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肺癌研究报告Lung cancer(英文)ppt课件
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adenocarcinoma, cancer of the glandular tissue
large cell carcinoma, cancer composed of large-sized cells
broncho-alveolar carcinoma
PPT学习交流
10
Non-Small Cell Lung Carcinoma (NSCLC)
PPT学习交流
8
Environmental Risk Factors Alcohol
Diet and Body Mass
Non-modifiable Risk Factors Age \Race \Sex
PPTs cell carcinoma,squamous epithelium of the lungs or bronchi
Lung cancer is especially common among men in North America, Europe, and Oceania. At the moment, lung cancer rates are higher than ever before among the people of central and Eastern Europe. In Japan, lung cancer has increased tenfold in men and eightfold in women since 1950. In addition, Chinese women, many of whom are nonsmokers, have very high lung cancer rates. This phenomenon has been associated with exposure to cooking oil vapors and other forms of air pollution in the indoor environments of China.
large cell carcinoma, cancer composed of large-sized cells
broncho-alveolar carcinoma
PPT学习交流
10
Non-Small Cell Lung Carcinoma (NSCLC)
PPT学习交流
8
Environmental Risk Factors Alcohol
Diet and Body Mass
Non-modifiable Risk Factors Age \Race \Sex
PPTs cell carcinoma,squamous epithelium of the lungs or bronchi
Lung cancer is especially common among men in North America, Europe, and Oceania. At the moment, lung cancer rates are higher than ever before among the people of central and Eastern Europe. In Japan, lung cancer has increased tenfold in men and eightfold in women since 1950. In addition, Chinese women, many of whom are nonsmokers, have very high lung cancer rates. This phenomenon has been associated with exposure to cooking oil vapors and other forms of air pollution in the indoor environments of China.
肺癌英文PPT演示幻灯片
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cell carcinoma).
7
Pathology And Classification
According to the different principles of management,it is divided into two types.
SCLC:small cell lung carcinoma. NSCLC:non small cell lung carcinoma.
5
Pathology And Classification
1. According to the position of tumor arising from ,it can be divided into two types .
Central type:Tumor arises from main bronchus, lobar and segmental bronchus . Peripheral type : Tumor arises beyond segmental bronchus .
11
Clinical Features
(4).Horner’s syndrome.It is caused by invading the cervical sympathetic ganglia on the involved side the pupil is small ptosis of the up eyelids,retraction of the eyeball and no sweat of the face.
(5)Cardiac effusion
12
Passive smoking is also a carcinogen factor.
7
Pathology And Classification
According to the different principles of management,it is divided into two types.
SCLC:small cell lung carcinoma. NSCLC:non small cell lung carcinoma.
5
Pathology And Classification
1. According to the position of tumor arising from ,it can be divided into two types .
Central type:Tumor arises from main bronchus, lobar and segmental bronchus . Peripheral type : Tumor arises beyond segmental bronchus .
11
Clinical Features
(4).Horner’s syndrome.It is caused by invading the cervical sympathetic ganglia on the involved side the pupil is small ptosis of the up eyelids,retraction of the eyeball and no sweat of the face.
(5)Cardiac effusion
12
Passive smoking is also a carcinogen factor.
