中英文对照课件原发性支气管肺癌ppt.ppt

1、中英文对照定义定义Definition 原发性支气管肺癌简称肺癌，是起源于原发性支气管肺癌简称肺癌，是起源于支气管粘膜或腺体的肿瘤。支气管粘膜或腺体的肿瘤。Primary bronchogenic carcinoma is abbreviated to lung cancer,it derives from bronchi mucosa or gland.3Epidemiology Lung Cancer Worldwide:most common cancer 2,000,000 cases per year China:first leading cause of cancer death

2、 in urban area 5 yrs cessation At 15 years,80-90%risk reduction Never gets to“never smoker”risk620 Year Lag7 If what happened on your inside happened on your outside,would you still smoke?8 2 职业致癌因子职业致癌因子 2 Occupation carcinogenic factor:Asbestos,Radon 3 空气污染空气污染 3 Air pollution（1）室外大环境污染）室外大环境污染（1）

3、Outdoor environment pollution（2）室内小环境污染）室内小环境污染（2）Indoor environment pollution 4 电离辐射电离辐射 4 Ionizing radiation9 5 饮食与营养饮食与营养 5 Diet and nutritionVITAMIN A?10 6 其他因素其他因素 6 Other factors 7 遗传因素遗传因素 7 Hereditary factor Tumor suppressor genes*p53 Dominant oncogenes*Kras*Her-2/neu11病理和分类病理和分类Pathology an

4、d classification12解剖学分类解剖学分类Anatomy classification 1 中央型肺癌中央型肺癌 1 Central lung cancer13 2 周围型肺癌周围型肺癌 2 Peripheral lung cancer14组织学分类组织学分类Histology classification 1 小细胞肺癌小细胞肺癌 1 Small cell lung cancer,SCLC（1）燕麦细胞型）燕麦细胞型（1）oat cell type（2）中间细胞型）中间细胞型（2）intermediate cell type（3）混合型）混合型（3）mixed type15 S

5、mall cell carcinoma Rare in non-smokers Large hilar mass 70%present with overt metastasis Very chemo-responsive Worst prognosis16Small cell carcinoma17 2 非小细胞肺癌非小细胞肺癌 2 Non-small cell lung cancer,NSCLC（1）鳞状细胞癌（鳞癌）鳞状细胞癌（鳞癌）（1）Squamous cell carcinoma,SCC（2）腺癌和支气管肺泡癌）腺癌和支气管肺泡癌（2）Adenocarcinoma，AC，and b

6、ronchoalveolar carcinoma（3）大细胞癌）大细胞癌（3）Large cell carcinoma（4）鳞腺癌）鳞腺癌（4）Adeno-squamous carcinoma18 Squamous cell carcinoma Now 2nd most common(1st in China)Strongly linked with smoking 60-80%in the proximal airways(central type)Cavitation Tendency to spread locally/regionally Prognosis slightly bett

7、er than Adenocarcinoma19Squamous Cell Carcinoma20Squamous Cell Carcinoma21鳞癌鳞癌22Lung Cancer Pathology Adenocarcinoma Most common pathology(2nd in China)“Non-smokers lung cancer”Women Peripheral(75%)Aggressive metastases23Adenocarcicoma Left Lower Lobe24Adenocarcinoma25Adenocarcinoma26Bronchoalveolar

8、 Cell Carcinoma BAC Aerogenous and lymphatic spread Least associated with cigarette smoking Usually peripheral Localized,multi-nodular or diffuse Slow metabolism Prognosis Localized vs.other27支气管肺泡癌支气管肺泡癌28 Large cell carcinoma Large peripheral mass with necrosis Malignant epithelial neoplasm Poorly

9、-differentiated Aggressive mets“Its a cancerits not small cellbut”29Large cell carcinoma30Large cell carcinoma3110100d2530187d恶性度最高最常见发病率(%)倍增时间不明显有关密切吸烟女性较轻老年男性好发年龄性别202533d3035100d大细胞癌腺癌小细胞癌鳞癌32鳞癌小细胞癌腺癌大细胞癌解剖分类中央型中央型周围周围生长方式管腔内管腔外管腔外转移晚早较早手术机会多少支气管肺泡癌瘢痕癌较大放化疗敏感33临床表现临床表现Clinical manifestation34原发肿

10、瘤引起的症状和体征原发肿瘤引起的症状和体征Symptoms and physical signs due to primary tumor 1 咳嗽咳嗽 1 Cough 2 咯血咯血 2 Hemoptysis 3 喘鸣喘鸣 3 Wheeze 4 气急气急 4 Breath lessness 5 发热发热 5 Fever 6 其他其他 6 Others35肿瘤局部扩展引起的症状和体征肿瘤局部扩展引起的症状和体征Symptoms and physical signs due to tumor local expanding1 胸痛胸痛1 Chest pain2 呼吸困难呼吸困难2 Dyspnea3

11、 吞咽困难吞咽困难3 Dysphagia:esophageal compression4 声音嘶哑声音嘶哑4 Hoarse voice:laryngeal nerve paralysis 5 上腔静脉阻塞综合征上腔静脉阻塞综合征5 Superior vena cava obstruction syndrome6 Horner综合征，肺上沟瘤综合征，肺上沟瘤6 Horners syndrome,Pancoasts tumor:Cervical/thoracic nerve invasion 7 臂丛神经压迫征臂丛神经压迫征7 Brachial plexus compression syndrom

