恶性黑色素瘤课件

恶性黑色素瘤PPT课件演示文稿本文档共29页；当前第1页；编辑于星期三\5点19分恶性黑色素瘤PPT课件本文档共29页；当前第2页；编辑于星期三\5点19分Whatismalignantmelanoma?Malignantmelanoma,alsoknownasmelanoma,istheoriginofepidermalmelanocyteornevusofmalignanttumors.

Thediseasecanbeseenatanyage,moreseeninmiddle-agedandolder,womenslightlymorethanmen.

本文档共29页；当前第3页；编辑于星期三\5点19分MelanomatriggersandcausesAirpollutionTopursuebeautyThelackofmedicineknowledgeImmunedeficiencyAbusingtheestrogendrugsMalignanttransformationofblackmoleRacialgeneticfactorsTraumaandchronicstimulationfactors

本文档共29页；当前第4页；编辑于星期三\5点19分AirpollutionHarmfulultravioletlightandsomeharmfulmaterialintheairmakeadifferenceofhumanskin,causingmelanocyteabnormalexpression,triggermelanoma.

本文档共29页；当前第5页；编辑于星期三\5点19分

Manypeopleinordertopursuethecleanskintousechemical

cosmetics,skinpollutioncausedbychemical,evensomeonewithchemicalmordantpurifyskinamole,stimulatestheexcessiveproliferationmelanocyte.Topursuebeauty本文档共29页；当前第6页；编辑于星期三\5点19分RacialgeneticfactorsMalignantmelanomaoccurinthewhiterace.Fortheincidenceofworldeachyeartolessthan1~2/10million,butAustralia'sQueenslandannualincidenceof16/10millionpopulation,itistheworld‘sleadinghighincidenceofmalignantmelanoma.AfricaandAsianpeoplerarelyhavethesickness.本文档共29页；当前第7页；编辑于星期三\5点19分PrimarysitesMalignantmelanoma90%occursintheskin,themostcommonintheback,metal-studded,leg,foot,toe,nailbed,scalpandsoon;afewoccursinvulvae,digestivetractandeyes.本文档共29页；当前第8页；编辑于星期三\5点19分Eyelesions

andOrallesions脉络膜黑色素瘤口腔黑色素瘤本文档共29页；当前第9页；编辑于星期三\5点19分◆Generallyspeakingmolessurfaceissmooth,melanomaofsurfaceiscoarser.Ifthesurfaceissmooth,andsuddenlybecomescoarseor,weshouldpayattentiontoit.

Clinicalcharacteristics

本文档共29页；当前第10页；编辑于星期三\5点19分◆Ulcerationnotonlyisoneoftheimportantmelanomaclinicalmanifestationswhichisdifferentfrommole,butalsohasthemeaningofprognosisthannoulcer.◆Patientsofmalignantmelanomagenerallyaretheold;theyouthorchildrenmelanomaarerare.本文档共29页；当前第11页；编辑于星期三\5点19分EarlyclinicalperformanceColor:amoleincreaseinsize,pigmentordarkerorlighter,amoledeepen,shiny,appearcolorchanged.Edge:amoletoradiateoutinmolesexpansion,appeararoundunevenindentedchange;becomeirregularorappearsatelliteformsmallamole,orseveralbirthmarkfusion,thesurfaceconcavo-convexinequality.Surface:rough;Oftencoarseandaccompaniedbyscaleformorflakedesquamation.Sometimeshavethedrainageoroozeblood,higherlesionscanface.本文档共29页；当前第12页；编辑于星期三\5点19分Lesionssurroundingskin:canappearedemaorloseskinglossorbecomewhite,gray.Kakesthesia:amolewithoutitchingordiscomfortpain.regionallymphnodeenlargement,faintlyvisibleblue-black

.早期临床表现本文档共29页；当前第13页；编辑于星期三\5点19分Late-stageclinicalmanifestations＊Specialtype：asmallnodularlesionsite,theboundaryclear,nocoated,tan-whiteorgrey-blue,qualityofamaterialissolid.＊

Frecklestype:morefromtheprimarylesionsmalignantfreckles;surfacewasflat;theedgegreatirregularity;theepidermisoftumorblockwithfrecklessamples,thistypeoftenoccuronelderlyfacialfreckleslesions,whichisrelativelyrare.

本文档共29页；当前第14页；编辑于星期三\5点19分＊Spreadtype:itsappearanceisshalloweczemakind,anditsjaggededgeisirregular,withblack,greyandpinkdisorderlycoloronthesurface.

