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讲课肺癌英文演示文稿本文档共62页;当前第1页;编辑于星期六\17点12分WhatisLungCancer?Beginswhencellsinthelunggrowoutofcontrolandformatumor本文档共62页;当前第2页;编辑于星期六\17点12分EtiologyandpathogenesisCigarettesmokingOtherfactorsincludeairpollutionsNowadaysItisreportedthattuberculosisisassociatedwiththeincidenceoflungcancer

本文档共62页;当前第3页;编辑于星期六\17点12分ClassificationsAccordingtoanatomy:(1)Centrallung(2)peripherallungcancer本文档共62页;当前第4页;编辑于星期六\17点12分本文档共62页;当前第5页;编辑于星期六\17点12分Accordingtohistologicclassification:Smallcelllungcancer(SCLC)andNon-smallcelllungcancer(NSCLC).NSCLCincludesSquamouscellcarcinoma,largecellcarcinoma,adenocarcinoma,adenosquamouscarcinoma.本文档共62页;当前第6页;编辑于星期六\17点12分Smallcelllungcancer(SCLC)

Oat-cellcarcinoma

SCLCgrowsveryrapidlyandisveryaggressive.Soonaftertheoriginalcellbecomescancerous,itquicklymultipliestoformatumor.ThesecellsswiftlyspreadtodistantsitesinthebodySCLCbelongsinagroupoftumorsderivedfromneuroendocrinecellsthatareresponsiblefortheproductionandsecretionofspecificpeptideproduct.theymayrelatedtoparaneoplasticsyndrome.本文档共62页;当前第7页;编辑于星期六\17点12分Cellsareovalorvaguelyspindle-shaped,havescantcytoplasm本文档共62页;当前第8页;编辑于星期六\17点12分本文档共62页;当前第9页;编辑于星期六\17点12分

Squamouscellcarcinomathemostfrequentformofthetumor(30-50percentofallcasesbronchialepitheliumandgrowthinsituItisrelatedtocigarettesmokingCavitationcanoccureinthedistaltotheobstructingmassCentrallocation本文档共62页;当前第10页;编辑于星期六\17点12分Intercellularbridgesandcellularpleomorphism本文档共62页;当前第11页;编辑于星期六\17点12分本文档共62页;当前第12页;编辑于星期六\17点12分squamouscellcarcinomausuallyoccursnearthebronchi,thetumorcancausecough(sometimesacoughthatistingedwithblood),shortnessofbreath,wheezing,andpneumoniaintheareabetweenthetumorandtheedgeofthelungitcausessymptomsearlyinthedisease

本文档共62页;当前第13页;编辑于星期六\17点12分adenocarcinomaareasofscarringisassociatedwiththeoccurrenceofadenocarcinoma.Peripheraladenocarcinomasareusuallywell-circumscribed,grey-whitemassesthatrarelycavitate.Itarisesfromthesubmucosalglands,locatedinperipheralairwaysandalveoliFemale本文档共62页;当前第14页;编辑于星期六\17点12分本文档共62页;当前第15页;编辑于星期六\17点12分本文档共62页;当前第16页;编辑于星期六\17点12分largecellcarcinoma本文档共62页;当前第17页;编辑于星期六\17点12分largenuclei,prominentnucleoli,abundantcytoplsma本文档共62页;当前第18页;编辑于星期六\17点12分usuallylocatedperipherallycanbequitelargeandnotinfrequentlycavitate本文档共62页;当前第19页;编辑于星期六\17点12分theSymptomsofLungCancerFatigue(tiredness)Cough