12、e36肿瘤远处转移引起的症状和体征肿瘤远处转移引起的症状和体征Symptoms and physical signs due to tumor distant metastasis 1 脑、中枢神经系统转移脑、中枢神经系统转移 1 Metastasize to brain,central nervous system37 2 肝转移肝转移 2 Metastasize to liver 3 骨转移骨转移 3 Metastasize to bone 4 皮下转移性结节皮下转移性结节 4 Subcutaneouly metastatic nodus 5 颈部或锁骨上淋巴结转移颈部或锁骨上淋巴结转移

13、5 Cervical or supraclavicular lymph node metastasis38肺癌作用于其他系统引起的肺外表现肺癌作用于其他系统引起的肺外表现Manifestation out of lung due to other systems affected by lung cancer 1 异位内分泌综合征异位内分泌综合征 1 Ectopic endocrine syndrome,EES（1）抗利尿激素分泌异常综合征抗利尿激素分泌异常综合征（1）Syndrome of inapprpriate antidiuretic hormone(SIADH)secretion（2

14、）异位异位ACTH综合征综合征（2）Ectopic ACTH syndrome（3）神经肌肉综合征神经肌肉综合征（3）Neuromyopathic syndrome（4）高钙血症高钙血症（4）Hypercalcinemia（5）其他：类癌综合征其他：类癌综合征（5）Others:Carcinoid syndrome39 2 其他肺外表现其他肺外表现 2 Other manifestation out of lung（1）多发性周围神经炎）多发性周围神经炎（1）Multiple peripheral neuritis（2）肌无力样综合征）肌无力样综合征（2）Eaton-Lambert syndr

15、ome40（3）肥大性肺性骨关节病）肥大性肺性骨关节病（3）Hypertrophic pulmonary osteoarthropathy,HPO病人病人正常人正常人41实验室和辅助检查实验室和辅助检查Laboratory and auxiliary examination42胸部胸部X线检查线检查 Chest radiograph 1 中央型肺癌中央型肺癌 1 Central lung cancer4344 2 周围型肺癌周围型肺癌 2 Peripheral lung cancer45464748电子计算机体层扫描电子计算机体层扫描CT49Posterior basal segment of

16、 left lower lobe,AC 50左上叶肺癌并左上叶不张Left upper lobe cancer combining atelectasis51Left lower lobe cancer combining obstructive pneumonia5253磁共振磁共振MRI5455痰脱落细胞学检查痰脱落细胞学检查Sputum exfoliative cytology testSCCACSCLC56纤维支气管镜检查纤维支气管镜检查Bronchofiberscopy575859SCCSCLCACLCC60核素闪烁显像核素闪烁显像Nuclide scintigraphy 1 骨骨闪

17、烁显像闪烁显像 1 Bone scintigraphy 2 正电子发射断层显像正电子发射断层显像 2 Positron emission tomography(PET)6162 病理学检查病理学检查 Pathology 癌标志物的检测癌标志物的检测 Cancer mark test 基因诊断基因诊断 Gene diagnosis 手术探查手术探查 Operations research63诊断和鉴别诊断诊断和鉴别诊断Diagnosis and differential diagnosis64诊断诊断Diagnosis 早期诊断早期诊断 Early diagnosis 症状症状 Symptom

18、体征体征 Physical sign 检查检查 Examination65鉴别诊断鉴别诊断Differential diagnosis 1 肺结核肺结核 1 Pulmonary tuberculosis66TuberculosisLung cancer67 肺真菌病肺真菌病 Pulmonary mycosis68 2 肺炎肺炎 2 Pneumonia 抗菌药物治疗有效，病灶吸收快而完全抗菌药物治疗有效，病灶吸收快而完全 Usually,antibacterial drug therapy is effective,and focus is absorbed quickly and comple

19、tely.69 3 肺脓肿肺脓肿 3 Lung abscess70 4 结核性渗出性胸膜炎结核性渗出性胸膜炎 4 Tuberculous exudative pleurisy71临床分期临床分期Clinical stage IA:T1N0 IB:T2 N0 IIA:T1 N1 IIB:T2 N1,T3 N0 IIIA:T3 N1,and T1-3 N2 IIIB:any T4,any N3 IV:any metastases72治治 疗疗Treatment73手术治疗手术治疗Operation treatment 1 NSCLC 2 SCLC74化学药物治疗化学药物治疗Chemotherapy

20、 1 SCLC 2 NSCLC75放射治疗放射治疗Radiotherapy 根治性根治性 Radical cure 姑息性姑息性 Palliative cure76介入性治疗介入性治疗Interventional therapy 1 支气管动脉灌注支气管动脉灌注 1 Bronchial artery infusion,BAI 2 经纤支镜经纤支镜 2 Through bronchofiberscopy77 生物反应调节剂和生物靶向治疗生物反应调节剂和生物靶向治疗 Biological response modifiers(BRM)and biological targeted therapy

21、中医药中医药 Chinese medicine78预后和预防预后和预防Prognosis and prevention79预后预后Prognosis The overall prognosis in bronchial carcinoma is very poor;With around 80%of patients dying within a year of diagnosis and less than 6%of patients surviving 5 years after diagnosis;The best prognosis is well-differentiated squamous cell tumors which have not metastasized and are amenable to surgical treatment.80预防预防Prevention 1 戒烟戒烟 1 Stop smoking 2 加强劳动保护加强劳动保护 2 Enhance labor protection 3 早期发现早期发现 3 Early discovery 4 化学预防化学预防 4 Chemical prophylaxis81