肺癌PPT课件
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显示Pancoast瘤与毗邻血管、臂丛神经的关 系,在矢状与冠状位扫描优于横轴位CT
• 痰细胞学检查
• 阳性率为60%左有,高者达80%以 上。其中,约2/3的病变位于中央, 在支气管镜能够观察到的范围内
• 胸水细胞学检查
• 与 痰一样,阴性结果并不重要,但 肯定的阳性发现却非常重要
• 常用三种方法 •灌注扫描 •检查肺癌的转移灶 •亲肿瘤扫描 •直接提示肺部肿瘤 •吸入扫描 •间接提示肺部肿瘤
FDG-PET在肺部肿瘤诊治中的应用:
确定肺内病变的存在及性质 对肺癌患者进行临床TNM分期。 发现常规检查未发现的亚临床转移病灶。 判断肿瘤对治疗的反应,指导治疗方案。 肿瘤局部复发的早期诊断。
纤维支气管镜检查
• 纤支镜检查除观察病灶外,主要目的在于钳 取组织进行病理检查以明确诊断 ;其对中央型 肺癌阳性率较高
• 胸内转移症状
• 胸水:血性胸水一般系肿瘤直接侵犯胸膜所致, 提示预后不佳
• 纵隔受累
• 压迫上腔静脉,引起上腔静脉综合征 • 压迫食管致吞咽困难 • 累及一侧喉返神经致声音嘶哑 • 肺尖部的肿瘤---Pancoast瘤,常常出现胸廓上口受累
的症状
*Pancoast瘤
支气管源癌,鳞癌为主,少数为小细胞癌。位 于肺尖部,常出现胸廓上口受累的症状,表现 为:1)胸腔上口软组织受累,合并邻近骨质破坏 和局部性疼痛;2)臂丛神经受累,引起患侧上肢、 手部疼痛,手部肌肉萎缩;3)支配头颈部同侧的 颈交感神经节受累,引起Horner综合征
某些金属和非金属物质 如铀、铬、镍、铍、氡、砷、锡、 石棉等有致癌作用。其中最重要的是石棉。石棉工人发生 肺癌的危险是普通人的6~10倍
大气污染 可使肺癌的发病率提高2~3倍:肺癌死亡率在城市 高于农村
• 痰细胞学检查
• 阳性率为60%左有,高者达80%以 上。其中,约2/3的病变位于中央, 在支气管镜能够观察到的范围内
• 胸水细胞学检查
• 与 痰一样,阴性结果并不重要,但 肯定的阳性发现却非常重要
• 常用三种方法 •灌注扫描 •检查肺癌的转移灶 •亲肿瘤扫描 •直接提示肺部肿瘤 •吸入扫描 •间接提示肺部肿瘤
FDG-PET在肺部肿瘤诊治中的应用:
确定肺内病变的存在及性质 对肺癌患者进行临床TNM分期。 发现常规检查未发现的亚临床转移病灶。 判断肿瘤对治疗的反应,指导治疗方案。 肿瘤局部复发的早期诊断。
纤维支气管镜检查
• 纤支镜检查除观察病灶外,主要目的在于钳 取组织进行病理检查以明确诊断 ;其对中央型 肺癌阳性率较高
• 胸内转移症状
• 胸水:血性胸水一般系肿瘤直接侵犯胸膜所致, 提示预后不佳
• 纵隔受累
• 压迫上腔静脉,引起上腔静脉综合征 • 压迫食管致吞咽困难 • 累及一侧喉返神经致声音嘶哑 • 肺尖部的肿瘤---Pancoast瘤,常常出现胸廓上口受累
的症状
*Pancoast瘤
支气管源癌,鳞癌为主,少数为小细胞癌。位 于肺尖部,常出现胸廓上口受累的症状,表现 为:1)胸腔上口软组织受累,合并邻近骨质破坏 和局部性疼痛;2)臂丛神经受累,引起患侧上肢、 手部疼痛,手部肌肉萎缩;3)支配头颈部同侧的 颈交感神经节受累,引起Horner综合征
某些金属和非金属物质 如铀、铬、镍、铍、氡、砷、锡、 石棉等有致癌作用。其中最重要的是石棉。石棉工人发生 肺癌的危险是普通人的6~10倍
大气污染 可使肺癌的发病率提高2~3倍:肺癌死亡率在城市 高于农村
肺癌英文PPT课件
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2.Symptoms
caused by the near organs or tissue involved by tumor.
(1).Dysphagia. (2).Hoarseness. (3).Pleural effusion due to invasion of the pleura.
Incidence and mortality
Bronchogenic carcinoma has increased remarkable in incidence and mortality during half of the century and has become the most frequent visceral malignant diseases of men.The mortality of lung cancer hold the first place among all kinds carcinomas.
