普外-腫瘤-英課件

NEOPLASIAGeneralSurgicalDepartmentFirstTechingHospitalofXJMUTeachingRequirements

1.Familiarwithcanceretiology,classificationandnaming.

2.Masterthediagnosis,transfermethodsandstaging.

3.Familiarwithcommoncancertherapies.

4.Follow-upoftumorpatients.DefinitionsNormalcellsinthetumoristhebodyindifferentinitiatingandpromotingfactorsproducedunderlong-termproliferationandabnormaldifferentiationandtheformationofneworganisms.(Neoplasm)NEOPLASIANEOPLASIANEOPLASIACategoryPurpose:toidentifythenatureofthetumor,tissuesource,

Treatmentprogramsandcanhelptoselecttheprognosis.

Thenatureofthetumor

Benigntumor

carcinoma

Borderlinetumors

Histogenesis

Cancer

Sarcoma

Blastoma

Cellmorphology,differentiation

Squamouscell

Glandularcells

Low,medium,well-differentiated

Namingrules:Organ+differentiation+Organization+celltypesourcesNEOPLASIANEOPLASIA

EtiologyEtiologyisnotcompletelyunderstood!

Theresultofinteractionbetweeninternalandexternalfactors

(environmentalfactorsandbodyfactors)

Morethan80%andenvironmentalfactorsNEOPLASIAPhysicalfactors1.ionizingradiation,includingxray,γ-rayandsub-atomicparticles(αparticles,βparticles,protonsandneutrons)andsocaninducechromosomalbreakage,translocation,genemutationsandincreasedcancerincidence.

2.UVeffectonDNA,causingtheformationofpyrimidinedimers,thelong-termover-exposureandskincancer,basalcellcarcinoma,melanomarelated.

3.Other,asbestosfiberdust-lungcancer,pleuralmesothelioma.NEOPLASIAGeneticfactors

Geneticsusceptibilitytocancer

(Hereditarysusceptibility)

Immunefactors

Tumorsandiscloselyrelatedtotheimmunestate

EndocrinefactorsNEOPLASIANutritionalfactors

InWesterncountries,high-fat,low-fiberdiet,highincidenceofcolorectalcancer;inChinaandJapan,low-fat,highfiberdiet,lowincidenceofcolorectalcancer,gastriccancerincidence.NEOPLASIATransferDirectspread

Plantingofthetransfer

Lymphnodemetastasis

HematogenousmetastasisNEOPLASIAGrowthpatternBenigntumor:expansion,exogenous

Malignanttumors:exogenous,expansion,infiltrationNEOPLASIAClinicalmanifestationsLocalperformance

Bump

Pain

Ulcer

Bleeding

Obstruction

TransfersymptomsNEOPLASIASymptoms

Anemia

Lowheat

Thin

Fatigue,etc.

CachexiaNEOPLASIAStagingofmalignanttumorsTNMT：（tumor）N：（node）M：（metastasis）NEOPLASIAPreventionPrimaryprevention:about80%ofhumancancerscausedbyenvironmentalfactors

Secondaryprevention:earlydetection,earlydiagnosisandearlytreatment

Tertiaryprevention:toimprovethequalityoflife,symptomatictreatmentNEOPLASIASurgeryRadicalsurgery

Extendedradicalmastectomy

SymptomaticorpalliativesurgeryNEOPLASIAChemotherapyAbletocurewithchemotherapyalone:choriocarcinoma,testicularseminoma,Burkittlymphoma,acutelymphoblasticleukemia.

Abletolong-termremission:granulosacells,suchasleukemia,Hodgkindisease,Wilmstumor,breastcancer.

Chemotherapydrugscanonlykillacertainpercentageoftumorcells.NEOPLASIARadiotherapyHighlysensitive:

Lymphoidhematopoietictumors,gonadaltumors,multiplemyeloma,Wilmstumorandotherpoorlydifferentiatedtumors.

Moderatelysensitive:

Partofsquamouscellcarcinomaandundifferentiatedcarcinoma,suchasthebasicbottomlinecancer,cervicalcancer,nasopharyngealcarcinoma(undifferentiatedcarcinoma,lymphoepithelialcarcinoma),esophagealcancer,breastcancer,lungcancer.

Lowsensitive:

Gastrointestinalcancer,softtissueandosteosarcoma,andsoon.NEOPLASIAFirst,theskinpapilloma

Second,theskincancer

Third,themoleandmelanoma

Fourth,lipoma

V.fibromaandfibroustumor-likelesions

VI,neurofibroma

VIIhemangioma

VIII,cystictumorsandcysts