最新原发性支气管肺癌中英文对照精品课件.ppt

原发性支气管肺癌中英文对照原发性支气管肺癌中英文对照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.2•5 饮食与营养饮食与营养•5 Diet and nutritionVITAMIN A???????????????????9•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/neu10病理和分类病理和分类Pathology and classification11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 cancer12•2 周围型肺癌周围型肺癌•2 Peripheral lung cancer13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 type14•Small cell carcinoma–Rare in non-smokers–Large hilar mass –70% present with overt metastasis–Very chemo-responsive…–Worst prognosis15Small cell carcinoma16•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 bronchoalveolar carcinoma•（（3）大细胞癌）大细胞癌•（（3））Large cell carcinoma•（（4）鳞腺癌）鳞腺癌•（（4））Adeno-squamous carcinoma17•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 better than Adenocarcinoma18Squamous Cell Carcinoma19Squamous Cell Carcinoma20鳞癌鳞癌21Lung Cancer Pathology•Adenocarcinoma–Most common pathology(2nd in China)–“Non-smoker’s lung cancer”–Women–Peripheral (75%)–Aggressive metastases22Adenocarcicoma Left Lower Lobe23Adenocarcinoma24Adenocarcinoma25Bronchoalveolar Cell Carcinoma•BAC–Aerogenous and lymphatic spread–Least associated with cigarette smoking–Usually peripheral•Localized, multi-nodular or diffuse–Slow metabolism–Prognosis•Localized vs. other26支气管肺泡癌支气管肺泡癌27•Large cell carcinoma–Large peripheral mass with necrosis–Malignant epithelial neoplasm–Poorly-differentiated–Aggressive mets–“It’s a cancer…it’s not small cell…but…”28Large cell carcinoma29Large cell carcinoma3010100d25～30187d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20～2533d30～35100d大细胞癌腺癌小细胞癌鳞癌31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32临床表现临床表现Clinical manifestation33原发肿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 Others34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 expanding•1 胸痛胸痛•1 Chest pain•2 呼吸困难呼吸困难•2 Dyspnea•3 吞咽困难吞咽困难•3 Dysphagia: esophageal compression•4 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 syndrome•6 Horner综合征，肺上沟瘤综合征，肺上沟瘤•6 Horner’s syndrome, Pancoast’s tumor: Cervical/thoracic nerve invasion •7 臂丛神经压迫征臂丛神经压迫征•7 Brachial plexus compression syndrome35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 system36•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•5 Cervical or supraclavicular lymph node metastasis37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）） 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 syndrome38•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 syndrome39•（（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40实验室和辅助检查实验室和辅助检查Laboratory and auxiliary examination41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 cancer4243•2 周围型肺癌周围型肺癌•2 Peripheral lung cancer44454647电子计算机体层扫描电子计算机体层扫描CT48Posterior basal segment of left lower lobe, AC 49左上叶肺癌并左上叶不张Left upper lobe cancer combining atelectasis50Left lower lobe cancer combining obstructive pneumonia5152磁共振磁共振MRI5354痰脱落细胞学检查痰脱落细胞学检查Sputum exfoliative cytology testSCCACSCLC55纤维支气管镜检查纤维支气管镜检查Bronchofiberscopy565758SCCSCLCACLCC59•核素闪烁显像核素闪烁显像•Nuclide scintigraphy• 1 骨骨γ闪烁显像闪烁显像• 1 Bone γ 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)6061•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 research62诊断和鉴别诊断诊断和鉴别诊断Diagnosis and differential diagnosis63诊断诊断Diagnosis•早期诊断早期诊断•Early diagnosis•症状症状•Symptom•体征体征•Physical sign•检查检查•Examination64鉴别诊断鉴别诊断Differential diagnosis•1 肺结核肺结核•1 Pulmonary tuberculosis65TuberculosisLung cancer66•肺真菌病肺真菌病•Pulmonary mycosis67•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 completely.68•3 肺脓肿肺脓肿•3 Lung abscess69•4 结核性渗出性胸膜炎结核性渗出性胸膜炎•4 Tuberculous exudative pleurisy70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 metastases71治治 疗疗Treatment72手术治疗手术治疗Operation treatment•1 NSCLC•2 SCLC73化学药物治疗化学药物治疗Chemotherapy•1 SCLC•2 NSCLC74放射治疗放射治疗Radiotherapy•根治性根治性•Radical cure•姑息性姑息性•Palliative cure75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 bronchofiberscopy76•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•中医药中医药•Chinese medicine77预后和预防预后和预防Prognosis and prevention78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.79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 prophylaxis80Thanks!81 结束语结束语谢谢大家聆听！！！谢谢大家聆听！！！82。