Ovariancarcinom卵巢肿瘤.ppt
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1、 Ovarian carcinom卵卵 巢巢 肿肿 瘤瘤Department of Obstetrics and Department of Obstetrics and Gynecology Gynecology 妇产科妇产科 Zhang Wei Zhang Wei 张张 蔚蔚卵巢l女性内生殖器女性内生殖器 Difficult to be detected in earlier period 不易早期发现 The 5year survival of Ovarian carcinoma is low(25%-30%)卵巢恶性肿瘤5年存活率较低 Purpose and RequestClinic
2、al manifestations 临床表现临床表现2Diagnosis and treatment 诊断及治疗诊断及治疗3Histological types 组织学分类组织学分类1Histological types组织学分类组织学分类 Malignancy 恶性恶性Benign 良性良性 Borderline交界性交界性Histological types组织学分类组织学分类lEpithelia tumors 上皮性肿瘤上皮性肿瘤lGerm cell tumors 生殖细胞肿瘤生殖细胞肿瘤lSex cord stromal tumors 性索间质肿瘤性索间质肿瘤lLipid cell t
3、umor 脂质细胞瘤脂质细胞瘤lGonadoblastoma 性腺母细胞瘤性腺母细胞瘤l 非卵巢特异性软组织肿瘤非卵巢特异性软组织肿瘤l No-classified tumors 未分类肿瘤未分类肿瘤l Metastases tumors 转移性肿瘤转移性肿瘤l Tumour-like condition 瘤样病变瘤样病变Clinical manifestations临床表现临床表现 Ovary benign tumor 卵巢良性肿瘤卵巢良性肿瘤 Slowmoving,mostly asymptomatic in earlier period;Compression symptom may b
4、e found when tumor augmentation发展缓慢,早期多无发展缓慢,早期多无症状,肿块增大可症状,肿块增大可出现压迫症状出现压迫症状,eisimptmtik adj.无症状的无症状的Ovary malignancy tumor 卵巢恶性肿瘤卵巢恶性肿瘤 Frequently asymptomatic in earlier period,Once symptoms occurrence Most include:abdominal distension,abdominal mass and ascites 早期常无症状,早期常无症状,一旦出现常表现为:一旦出现常表现为:腹胀
5、腹胀腹部肿块和腹部肿块和腹水腹水saiti:zn.腹水腹水 Complications 并发症并发症Torsion of pedicle 蒂扭转蒂扭转Rupture 破裂破裂Infection 感染感染Canceration 恶变恶变Diagnosis诊断诊断 Ultrasound 超声检查超声检查 Tumor marker 肿瘤记标物肿瘤记标物 Abdominoscope 腹腔镜检查腹腔镜检查 Radiological diagnosis 放射学放射学 Cytological examination 细胞学细胞学Tumor marker 肿瘤记标物肿瘤记标物AFP endodermal si
6、nus tumor 卵巢内胚窦瘤卵巢内胚窦瘤HCG choriocarcinoma 绒毛膜癌绒毛膜癌CA125 Ovarian epithelial cancer 卵巢上皮癌卵巢上皮癌性激素性激素 Granular cell carcinoma 颗粒细胞癌颗粒细胞癌Differentiate良性肿瘤和恶性肿瘤鉴别良性肿瘤和恶性肿瘤鉴别鉴别内容鉴别内容良性肿瘤良性肿瘤恶性肿瘤恶性肿瘤病史病史病程长,生长缓慢病程长,生长缓慢病程短,迅速增长病程短,迅速增长包块部位及性质包块部位及性质单侧多,囊性,光滑,活动单侧多,囊性,光滑,活动双侧多,实性或囊性,不双侧多,实性或囊性,不规则,固定,后穹窿性结规
7、则,固定,后穹窿性结节或包块节或包块腹水征腹水征多无多无常有腹水,可能查到恶性常有腹水,可能查到恶性细胞细胞一般情况一般情况良好良好可能消瘦,恶病质可能消瘦,恶病质B型超声型超声为液性暗区,边界清晰,有为液性暗区,边界清晰,有间隔光带间隔光带液性暗区内有杂乱光团、液性暗区内有杂乱光团、光点,界限不清光点,界限不清CA125(50岁岁)35IU/mlRoute of metastasis转移途径转移途径Direct metastasis 直接蔓延直接蔓延Abdominal metastasis 腹腔转移腹腔转移Lymphatic metastasis 淋巴转移淋巴转移Hematogenous m
8、etastasis 血行转移血行转移mtstsis n.转移转移FIGO staging of ovarian neoplasmsStage Definition I growth limited to the ovaries 肿瘤局限于卵巢肿瘤局限于卵巢 I a one ovary involved 局限单侧卵巢 I b both ovary involved 局限双侧卵 I c a orb with ruptured capsule,tumor on the surface of capsule,positive peritoneal washings or malignant ascit
9、es a 或b 肿瘤伴以下任何情况:包膜破裂,卵巢 表面有肿瘤,腹水或腹腔液中洗液中含有恶性细胞 extension of the neoplasm from the ovary to the pelvis 卵巢肿瘤向盆卵巢肿瘤向盆 腔内转移腔内转移 a extension to the uterus and tubes 蔓延到子宫和输卵管 b extension to other pelvic tissues 蔓延到其他盆腔组织 Stage definition c a or b with rupture capsule,positive peritoneal washings or mal
10、ignant ascites a 或b 伴包膜破裂或腹腔冲洗液含恶性细胞 disease extension to the abdominal cavity 肿瘤向腹腔转移肿瘤向腹腔转移 a abdominal peritoneal surfaces with microscopic metastases 盆腔腹膜表面有镜下转移 b tumor metastasis2cm in size 腹腔转移灶直径2cm c tumor metastasis2cm in size 腹腔转移灶直径2cm distant metastatic disease 远处转移远处转移FIGO staging of o
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