讲课肺癌英文演示文稿

讲课肺癌英文演示文稿现在是1页\一共有62页\编辑于星期五WhatisLungCancer?Beginswhencellsinthelunggrowoutofcontrolandformatumor现在是2页\一共有62页\编辑于星期五EtiologyandpathogenesisCigarettesmokingOtherfactorsincludeairpollutionsNowadaysItisreportedthattuberculosisisassociatedwiththeincidenceoflungcancer

现在是3页\一共有62页\编辑于星期五ClassificationsAccordingtoanatomy:(1)Centrallung(2)peripherallungcancer现在是4页\一共有62页\编辑于星期五现在是5页\一共有62页\编辑于星期五Accordingtohistologicclassification:Smallcelllungcancer(SCLC)andNon-smallcelllungcancer(NSCLC).NSCLCincludesSquamouscellcarcinoma,largecellcarcinoma,adenocarcinoma,adenosquamouscarcinoma.现在是6页\一共有62页\编辑于星期五Smallcelllungcancer(SCLC)

Oat-cellcarcinoma

SCLCgrowsveryrapidlyandisveryaggressive.Soonaftertheoriginalcellbecomescancerous,itquicklymultipliestoformatumor.ThesecellsswiftlyspreadtodistantsitesinthebodySCLCbelongsinagroupoftumorsderivedfromneuroendocrinecellsthatareresponsiblefortheproductionandsecretionofspecificpeptideproduct.theymayrelatedtoparaneoplasticsyndrome.现在是7页\一共有62页\编辑于星期五Cellsareovalorvaguelyspindle-shaped,havescantcytoplasm现在是8页\一共有62页\编辑于星期五现在是9页\一共有62页\编辑于星期五

Squamouscellcarcinomathemostfrequentformofthetumor(30-50percentofallcasesbronchialepitheliumandgrowthinsituItisrelatedtocigarettesmokingCavitationcanoccureinthedistaltotheobstructingmassCentrallocation现在是10页\一共有62页\编辑于星期五Intercellularbridgesandcellularpleomorphism现在是11页\一共有62页\编辑于星期五现在是12页\一共有62页\编辑于星期五squamouscellcarcinomausuallyoccursnearthebronchi,thetumorcancausecough(sometimesacoughthatistingedwithblood),shortnessofbreath,wheezing,andpneumoniaintheareabetweenthetumorandtheedgeofthelungitcausessymptomsearlyinthedisease

现在是13页\一共有62页\编辑于星期五adenocarcinomaareasofscarringisassociatedwiththeoccurrenceofadenocarcinoma.Peripheraladenocarcinomasareusuallywell-circumscribed,grey-whitemassesthatrarelycavitate.Itarisesfromthesubmucosalglands,locatedinperipheralairwaysandalveoliFemale现在是14页\一共有62页\编辑于星期五现在是15页\一共有62页\编辑于星期五现在是16页\一共有62页\编辑于星期五largecellcarcinoma现在是17页\一共有62页\编辑于星期五largenuclei,prominentnucleoli,abundantcytoplsma现在是18页\一共有62页\编辑于星期五usuallylocatedperipherallycanbequitelargeandnotinfrequentlycavitate现在是19页\一共有62页\编辑于星期五theSymptomsofLungCancerFatigue(tiredness)Cough

ShortnessofbreathChestpainLossofappetiteCoughingupphlegmHemoptysis(coughingupblood)Ifcancerhasspread,symptomsincludebonepain,difficultybreathing,abdominalpain,headache,weakness,andconfusion现在是20页\一共有62页\编辑于星期五Duetoprimarylesions:cough,dyspnea,hemoptysis,sputum,wheezing,weightloss,fever,pneumoniaDuetolocalextension:chestpain,hoarseness,superiorvenacavasyndrome,horner’ssyndrome,dysphagia,pericardialeffusion,pleuraleffusion,diaphragmparalysisOnly5-15percentofpatientsareasymptomaticwhendiscoveredtohavebronchogeniccarcinoma.现在是21页\一共有62页\编辑于星期五Regionnalspreadtohilarandmediastinalnodesmaycausedysphagiaduetoesophagealcompressionhorsenessduetorecurrentlaryngealnervecompressionhorner’ssyndromeduetosympatheticnerveinvolvementelevationofthehemidiaphragmfromphrenicnervecompression.现在是22页\一共有62页\编辑于星期五Superiorsulcus,orpancoast’stumormayinvolvethebrachialplexus,resultinginac7-t2neuropathywithpain,numbness,andweaknessofthearm.CardiacinvolvementisseeninAbout20-25percentofpatients

现在是23页\一共有62页\编辑于星期五Extrapulmonarymanifestations.Includingmetastasistootherorgans,suchasbrain,centralnervoussystem,skeletonsystem,liver,adrenalglandsandlymphnodesects.Paraneoplasticsyndromesareremoteeffectsoftumor.Theyleadtometabolicandneuromusculardisturbancesunrelatedtotheprimarytumor,metastases,ortreatment.Theymaybethefirstsignofthetumor.Theydonotindicatethatatumorhasspread.现在是24页\一共有62页\编辑于星期五PhysicalexaminationsUsuallyinearlystage,mostofthepatientswithlungcancerhavenopositivephysicalfindings.Generalfindingsincludeabnormalpercussion,breathsoundschanges,moistrales(whenpneumoniahappens)Digitalclubbing,superiorvenacavasyndrome,horner’ssyndrome(unilaterallyconstrictedpupil,enophthalmos,narrowedpalpebralfissureandlossofsweatingonthesamesideoftheface.现在是25页\一共有62页\编辑于星期五PhysicalexaminationsEndobronchialobstructionmayresultinalocalizedwheezeLobarcollapsemayresultinanareaofdecreasedbreathsoundsanddullnesstopercussion.现在是26页\一共有62页\编辑于星期五HowisLungCancerEvaluated?Becausealmostallpatientswillhaveatumorinthelung,achestx-rayorCTscanofthechestisperformedThediagnosismustbeconfirmedwithabiopsyThelocation(s)ofallsitesofcancerisdeterminedbyadditionalCTscans,PET(positronemissiontomography)scans,andMRI(magneticresonanceimaging)Itisimportanttofindoutifcancerstartedinthelungorsomewhereelseinthebody.Cancerarisinginotherpartsofthebodycanspreadtothelungaswell现在是27页\一共有62页\编辑于星期五ChestX-ray

