恶性黑色素瘤课件

恶性黑色素瘤PPT课件演示文稿目前一页\总数二十九页\编于八点恶性黑色素瘤PPT课件目前二页\总数二十九页\编于八点Whatismalignantmelanoma?Malignantmelanoma,alsoknownasmelanoma,istheoriginofepidermalmelanocyteornevusofmalignanttumors.

Thediseasecanbeseenatanyage,moreseeninmiddle-agedandolder,womenslightlymorethanmen.

目前三页\总数二十九页\编于八点MelanomatriggersandcausesAirpollutionTopursuebeautyThelackofmedicineknowledgeImmunedeficiencyAbusingtheestrogendrugsMalignanttransformationofblackmoleRacialgeneticfactorsTraumaandchronicstimulationfactors

目前四页\总数二十九页\编于八点AirpollutionHarmfulultravioletlightandsomeharmfulmaterialintheairmakeadifferenceofhumanskin,causingmelanocyteabnormalexpression,triggermelanoma.

目前五页\总数二十九页\编于八点

Manypeopleinordertopursuethecleanskintousechemical

cosmetics,skinpollutioncausedbychemical,evensomeonewithchemicalmordantpurifyskinamole,stimulatestheexcessiveproliferationmelanocyte.Topursuebeauty目前六页\总数二十九页\编于八点RacialgeneticfactorsMalignantmelanomaoccurinthewhiterace.Fortheincidenceofworldeachyeartolessthan1~2/10million,butAustralia'sQueenslandannualincidenceof16/10millionpopulation,itistheworld‘sleadinghighincidenceofmalignantmelanoma.AfricaandAsianpeoplerarelyhavethesickness.目前七页\总数二十九页\编于八点PrimarysitesMalignantmelanoma90%occursintheskin,themostcommonintheback,metal-studded,leg,foot,toe,nailbed,scalpandsoon;afewoccursinvulvae,digestivetractandeyes.目前八页\总数二十九页\编于八点Eyelesions

andOrallesions脉络膜黑色素瘤口腔黑色素瘤目前九页\总数二十九页\编于八点◆Generallyspeakingmolessurfaceissmooth,melanomaofsurfaceiscoarser.Ifthesurfaceissmooth,andsuddenlybecomescoarseor,weshouldpayattentiontoit.

Clinicalcharacteristics

目前十页\总数二十九页\编于八点◆Ulcerationnotonlyisoneoftheimportantmelanomaclinicalmanifestationswhichisdifferentfrommole,butalsohasthemeaningofprognosisthannoulcer.◆Patientsofmalignantmelanomagenerallyaretheold;theyouthorchildrenmelanomaarerare.目前十一页\总数二十九页\编于八点EarlyclinicalperformanceColor:amoleincreaseinsize,pigmentordarkerorlighter,amoledeepen,shiny,appearcolorchanged.Edge:amoletoradiateoutinmolesexpansion,appeararoundunevenindentedchange;becomeirregularorappearsatelliteformsmallamole,orseveralbirthmarkfusion,thesurfaceconcavo-convexinequality.Surface:rough;Oftencoarseandaccompaniedbyscaleformorflakedesquamation.Sometimeshavethedrainageoroozeblood,higherlesionscanface.目前十二页\总数二十九页\编于八点Lesionssurroundingskin:canappearedemaorloseskinglossorbecomewhite,gray.Kakesthesia:amolewithoutitchingordiscomfortpain.regionallymphnodeenlargement,faintlyvisibleblue-black

.早期临床表现目前十三页\总数二十九页\编于八点Late-stageclinicalmanifestations＊Specialtype：asmallnodularlesionsite,theboundaryclear,nocoated,tan-whiteorgrey-blue,qualityofamaterialissolid.＊

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

目前十四页\总数二十九页\编于八点＊Spreadtype:itsappearanceisshalloweczemakind,anditsjaggededgeisirregular,withblack,greyandpinkdisorderlycoloronthesurface.

＊Nodulartype:tumornodulesareoutoftheskinsurface;thecolorisdarkbrown,grayredandrarelycolorless.Bumpsurfaceisshownmorecauliflowershape,polypoidorbacteriashape,oftenhappenulcers.目前十五页\总数二十九页\编于八点PathologicaltypeSuperficialexpandabletype:about70%,itisvisibleatsurfaceanywhere;goalongthesurfacetoexpand,andthenexpandtothedepth,calledthe"verticaldevelopment".

目前十六页\总数二十九页\编于八点nodulartype:about15%,verticaldevelopment;penetratetosubcutaneoustissue;pronetolymphnodemetastases;evenmoredeadly.目前十七页\总数二十九页\编于八点Ephelidestype:about5%,itprimaryoccurinoldpeoplefacialskinwhereblackfreckleslongstand;thistypedohorizontalgrowthandenlarge2cm~3cmormorearound.目前十八页\总数二十九页\编于八点Extremityblackmoletype:about10%thathappensatpalms,foot,nailbedandmucousmembranes.目前十九页\总数二十九页\编于八点Treatment☆Surgicaltreatment:earlycircumscribedprimaryfocishouldbecarriedoutextensively;thescopeshouldbeapartfromtheprimaryfoci3～

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

.目前二十页\总数二十九页\编于八点☆Biologicalimmunetherapy:biologicalimmunetherapyviathevariousbiologicalagentsandbiotechnologymeanstoenhanceimmunityandanti-cancerabilitytosuppressandkillcancercells;atpresent,immunecellssuchasDCcells,CIKcellhaveappliedtoclinicaltherapy,whichgainsgoodeffects;biologicalimmunetherapyisthemosteffective,securityadjuvanttherapies.人类黑色素瘤抗原目前二十一页\总数二十九页\编于八点Radiotherapy:Inadditiontosomeveryearlyfrecklestypeofmalignantmelanomaareeffective,otherprimaryfocigenerallyhavepoorcurativeeffect.Sowedidnotuseradiationtherapytocuretheprimaryfoci,andmetastasisadoptradiotherapy.目前二十二页\总数二十九页\编于八点☆Endocrinetherapy:

anti-estrogendrugsmakesomecasesevenotherdrugtreatmentfailurecasesgetcurativeeffect,andmaketheillnesstoalleviate.目前二十三页\总数二十九页\编于八点☆Chemicaltreatment:

⒈Singledrug:

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

目前二十四页\总数二十九页\编于八点⒉Combination:combinationcanimprovetheefficient,reducetoxicityreaction.⑴DAVcase(DTIc、ACNu、VCR):thefirstchoiceformelanomachemotherapyregimens.

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

目前二十五页\总数二十九页\编于八点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%.

目前二十六页\总数二十九页\编于八点2010melanomafieldprogressreview

melanomatreatmentfinallyusherasilverlining

﹡ResistancetoCTLA-4singleresistanceagainstgeneticmutationsand(B-RAFandC-KIT)smallmoleculartargeteddrugs,whichprolongthesurvivalofadvancedmelanomapatientsandachieveremarkablebreakthrough.Itispossibleforthetreatmentofadvancedmelanomapatientsbringthoroughrevolution.目前二十七页\总数二十九页\编于八点﹡