5.Diets and Nutrition.
6.Chronic irritation.
7.Genetic factors.
Pathology And Classification
1. According to the position of tumor arising from ,it can be divided into two types . Central type:Tumor arises from main bronchus, lobar and segmental bronchus . Peripheral type : Tumor arises beyond segmental bronchus .
caused by the near organs or tissue involved by tumor.
(1).Dysphagia. (2).Hoarseness. (3).Pleural effusion due to invasion of the pleura.
Incidence and mortality
Bronchogenic carcinoma has increased remarkable in incidence and mortality during half of the century and has become the most frequent visceral malignant diseases of men.The mortality of lung cancer hold the first place among all kinds carcinomas.
5.Diets and Nutrition.
6.Chronic irritation.
7.Genetic factors.
Pathology And Classification
1. According to the position of tumor arising from ,it can be divided into two types . Central type:Tumor arises from main bronchus, lobar and segmental bronchus . Peripheral type : Tumor arises beyond segmental bronchus .
肺癌诊断及治疗英文版护理课件
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Nursing care for lung cancer
Psychological care for lung cancer patients
01
Provide emotional support
It is essential to offer emotional support to lung cancer patients,
as they may experience anxiety, fatigue, and depression due to
the diagnosis
02
Inform and educate
It is important to provide information and education about lung
Epiology of lung cancer
Incident
Lung cancer is one of the most common cancers in the world, accounting for about 13% of all cancers The incidence rate is highest in developed countries and is increasing in developing countries
situation and provide resources for coping with stress and
negative emotions
Pain management in lung cancer patients
01
Assess paint
Regularly assess patients' paint levels to identify and manage any paint they may be experiencing
肺癌ppt课件-PPT完整版本
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p<0.001 across treatments
完整编辑ppt
p=0.61 across treatments
Main bronchus
Metastasis to distant
organs
Contralateral lymph node
完整编辑ppt
Stage 0 Stage IA Stage IIB Stage IIIB Stage IV
30
非小细胞肺癌:临床分期与预后
Survival 100
(%)
90
recurrence
rate (% of
40
patients)
30
20
10
0 Limited Lobectomy resection (n=125) (n=122)
p<0.05
Segmen- Lobectomy tectomy (n=105) (n=68)
Ginsberg and Rubinstein1995
64
Surgery alone (n=32)
11
Rosell et al 1994 Surgery plus radiotherapy plus
26
chemotherapy (n=30)
Surgery plus radiotherapy (n=30)
8
完整编辑ppt
p value 0.095 <0.008 <0.001
完整编辑ppt
15
Transthoracic needle aspiration (TTNA) of a non-small cell Pancoast tumor
完整编辑ppt
16
肺癌新分类ppt课件
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4.在进展期 非小细胞肺癌患者(NSCLC),应尽可 能确定其为腺癌பைடு நூலகம்鳞癌,因有以下重要的原因:
腺癌或者NSCLC 应检测EGFR突变,因其突变的 存在可以预测其对EGFR酪氨酸激酶抑制剂 (TKIs)的反应; 与鳞癌比较,腺癌组织学是预测培美曲塞治疗 的一个强有力的指标; 潜在致命性的大出血可发生于接受贝伐单抗治 疗的鳞癌患者。
原位腺癌和微小浸润性腺癌通常表现为非黏液
型或极罕见黏液型亚型,这两类患者若接 受根治性手术,则其疾病特异性生存率分 别为100%或接近100%。
3.浸润性腺癌分类中是以其生长模式为主要构 成而定的, 分型 鳞屑状、腺泡状、乳头状和实体性,微乳头状癌 (新增)
腺癌的变型:
浸润性黏液腺癌、胶体型、胎儿型和肠型腺癌。
FIGURE 2. Nonmucinous adenocarcinoma in situ. A, This circumscribed nonmucinous tumor grows purely with a lepidic pattern. No foci of invasion or scarring are seen. B, The tumor shows atypical pneumocytes proliferating along the slightly thickened, but preserved, alveolar walls.