ItisthemostimportantmethodtofindlungcancerThemostfrequentfindingisamassinthelungfield现在是28页\一共有62页\编辑于星期五现在是29页\一共有62页\编辑于星期五现在是30页\一共有62页\编辑于星期五OnchestX-ray,secondarymanifestationsincludelobarcollapse,pleuraleffusion,pneumonitis,elevationofthehemidiaphragm,hilarandmediastinaladenopathy,anderosionofribsorvertebraeduetometastases.现在是31页\一共有62页\编辑于星期五现在是32页\一共有62页\编辑于星期五现在是33页\一共有62页\编辑于星期五Obstructiveatelectasis现在是34页\一共有62页\编辑于星期五LungcanceronCT

CTisthemostusefulinevaluatingpatientswithpulmonaryandmediastinalmasses.Itisalsousefulfordetectingmultiplemetastases.CTcanshowamasstobelocatedinwhichlobeoflungfieldandthesizeofthemass.Italsoshowsthenoduleinthemediastinum.Sometimes,whenamasslocatebehindtheheart,chestX-raycan`tdetectit.CTcandetectsomesecretsitesoflungcancer.

现在是35页\一共有62页\编辑于星期五现在是36页\一共有62页\编辑于星期五Bronchoscopy现在是37页\一共有62页\编辑于星期五RigidandflexiblescopeBiopsyandselectivewashingsLargersamplesthanflexiblescopeExactlocationLobectomyPneumonectomyUnresectableSleeve现在是38页\一共有62页\编辑于星期五现在是39页\一共有62页\编辑于星期五TransthoraciclungbiopsyItmaybeutilizedwhentumorlocatedinperipheralairway.TransthoracicneedlewithguidancebyCTcanbeusedtodetectlesionslocatednearthechestwall现在是40页\一共有62页\编辑于星期五现在是41页\一共有62页\编辑于星期五VideoAssistedThoracicSurgeryDiagnosisofpleuraldiseaseWedgeresection现在是42页\一共有62页\编辑于星期五现在是43页\一共有62页\编辑于星期五Mediasteinoscopy&Mediasteinotomy现在是44页\一共有62页\编辑于星期五现在是45页\一共有62页\编辑于星期五DiagnosesunresectablediseaseEliminateN2diseasefromsurgicalresection现在是46页\一共有62页\编辑于星期五ThoracotomyIfthemethodsmentionedabovearenotusefulfordetectingthecelltypeoflungcancer,thoracotomymaybeused现在是47页\一共有62页\编辑于星期五StagingoflungcancerStagingisawayofdescribingacancer,suchasthesizeofthetumorandwhereithasspreadStagingisthemostimportanttooldoctorshavetodetermineapatient’sprognosis

ThetypeoftreatmentapersonreceivesdependsonthestageofthecancerStagingisdifferentfornon-smallcelllungcancerandsmallcelllungcancer

现在是48页\一共有62页\编辑于星期五StageINon-SmallCellLungCancerCancerisfoundonlyinthelungSurgicalremovalrecommendedRadiationtherapyand/orchemotherapymayalsobeused现在是49页\一共有62页\编辑于星期五StageIINon-SmallCellLungCancerThecancerhasspreadtolymphnodesinthelungTreatmentissurgerytoremovethetumorandnearbylymphnodesChemotherapyrecommended;radiationtherapysometimesgivenafterchemotherapy

现在是50页\一共有62页\编辑于星期五StageIIINon-SmallCellLungCancerThecancerhasspreadtothelymphnodeslocatedinthecenterofthechest,outsidethelungStageIIIAcancerhasspreadtolymphnodesinthechest,onthesamesidewherethecanceroriginatedStageIIIBcancerhasspreadtolymphnodesontheoppositesideofthechest,underthecollarbone,orthepleura(liningofthechestcavity)SurgeryorradiationtherapywithchemotherapyrecommendedforstageIIIAChemotherapyandsometimesradiationtherapyrecommendedforstageIIIB

现在是51页\一共有62页\编辑于星期五StageIVNon-SmallCellLungCancerThecancerhasspreadtodifferentlobesofthelungortootherorgans,suchasthebrain,bones,andliverStageIVnon-smallcelllungcanceristreatedwithchemotherapy现在是52页\一共有62页\编辑于星期五Smallcelllungcancerhasoftenmetastasizedatthetimeofdiagnosis.TNMstagingisnotsuitedtosmallcelllungcancer.现在是53页\一共有62页\编辑于星期五TreatmentIncluding:A:SurgeryB:ChemotherapyC:RadiationtherapyD:Someothertherapyimmunologictherapy,Chinesetraditionaltherapy现在是54页\一共有62页\编辑于星期五SurgeryNon-smallcelllungcancer:patientswithstageIandIIareconsideredcandidatesforsurgicalresection,withstageIIIcancermaybecandidatesforsurgerywithpostoperativeradiationofthemediastinum.现在是55页\一共有62页\编辑于星期五现在是56页\一共有62页\编辑于星期五SurgeryWemustmeasurepulmona