病理學(xué)：消化系統(tǒng)疾病2

1、1 1 2 2 3 3 4 4 5 5 6 6 7 7 Diseases of the GI Tract Esophagus Stomach Small and large intestines Appendix Barrett esophagus Peptic ulcer IBD Esophageal Ca Gastric CaColorectal Ca Anatomic/Development/motor Disorders Inflammatory Diseases Esophagitis Gastritis Enterocolitis Appendicitis Tumors Adeno

2、ma Reflux Chronic Carcinoid (NETs) 8 8 Small intestine 9 9 1010 Large intestine 1111 1212 1313 GUT: the largest immune organ 1414 1515 1616 () 1717 1818 1919 CD UC CD 2020 UC 2121 UC 2222 2323 24 Dysplasia in IBD Increased risk of carcinoma development UC CD LGHG 2525 2626 2727 2828 2929 3030 3131 3

3、232 3333 3434 T = Primary Tumor Tis Carcinoma in situ, invasion of lamina propria T1 Tumor invades submucosa T2 Tumor invades muscularis propria T3 Tumor invades through the muscularis propria into pericolorectal tissues T4a Tumor penetrates the visceral peritoneum T4b Tumor directly invades or is a

4、dherent to other organs or structures N = Regional Lymph Nodes N0 No regional lymph node metastasis N1 Metastasis in 1-3 lymph nodes N2a Metastasis in 4-6 lymph nodes N2b Metastasis in more than 7 lymph nodes M = Distant Metastasis M0 No distant metastasis M1a Metastasis confined to one organ or sit

5、e M1b Metastases in more than one organ/site or the peritoneum 3535 StageTNM 0TisN0M0 IT1-2N0M0 IIAT3N0M0 IIBT4aN0M0 IICT4bN0M0 IIIAT1-2 T1 N1 N2a M0 IIIBT3-T4a T2-3 T1-2 N1 N2a N2b M0 IIICT4a T3-4a T4b N2a N2b N1-2 M0 IVAny TAny NM1 3636 3737 3838 () 3939 4040 Germ-line or somatic mutation Prooncog

6、enes mutation LOH of additional cancer suppressor gene Additional mutation Gross chromosomal alterations (aneuploid) 41 2007-1 Screening begins at age 10-15y Chemoprevention Prophylactic total colectomy FAP 4242 4343 4444 MSI 4545 MSI Diploid 4646 4747 Diseases of the GI Tract Esophagus Stomach Smal

7、l and large intestines Appendix Barrett esophagus Peptic ulcer IBD Esophageal Ca Gastric CaColorectal Ca Anatomic/Development/motor Disorders Inflammatory Diseases Esophagitis Gastritis Enterocolitis Appendicitis Tumors Adenoma Reflux Chronic Carcinoid (NETs) 48 Gastrointestinal neuroendocrine neoplasms 49 Gastrointestinal neuroendocrine neoplasms Robbins basic pathology 8e Robbins basic pathology 8e 5050 Diseases of the GI Tract Esophagus Stomach Small and large intestines Appendix Barrett esophagus Peptic ulcer IBD Esophageal Ca Gastric CaColorectal Ca Anatomic/Development/motor Disorde