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子宫内膜癌 Carcinoma of endometrium

子宫内膜癌 Carcinoma of endometrium. 山西医科大学第一医院妇产科 李 莉. 学 习 要 点. ★ 子宫内膜癌的 转移途径 ★ 子宫内膜癌的 早期诊断方法 ★ 子宫内膜癌的 治疗原则. Etiology. ★ 雌激素依赖型 ★ 非雌激素依赖型. Pathology. 弥漫型. Pathology. 局限型. Metastasis. ★ Direct extension ★ Lymphatic metastasis ★ Ｂ lood spread.

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子宫内膜癌 Carcinoma of endometrium

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  1. 子宫内膜癌Carcinoma of endometrium 山西医科大学第一医院妇产科 李 莉

  2. 学 习 要 点 ★ 子宫内膜癌的转移途径 ★ 子宫内膜癌的早期诊断方法 ★ 子宫内膜癌的治疗原则

  3. Etiology ★ 雌激素依赖型 ★ 非雌激素依赖型

  4. Pathology 弥漫型

  5. Pathology 局限型

  6. Metastasis ★Direct extension ★Lymphatic metastasis ★Ｂloodspread

  7. Staging ★Clinical staging （ FIGO, 1971） ★Surgical staging ( FIGO, 2000 )

  8. Staging 临床分期 FIGO，1971 (1) 0期 腺瘤样增生或原位癌（不列入治疗效果统计） I期 癌局限于宫体 Ia期 宫腔长度 ≤ 8cm Ib期 宫腔长度 > 8cm G1:高分化腺癌 根据组织学分级：又分 G2 :中分化癌 G3 :未分化癌

  9. Staging 临床分期 FIGO，1971 (2) II 期 癌已侵犯宫颈 III期 癌扩散至子宫以外盆腔内（阴道或宫 旁组织可能受累），但未超出真骨盆 IV期 癌超出真骨盆或侵犯膀胱或直肠粘膜， 或有盆腔以外的播散 IVa期 癌侵犯附近器官，如直肠、膀胱 IVb期 癌有远处转移

  10. Staging 手术分期 FIGO，2000 (1) I期 癌局限于宫体 IA 癌局限于子宫内膜 IB 侵犯肌层≤1/2 IC 侵犯肌层 ＞1/2 II期 癌扩散至宫颈，但未超越子宫 IIA 仅累及宫颈管腺体 IIB 浸润宫颈间质

  11. Staging 手术分期 FIGO，2000 (2) III期 癌局部或（和）区域转移 IIIA 癌浸润至浆膜和（或）附件，或腹水含癌细胞 或腹腔冲洗液阳性 IIIB 癌扩散至阴道 IIIC 癌转移至盆腔和或腹主动脉旁淋巴结 IVA 癌浸润膀胱粘膜和或直肠粘膜 IVB 远处转移不包括（阴道、盆腔粘膜、附件及腹 主动脉旁淋巴结但包括腹腔内其他淋巴结转）

  12. Clinical findings • Vaginal Bleedings • 2. Abnormal vaginal discharge • 3. Pain • 4. Physical examination

  13. Diagnosis History Fractional curettage Hysteroscopy

  14. Differentdiagnosis 1. Dysfunctions uterine bleeding 2. Endometrial Polyps 3. submucaus myoma 4. Atrophic vaginitis 5. The cervical adenocarcinoma

  15. Treatment 1. Surgical treatment 2. Surgical treatment & Radiation therapy 3. Hormone therapy 4. Chemotherapy

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