ShortnessofbreathChestpainLossofappetiteCoughingupphlegmHemoptysis(coughingupblood)Ifcancerhasspread,symptomsincludebonepain,difficultybreathing,abdominalpain,headache,weakness,andconfusion本文档共62页;当前第20页;编辑于星期六\17点12分Duetoprimarylesions:cough,dyspnea,hemoptysis,sputum,wheezing,weightloss,fever,pneumoniaDuetolocalextension:chestpain,hoarseness,superiorvenacavasyndrome,horner’ssyndrome,dysphagia,pericardialeffusion,pleuraleffusion,diaphragmparalysisOnly5-15percentofpatientsareasymptomaticwhendiscoveredtohavebronchogeniccarcinoma.本文档共62页;当前第21页;编辑于星期六\17点12分Regionnalspreadtohilarandmediastinalnodesmaycausedysphagiaduetoesophagealcompressionhorsenessduetorecurrentlaryngealnervecompressionhorner’ssyndromeduetosympatheticnerveinvolvementelevationofthehemidiaphragmfromphrenicnervecompression.本文档共62页;当前第22页;编辑于星期六\17点12分Superiorsulcus,orpancoast’stumormayinvolvethebrachialplexus,resultinginac7-t2neuropathywithpain,numbness,andweaknessofthearm.CardiacinvolvementisseeninAbout20-25percentofpatients

本文档共62页;当前第23页;编辑于星期六\17点12分Extrapulmonarymanifestations.Includingmetastasistootherorgans,suchasbrain,centralnervoussystem,skeletonsystem,liver,adrenalglandsandlymphnodesects.Paraneoplasticsyndromesareremoteeffectsoftumor.Theyleadtometabolicandneuromusculardisturbancesunrelatedtotheprimarytumor,metastases,ortreatment.Theymaybethefirstsignofthetumor.Theydonotindicatethatatumorhasspread.本文档共62页;当前第24页;编辑于星期六\17点12分PhysicalexaminationsUsuallyinearlystage,mostofthepatientswithlungcancerhavenopositivephysicalfindings.Generalfindingsincludeabnormalpercussion,breathsoundschanges,moistrales(whenpneumoniahappens)Digitalclubbing,superiorvenacavasyndrome,horner’ssyndrome(unilaterallyconstrictedpupil,enophthalmos,narrowedpalpebralfissureandlossofsweatingonthesamesideoftheface.本文档共62页;当前第25页;编辑于星期六\17点12分PhysicalexaminationsEndobronchialobstructionmayresultinalocalizedwheezeLobarcollapsemayresultinanareaofdecreasedbreathsoundsanddullnesstopercussion.本文档共62页;当前第26页;编辑于星期六\17点12分HowisLungCancerEvaluated?Becausealmostallpatientswillhaveatumorinthelung,achestx-rayorCTscanofthechestisperformedThediagnosismustbeconfirmedwithabiopsyThelocation(s)ofallsitesofcancerisdeterminedbyadditionalCTscans,PET(positronemissiontomography)scans,andMRI(magneticresonanceimaging)Itisimportanttofindoutifcancerstartedinthelungorsomewhereelseinthebody.Cancerarisinginotherpartsofthebodycanspreadtothelungaswell本文档共62页;当前第27页;编辑于星期六\17点12分ChestX-ray

ItisthemostimportantmethodtofindlungcancerThemostfrequentfindingisamassinthelungfield本文档共62页;当前第28页;编辑于星期六\17点12分本文档共62页;当前第29页;编辑于星期六\17点12分本文档共62页;当前第30页;编辑于星期六\17点12分OnchestX-ray,secondarymanifestationsincludelobarcollapse,pleuraleffusion,pneumonitis,elevationofthehemidiaphragm,hilarandmediastinaladenopathy,anderosionofribsorvertebraeduetometastases.本文档共62页;当前第31页;编辑于星期六\17点12分本文档共62页;当前第32页;编辑于星期六\17点12分本文档共62页;当前第33页;编辑于星期六\17点12分Obstructiveatelectasis本文档共62页;当前第34页;编辑于星期六\17点12分LungcanceronCT

