma 20 SquamousCellCarcinoma 21 鳞癌 22 LungCancerPathology AdenocarcinomaMostcommonpathology 2ndinChina Non smoker slungcancer WomenPeripheral 75 Aggressivemetastases 23 AdenocarcicomaLeftLowerLobe 24 Adenocarcinoma 25 Adenocarcinoma 26 BronchoalveolarCellCarcinoma BACAerogenousandlymphaticspreadLeastassociatedwithcigarettesmokingUsuallyperipheralLocalized multi nodularordiffuseSlowmetabolismPrognosisLocalizedvs other 27 支气管肺泡癌 28 LargecellcarcinomaLargeperipheralmasswithnecrosisMalignantepithelialneoplasmPoorly differentiatedAggressivemets It sacancer it snotsmallcell but 29 Largecellcarcinoma 30 Largecellcarcinoma 31 32 33 临床表现 Clinicalmanifestation 34 原发肿瘤引起的症状和体征Symptomsandphysicalsignsduetoprimarytumor 1咳嗽1Cough2咯血2Hemoptysis3喘鸣3Wheeze4气急4Breathlessness5发热5Fever6其他6Others 35 肿瘤局部扩展引起的症状和体征Symptomsandphysicalsignsduetotumorlocalexpanding 1胸痛1Chestpain2呼吸困难2Dyspnea3吞咽困难3Dysphagia esophagealcompression4声音嘶哑4Hoarsevoice laryngealnerveparalysis5上腔静脉阻塞综合征5Superiorvenacavaobstructionsyndrome6Horner综合征 肺上沟瘤6Horner ssyndrome Pancoast stumor Cervical thoracicnerveinvasion7臂丛神经压迫征7Brachialplexuscompressionsyndrome 36 肿瘤远处转移引起的症状和体征Symptomsandphysicalsignsduetotumordistantmetastasis 1脑 中枢神经系统转移1Metastasizetobrain centralnervoussystem 37 2肝转移2Metastasizetoliver3骨转移3Metastasizetobone4皮下转移性结节4Subcutaneoulymetastaticnodus5颈部或锁骨上淋巴结转移5Cervicalorsupraclavicularlymphnodemetastasis 38 肺癌作用于其他系统引起的肺外表现Manifestationoutoflungduetoothersystemsaffectedbylungcancer 1异位内分泌综合征1Ectopicendocrinesyndrome EES 1 抗利尿激素分泌异常综合征 1 Syndromeofinapprpriateantidiuretichormone SIADH secretion 2 异位ACTH综合征 2 EctopicACTHsyndrome 3 神经肌肉综合征 3 Neuromyopathicsyndrome 4 高钙血症 4 Hypercalcinemia 5 其他 类癌综合征 5 Others Carcinoidsyndrome 39 2其他肺外表现2Othermanifestationoutoflung 1 多发性周围神经炎 1 Multipleperipheralneuritis 2 肌无力样综合征 2 Eaton Lambertsyndrome 40 3 肥大性肺性骨关节病 3 Hypertrophicpulmonaryosteoarthropathy HPO 41 实验室和辅助检查 Laboratoryandauxiliaryexamination 42 胸部X线检查Chestradiograph 1中央型肺癌1Centrallungcancer 43 44 2周围型肺癌2Peripherallungcancer 45 46 47 48 电子计算机体层扫描CT 49 Posteriorbasalsegmentofleftlowerlobe AC 50 左上叶肺癌并左上叶不张 Leftupperlobecancercombiningatelectasis 51 Leftlowerlobecancercombiningobstructivepneumonia 52 53 磁共振MRI 54 55 痰脱落细胞学检查Sputumexfoliativecytologytest SCC AC SCLC 56 纤维支气管镜检查Bronchofiberscopy 57 58 59 SCC SCLC AC LCC 60 核素闪烁显像Nuclidescintigraphy1骨 闪烁显像1Bone scintigraphy2正电子发射断层显像2Positronemissiontomography PET 61 62 病理学检查Pathology癌标志物的检测Cancermarktest基因诊断Genediagnosis手术探查Operationsresearch 63 诊断和鉴别诊断 Diagnosisanddifferentialdiagnosis 64 诊断Diagnosis 早期诊断Earlydiagnosis症状Symptom体征Physicalsign检查Examination 65 鉴别诊断Differentialdiagnosis 1肺结核1Pulmonarytuberculosis 66 Tuberculosis Lungcancer 67 肺真菌病Pulmonarymycosis 68 2肺炎2Pneumonia抗菌药物治疗有效 病灶吸收快而完全Usually antibacterialdrugtherapyiseffective andfocusisabsorbedquicklyandcompletely 69 3肺脓肿3Lungabscess 70 4结核性渗出性胸膜炎4Tuberculousexudativepleurisy 71 临床分期Clinicalstage IA T1N0IB T2N0IIA T1N1IIB T2N1 T3N0IIIA T3N1 andT1 3N2IIIB anyT4 anyN3IV anymetastases 72 治疗 Treatment 73 手术治疗Operationtreatment 1NSCLC2SCLC 74 化学药物治疗Chemotherapy 1SCLC2NSCLC 75 放射治疗Radiotherapy 根治性Radicalcure姑息性Palliativecure 76 介入性治疗Interventionaltherapy 1支气管动脉灌注1Bronchialarteryinfusion BAI2经纤支镜2Throughbronchofiberscopy 77 生物反应调节剂和生物靶向治疗Biologicalresponsemodifiers BRM andbiologicaltargetedtherapy中医药Chinesemedicine 78 预后和预防 Prognosisandprevention 79 预后Prognosis Theoverallprognosisinbronchialcarcinomaisverypoor Witharound80 ofpatientsdyingwithinayearofdiagnosisandlessthan6 ofpatientssurviving5yearsafterdiagnosis Thebestprognosisiswell differentiatedsquamouscelltumorswhichhavenotmetastasizedandareamenabletosurgicaltreatment 80 预防Prevention 1戒烟1Stopsmoking2加强劳动保护2Enhancelaborprotection3早期发现3Earlydiscovery4化学预防4Chemicalprophylaxis 81 Thanks