AAH是指肺内小的(<0.5cm)、局限性、II型肺 泡细胞和(或)Clara细胞增生性病变(Clara细胞 是一种无纤毛上皮细胞,主要分布于终末细支气管和呼吸 性细支气管上皮;Clara细胞具有活跃的增殖分化特性增生 细胞呈圆形、立方形、低柱状或钉样(peg),有轻- 中度异型性,核内包涵体常见,细胞间常有空隙、沿肺泡 壁生长,有时累及呼吸性细支气管壁。AAH可以表现为 富于细胞和异型性,此时形态学鉴别AAH和原位腺癌非 常困难,
第十届世界肺癌会议(英文)PPT课件
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pneuonectomy and the remainder had lobectomy 39% of pts in each arm had stage Ⅲ,and 46% had scc
International adjuvant lung cancer trial (IALT)
74% pts received at least 240mg/m2 of DDP;8% pts assigned to the chemotherapy arm received no chemotherapy
NSCLCCG ALPI IALT BLT
n Hazard ratio for chemotherapy 95% CI
1,394 1,209 1,869 381
o.87 0.96 0.86 1.02
0.74-1.02 0.81-1.13 0.76-0.98 0.77-1.35
commentary
Some point to the better compliance with treatment in the IALT study
Chemotherapy used in IALT
Adjuvant chemotherapy regimen
% of the pts
Cisplatin 300-400mg/m2 over 3-4 cycles with
etoposide
56
vinovelbine
27
vinblastin
11
vindesine
There was no benefit to chemotherapy in terms of overall survival or progression-free survival
International adjuvant lung cancer trial (IALT)
74% pts received at least 240mg/m2 of DDP;8% pts assigned to the chemotherapy arm received no chemotherapy
NSCLCCG ALPI IALT BLT
n Hazard ratio for chemotherapy 95% CI
1,394 1,209 1,869 381
o.87 0.96 0.86 1.02
0.74-1.02 0.81-1.13 0.76-0.98 0.77-1.35
commentary
Some point to the better compliance with treatment in the IALT study
Chemotherapy used in IALT
Adjuvant chemotherapy regimen
% of the pts
Cisplatin 300-400mg/m2 over 3-4 cycles with
etoposide
56
vinovelbine
27
vinblastin
11
vindesine
There was no benefit to chemotherapy in terms of overall survival or progression-free survival
肺癌英文版[荟萃知识]
![肺癌英文版[荟萃知识]](https://img.taocdn.com/s3/m/c061811c51e79b8968022699.png)
Central type:Tumor arises from main bronchus, lobar and segmental bronchus . Peripheral type : Tumor arises beyond segmental bronchus .
专业知识
6
Pathology And Classification
专业知识
3
Etiology
The cause of lung cancer is unknown.It is believed that there are following related factors.
1. Excessive cigarette smoking:Smoking index(Brinkman Index) is equal to cigarettes per day smoking time(years).
Bronchogenic Carcinoma (Lung Cancer)
Respiratory department
专业知识
1
Definition
Bronchogenic carcinoma refers to the malignant tumor which grows in the bronchus. Originating from mucus or gland of bronchus.
pleura.
专业知识
11
Clinical Features
(4).Horner’s syndrome.It is caused by invading the cervical sympathetic ganglia on the involved side the pupil is small ptosis of the up eyelids,retraction of the eyeball and no sweat of the face.
专业知识
6
Pathology And Classification
专业知识
3
Etiology
The cause of lung cancer is unknown.It is believed that there are following related factors.
1. Excessive cigarette smoking:Smoking index(Brinkman Index) is equal to cigarettes per day smoking time(years).
Bronchogenic Carcinoma (Lung Cancer)
Respiratory department
专业知识
1
Definition
Bronchogenic carcinoma refers to the malignant tumor which grows in the bronchus. Originating from mucus or gland of bronchus.
pleura.