＊Nodulartype:tumornodulesareoutoftheskinsurface;thecolorisdarkbrown,grayredandrarelycolorless.Bumpsurfaceisshownmorecauliflowershape,polypoidorbacteriashape,oftenhappenulcers.本文档共29页；当前第15页；编辑于星期三\5点19分PathologicaltypeSuperficialexpandabletype:about70%,itisvisibleatsurfaceanywhere;goalongthesurfacetoexpand,andthenexpandtothedepth,calledthe"verticaldevelopment".

本文档共29页；当前第16页；编辑于星期三\5点19分nodulartype:about15%,verticaldevelopment;penetratetosubcutaneoustissue;pronetolymphnodemetastases;evenmoredeadly.本文档共29页；当前第17页；编辑于星期三\5点19分Ephelidestype:about5%,itprimaryoccurinoldpeoplefacialskinwhereblackfreckleslongstand;thistypedohorizontalgrowthandenlarge2cm~3cmormorearound.本文档共29页；当前第18页；编辑于星期三\5点19分Extremityblackmoletype:about10%thathappensatpalms,foot,nailbedandmucousmembranes.本文档共29页；当前第19页；编辑于星期三\5点19分Treatment☆Surgicaltreatment:earlycircumscribedprimaryfocishouldbecarriedoutextensively;thescopeshouldbeapartfromtheprimaryfoci3～

5cm;theprimaryfocishouldbeexcisedtosubcutaneoustissueandmusclemembrane;whentouchthelymphnodeenlargement,generallyspeakingshouldmakelymphnodeclean;aftertheoperation,adjuvantchemotherapyandimmunetherapyisnecessary

.本文档共29页；当前第20页；编辑于星期三\5点19分☆Biologicalimmunetherapy:biologicalimmunetherapyviathevariousbiologicalagentsandbiotechnologymeanstoenhanceimmunityandanti-cancerabilitytosuppressandkillcancercells;atpresent,immunecellssuchasDCcells,CIKcellhaveappliedtoclinicaltherapy,whichgainsgoodeffects;biologicalimmunetherapyisthemosteffective,securityadjuvanttherapies.人类黑色素瘤抗原本文档共29页；当前第21页；编辑于星期三\5点19分Radiotherapy:Inadditiontosomeveryearlyfrecklestypeofmalignantmelanomaareeffective,otherprimaryfocigenerallyhavepoorcurativeeffect.Sowedidnotuseradiationtherapytocuretheprimaryfoci,andmetastasisadoptradiotherapy.本文档共29页；当前第22页；编辑于星期三\5点19分☆Endocrinetherapy:

anti-estrogendrugsmakesomecasesevenotherdrugtreatmentfailurecasesgetcurativeeffect,andmaketheillnesstoalleviate.本文档共29页；当前第23页；编辑于星期三\5点19分☆Chemicaltreatment:

⒈Singledrug:

⑴)亚硝脲类药物:havecertaineffectofmelanoma.⑵氮烯咪胺(DTIC):DTIChasmadethetreatmentofmelanomaforwardonestep,becomethemostwidelyuseddrugs.Eachdosefor350mg/m2,repeat6days,28daysforoneperiodoftreatment,efficientrateis35%.

本文档共29页；当前第24页；编辑于星期三\5点19分⒉Combination:combinationcanimprovetheefficient,reducetoxicityreaction.⑴DAVcase(DTIc、ACNu、VCR):thefirstchoiceformelanomachemotherapyregimens.

Thepreparationmethod:DTIcloo~200mg,5ACNUl00mgivd1VCR2mgivd1~21days,eachivd1repeated1time.

本文档共29页；当前第25页；编辑于星期三\5点19分⑵DDBTcase(DTIC、DDP、BCNU、TAM)

Method:DTIC220mg/m2,I.V.d1~3/3w,DDP25mg/m2,i.v.gttd1~3w,BCNUl50mg/m2,I.V.d1/6w,TAM10mgPO,2/d.Efficientrateis52.5%.⑶CBDcase(CCNU、BLM、DDP)

Method:CCNU80mg/m2,oral,d1/6w,BLMl5u/m2,I.V.d3~7/6w,DDP40mg/m2,I.V.d8/6w.Efficientrateis48%.

本文档共29页；当前第26页；编辑于星期三\5点19分2010melanomafieldprogressreview

melanomatreatmentfinallyusherasilverlining

﹡ResistancetoCTLA-4singleresistanceagainstgeneticmutationsand(B-RAFandC-KIT)smallmoleculartargeteddrugs,whichprolongthesurvivalofadvancedmelanomapatientsandachieveremarkablebreakthrough.Itispossibleforthetreatmentofadvancedmelanomapatientsbringthoroughrevolution.本文档共29页；当前第27页；编辑于星