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

本文档共62页;当前第35页;编辑于星期六\17点12分本文档共62页;当前第36页;编辑于星期六\17点12分Bronchoscopy本文档共62页;当前第37页;编辑于星期六\17点12分RigidandflexiblescopeBiopsyandselectivewashingsLargersamplesthanflexiblescopeExactlocationLobectomyPneumonectomyUnresectableSleeve本文档共62页;当前第38页;编辑于星期六\17点12分本文档共62页;当前第39页;编辑于星期六\17点12分TransthoraciclungbiopsyItmaybeutilizedwhentumorlocatedinperipheralairway.TransthoracicneedlewithguidancebyCTcanbeusedtodetectlesionslocatednearthechestwall本文档共62页;当前第40页;编辑于星期六\17点12分本文档共62页;当前第41页;编辑于星期六\17点12分VideoAssistedThoracicSurgeryDiagnosisofpleuraldiseaseWedgeresection本文档共62页;当前第42页;编辑于星期六\17点12分本文档共62页;当前第43页;编辑于星期六\17点12分Mediasteinoscopy&Mediasteinotomy本文档共62页;当前第44页;编辑于星期六\17点12分本文档共62页;当前第45页;编辑于星期六\17点12分DiagnosesunresectablediseaseEliminateN2diseasefromsurgicalresection本文档共62页;当前第46页;编辑于星期六\17点12分ThoracotomyIfthemethodsmentionedabovearenotusefulfordetectingthecelltypeoflungcancer,thoracotomymaybeused本文档共62页;当前第47页;编辑于星期六\17点12分StagingoflungcancerStagingisawayofdescribingacancer,suchasthesizeofthetumorandwhereithasspreadStagingisthemostimportanttooldoctorshavetodetermineapatient’sprognosis

ThetypeoftreatmentapersonreceivesdependsonthestageofthecancerStagingisdifferentfornon-smallcelllungcancerandsmallcelllungcancer

本文档共62页;当前第48页;编辑于星期六\17点12分StageINon-SmallCellLungCancerCancerisfoundonlyinthelungSurgicalremovalrecommendedRadiationtherapyand/orchemotherapymayalsobeused本文档共62页;当前第49页;编辑于星期六\17点12分StageIINon-SmallCellLungCancerThecancerhasspreadtolymphnodesinthelungTreatmentissurgerytoremovethetumorandnearbylymphnodesChemotherapyrecommended;radiationtherapysometimesgivenafterchemotherapy

本文档共62页;当前第50页;编辑于星期六\17点12分StageIIINon-SmallCellLungCancerThecancerhasspreadtothelymphnodeslocatedinthecenterofthechest,outsidethelungStageIIIAcancerhasspreadtolymphnodesinthechest,onthesamesidewherethecanceroriginatedStageIIIBcancerhasspreadtolymphnodesontheoppositesideofthechest,underthecollarbone,orthepleura(liningofthechestcavity)SurgeryorradiationtherapywithchemotherapyrecommendedforstageIIIAChemotherapyandsometimesradiationtherapyrecommendedforstageIIIB

本文档共62页;当前第51页;编辑于星期六\17点12分StageIVNon-SmallCellLungCancerThecancerhasspreadtodifferentlobesofthelungortootherorgans,suchasthebrain,bones,andliverStageIVnon-smallcelllungcanceristreatedwithchemotherapy本文档共62页;当前第52页;编辑于星期六\17点12分Smallcelllungcancerhasoftenmetastasizedatthetimeofdiagnosis.TNMstagingisnotsuitedtosmallcelllungcancer.本文档共62页;当前第53页;编辑于星期六\17点12分TreatmentIncluding:A:SurgeryB:ChemotherapyC:RadiationtherapyD:Someothertherapyimmunologictherapy,Chinesetraditionaltherapy本文档共62页;当前第54页;编辑于星期六\17点12分SurgeryNon-smallcelllungcancer:patientswithstageIandIIareconsideredcandidatesforsurgicalresection,withstageIIIcancermaybecandidatesforsurgerywithpostoperativeradiationofthemediastinum.本文档共62页;当前第55页;编辑于星期六\17点12分本文档共62页;当前第56页;编辑于星期六\17点12分SurgeryWemustmeasurepulmon

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