专业知识
11
Clinical Features
(4).Horner’s syndrome.It is caused by invading the cervical sympathetic ganglia on the involved side the pupil is small ptosis of the up eyelids,retraction of the eyeball and no sweat of the face.
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1、 鳞状上皮细胞癌 包括梭形细胞癌
(1)占原发肺癌的40-50%;柱状上皮纤毛丧失、 基底细胞鳞状化生、不典型增生、发育不全易突 变为癌。
(2)多见于老年男性; (3)与吸烟关系密切; (4)中央型多见; (5)管内生长,易导致肺不张及阻塞性肺炎; (6)癌组织易变性、坏死,形成空洞或肺脓肿; (7)生长缓慢,转移晚,手术机会相对较多。
支气管肺泡癌瘢
多
少
较大
痕癌
放化疗敏感
四、临床表现:
• 5%-15%发现时无症状
(一)由原发肿瘤引起的症状 (二) 肿瘤局部扩展引起的症状 (三)癌肿远处转移引起的症状 (四) 肿瘤作用于其他系统引起的肺外表现
(伴癌综合征)
(一)由原发肿瘤引起的症状
1、 咳嗽: 2、血痰或咯血: 3、 气短或喘鸣:阻塞或压迫 4、胸闷、气急:支气管狭窄、肺门淋巴 结转移压迫、胸水、心包积液、膈麻痹、 上腔静脉阻塞以及肺广泛受累 5、体重下降:肿瘤毒素、消耗、感染、 食欲减退
发病率 (%)
倍增时间
鳞癌 最常见 30~35 100d
小细胞癌 恶性度最高
腺癌
大细胞癌
20~25 33d
25~30 187d
10 100d
好发年龄性别
老年 男性
较轻
女性
吸烟
密切
有关
不明显
解剖分类 生长方式
转移
手术机会
鳞癌
小细胞癌
腺癌
大细胞癌
中央型 管腔内
晚
中央型 管腔外
早
周围 管腔外 较早
周围
6、 Horner综合征:肺上沟癌压迫
颈交感 也可压迫臂丛(腋下、上肢 内侧的火灼样疼痛)
(三)癌肿远处转移引起的症状 1、脑转移: 2、骨转移:肋骨、脊椎、骨
盆 3、肝、胰腺转移: 4、淋巴结转移:锁骨上常见
(四)肺外表现
副癌综合征(paraneoplastic综合症) 1、肥大性肺性骨关节病 多侵犯上下肢长
原发性支气管肺癌 (第一位的
bronchogenic癌)
一、概述:
• 肺癌----起源于支气管粘膜或腺体的癌,常有区域 性淋巴结和血行转移,早期常有刺激性咳嗽、痰中 带血等。
• 肺癌为全球最主要的癌症,是我国第一大癌症。 • 发病率及死亡率居首位,正每年4.5%的速度增加。 • 多发生于40岁以上,男女比为2.3:1,男性首位
细胞型、小细胞型和基底细胞型。 (2)腺癌 包括腺泡状腺癌、乳头状腺癌、
细支气管肺泡癌、实体癌粘液形成
(二)按组织病理学分类
(3)大细胞癌 包括大细胞神经内分泌癌、复合性 大细胞神经内分泌癌、基底细胞样癌、透明细胞 癌、伴横纹肌样表型的大细胞癌
(4)其它 腺鳞癌、类癌、肉瘤样癌、唾液腺型癌 等
2、小细胞肺癌 燕麦细胞型、中间细胞型、复合燕 麦细胞型
• 6、其它:黑色棘皮症、皮肌炎、硬皮症等。
肺癌症状小结
