非誠勿擾與惡性黑色素瘤課件

1、“非誠勿擾”與惡性黑色素瘤“非誠勿擾”與catalogueWhat is malignant melanoma?Melanoma triggers and causesPrimary sitesClinical characteristicsEarly clinical performanceLate-stage clinical manifestationsPathological typeTreatment2019 melanoma field progress reviewcatalogueWhat is malignant melWhat is malignant melanoma?M

2、alignant melanoma, also known as melanoma, is the origin of epidermal melanocyte or nevus of malignant tumors.The disease can be seen at any age, more seen in middle-aged and older, women slightly more than men. What is malignant melanoma?MalMelanoma triggers and causesAir pollutionTo pursue beautyT

3、he lack of medicine knowledgeImmune deficiencyAbusing the estrogen drugsMalignant transformation of black moleRacial genetic factors Trauma and chronic stimulation factors Melanoma triggers and causesAiAir pollution Harmful ultraviolet light and some harmful material in the air make a difference of

4、human skin, causing melanocyte abnormal expression, trigger melanoma. Air pollution Harmful ultravMany people in order to pursue the clean skin to use chemical cosmetics, skin pollution caused by chemical, even someone with chemical mordant purify skin a mole, stimulates the excessive proliferation

5、melanocyte.To pursue beautyMany people in order to pursuRacial genetic factorsMalignant melanoma occur in the white race. For the incidence of world each year to less than 1 2/10 million, but Australias Queensland annual incidence of 16/10 million population, it is the worlds leading high incidence

6、of malignant melanoma. Africa and Asian people rarely have the sickness.Racial genetic factorsMalignanPrimary sitesMalignant melanoma 90 % occurs in the skin, the most common in the back, metal-studded ,leg, foot, toe, nail bed, scalp and so on ; a few occurs in vulvae, digestive tract and eyes.Prim

7、ary sitesMalignant melanomEye lesionsand Oral lesions脈絡(luò)膜黑色素瘤口腔黑色素瘤Eye lesionsand Oral lesions脈絡(luò) Generally speaking moles surface is smooth, melanoma of surface is coarser. If the surface is smooth, and suddenly becomes coarse or , we should pay attention to it. Clinical characteristics Generally spe

8、aking moles surUlceration not only is one of the important melanoma clinical manifestations which is different from mole, but also has the meaning of prognosis than no ulcer.Patients of malignant melanoma generally are the old; the youth or children melanoma are rare .Ulceration not only is one ofEa

9、rly clinical performance Color: a mole increase in size, pigment or darker or lighter, a mole deepen, shiny, appear color changed . Edge: a mole to radiate out in moles expansion, appear around uneven indented change; become irregular or appear satellite form small a mole, or several birthmark fusio

10、n, the surface concavo-convex inequality .Surface: rough; Often coarse and accompanied by scale form or flake desquamation. Sometimes have the drainage or ooze blood, higher lesions can face .Early clinical performance ColLesions surrounding skin :can appear edema or lose skin gloss or become white,

11、 gray.Kakesthesia: a mole without itching or discomfort pain. regional lymph node enlargement, faintly visible blue-black .早期臨床表現(xiàn)Lesions surrounding skin :can Late-stage clinical manifestations Special type ：a small nodular lesion site, the boundary clear, no coated, tan-white or grey-blue, quality

12、of a material is solid. Freckles type :more from the primary lesions malignant freckles ; surface was flat; the edge great irregularity ; the epidermis of tumor block with freckles samples , this type often occur on elderly facial freckles lesions , which is relatively rare. Late-stage clinical mani

13、festatSpread type : its appearance is shallow eczema kind, and its jagged edge is irregular ,with black, grey and pink disorderly color on the surface . Nodular type: tumor nodules are out of the skin surface; the color is dark brown, gray red and rarely colorless. Bump surface is shown more caulifl

14、ower shape, polypoid or bacteria shape, often happen ulcers .Spread type : its appearance Pathological typeSuperficial expandable type: about 70%, it is visible at surface anywhere ; go along the surface to expand, and then expand to the depth , called the vertical development. Pathological typeSupe

15、rficial enodular type: about 15%,vertical development; penetrate to subcutaneous tissue; prone to lymph node metastases; even more deadly.nodular type: about 15%,verticEphelides type :about 5%,it primary occur in old people facial skin where black freckles long stand; this type do horizontal growth

16、and enlarge 2cm 3cm or more around.非誠勿擾與惡性黑色素瘤課件Extremity black mole type: about 10% that happens at palms, foot, nail bed and mucous membranes.Extremity black mole type:Treatment Surgical treatment : early circumscribed primary foci should be carried out extensively; the scope should be apart from

17、the primary foci 3 5cm ; the primary foci should be excised to subcutaneous tissue and muscle membrane ; when touch the lymph node enlargement, generally speaking should make lymph node clean; after the operation ,adjuvant chemotherapy and immune therapy is necessary .Treatment Surgical treatment Bi

18、ological immune therapy :biological immune therapy via the various biological agents and biotechnology means to enhance immunity and anti-cancer ability to suppress and kill cancer cells; at present, immune cells such as DC cells, CIK cell have applied to clinical therapy, which gains good effects;

19、biological immune therapy is the most effective, security adjuvant therapies.人類黑色素瘤抗原Biological immune therapy :biRadiotherapy: In addition to some very early freckles type of malignant melanoma are effective, other primary foci generally have poor curative effect. So we did not use radiation therap

20、y to cure the primary foci, and metastasis adopt radiotherapy.Radiotherapy: In addition to sEndocrine therapy : anti-estrogen drugs make some cases even other drug treatment failure cases get curative effect, and make the illness to alleviate.非誠勿擾與惡性黑色素瘤課件Chemical treatment : Single drug: )亞硝脲類藥物: h

21、ave certain effect of melanoma. 氮烯咪胺(DTIC): DTIC has made the treatment of melanoma forward one step, become the most widely used drugs. Each dose for 350mg/m2, repeat 6 days, 28 days for one period of treatment, efficient rate is 35%. Chemical treatment : Combination: combination can improve the ef

22、ficient, reduce toxicity reaction. DAV case (DTIc、ACNu、VCR): the first choice for melanoma chemotherapy regimens. The preparation method: DTIcloo 200mg, 5ACNUl00mgiv d1VCR 2mg iv d1 21 days, each iv d1 repeated 1 time. Combination: combination canDDBT case (DTIC、DDP、BCNU、TAM) Method:DTIC220mg/m2, I.

23、V. d1 3/3w, DDP 25mg/m2, i.v.gtt d1 3w, BCNUl 50mg/m2, I.V. d1/6w, TAM 10mgPO, 2 / d. Efficient rate is 52.5%. CBD case (CCNU、BLM、DDP) Method: CCNU 80mg/m2, oral, d1/6w, BLMl 5u/m2, I.V. d3 7/6w, DDP 40mg/m2, I.V. d8/6w. Efficient rate is 48%. DDBT case (DTIC、DDP、BCNU、TAM)2019 melanoma field progres

24、s review melanoma treatment finally usher a silver lining Resistance to CTLA - 4 single resistance against genetic mutations and (B - RAF and C - KIT) small molecular targeted drugs ,which prolong the survival of advanced melanoma patients and achieve remarkable breakthrough. It is possible for the treatment of advanced melanoma patients bring thorough revolution.2019 melanoma field prog