呼吸道症状——应有尽有 转移症状——殊连全身 肺外表现——五花八门
五、影像学与其他检查
• (一)胸部普通X线检查:是发现肺癌 最重要的方法。
•
1、中央型肺癌:
•
(1)瘤体征象:
•
(2)支气管阻塞征象:
•
(3)胸部转移征象:
•
• 2、周围型肺癌:
胞癌之间。肺门附近或肺边缘,转移较小细胞晚, 手术切除机会大。
4、 腺癌(腺癌):
(1)女性多见; (2)占25%; (3)周围性; (4)管外生长;腺管或乳头状结构 (5)腺癌富血管,故局部侵润和血行泡细胞型腺癌)
支气管肺癌(大细胞未分化型)
支气管肺癌(小细胞未分化型)
6、发热:肿瘤坏死或阻塞性肺炎
(二) 肿瘤局部扩展引起的症状
1、胸痛:侵犯胸膜、肋骨、胸壁、 压迫肋间神经 钝痛、隐痛
2、呼吸困难:压迫大气道 3、咽下困难:侵犯或压迫食管、气 管食管瘘
4、声音嘶哑:直接压迫或转移到纵 隔淋巴结压迫喉返神经(多为左侧)
5、上腔静脉阻塞综合征:侵犯纵隔 淋巴结压迫、右上肺原发肺癌侵犯、 癌栓阻塞
内分泌失调、家族遗传和基因改变等
三、病理和分类
(一)按解剖学部位分类
1、中央型肺癌:发生在段以上支气管至主 支气管的肺癌;约占3/4,鳞癌、小细胞未 分化癌多见。
2、周围型肺癌:发生在段以下支气管的 肺癌;约占1/4,腺癌多见。
(二)按组织病理学分类
1、非小细胞肺癌 (1)鳞状上皮细胞癌 包括乳头状型、透明
2、小细胞肺癌(类似淋巴细胞)
(1)占原发肺癌的10-15%; (2)多发生在40-50岁; (3)与吸烟关系密切; (4)中央型多见; (5)生长快,转移早; (6)对放、化疗敏感; (7)可引起伴癌综合症。燕麦细胞型和中间型 可含神经内分泌颗粒,分泌5-羟色胺、儿茶酚胺、 组胺、激肽等。
3、大细胞癌:生物学特性界于鳞癌和小细
骨远端 2、异位内分泌综合征 分泌促性腺激素、
促肾上腺皮质激素、抗利尿激素
• 3、神经肌肉综合征(神经-肌肉综合症)小脑 皮质变性、脊髓小脑变性、周围神经病变、 重症肌无力和肌病
• 4、高钙血症 骨骼破坏或分泌异生性甲状 旁腺样激素
• 5、类癌综合症:分泌5-羟色胺(哮喘样、 阵发心动过速、水样腹泻、皮肤潮红)
肿瘤。 • 家族史与吸烟对肺癌影响较大,空气污染也有重
要影响。
二、病因和发病机制
1、吸烟:重要危险因素 苯并芘 主动、被动吸烟 纸烟>雪茄>烟斗 吸烟→纤毛脱落、上皮增生、核
异形变 2、职业致癌因子:石棉、无机砷化合物、铬镍等 3、空气污染:大、小环境 4、电离辐射:中子、α射线、χ射线 5、饮食与营养:V-A、β胡萝卜素可减少 6、其他:结核、病毒感染、真菌毒素、免疫低下、
•
(1)瘤体征象
•
(2)癌性空洞
•
(3)易侵犯:胸膜、 肋骨细支
气管
• 3、肺泡细胞癌:结节型、弥漫型
中心型肺癌
右上叶周围型肺癌
右上肺癌
肺癌(波浪征)
• (二)CT 发现小病灶和位于心脏后 、 脊柱旁、肺尖、近膈面、肋骨头的病灶以 及转移灶。
• (三)MRI 明确肿瘤与大血管的关系
• (四)SPECT(光电子发射计算机断层 显像)
• (五)PET (正电子发射计算机体层显 像)定性 探查细胞代谢
• (六)痰脱落细胞检查:是简单有效的 早期诊 断方法(无创性) 阳性率70%-80%
左下叶后基底段腺癌
左上叶肺癌并左上叶不张
左下叶肺癌并左下肺阻塞性肺炎
磁共振显示周围型肺癌