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1、PrimaryLiverCancerLiverCancerInstituteZhongshanHospitalFudanUniversityDefinitionMalignanttumorsfromHepatocytesandintrehepaticcholangiocytes“KingofCancer”----Short-termsurvivalperiod（3-6m）Highincidenceatage40-50yEpidemiologyEtiology&PathogenesisPathologyClinicalManifestationClinicalSt
2、agingDiagnosisTreatmentPreventionIncidenceNo.5intheworld1990Worldwide---541000China---318000(58.8%)2005Worldwide---626000China:55%TheSecondCancerKillerinChinaUrban---Lung,LiverRural---Stomach,LiverMortalityinChina---20.4/100000(1990-1992)HighRiskAreasWorldwide－－Sub-SaharanAfrica（Moza
3、mbique,Uganda,SouthAfrica）SoutheastAsia（China,Malaysia,Indonesia,Singapore……）China－－Southeast（Jiangsu,Guangxi,Guangdong,Fujian……）Highest：Qidong,Haimen,Fushui,ShundeWorldwideIncidenceofLiverCancerEpidemiologyEtiology&PathogenesisPathologyClinicalManifestationClinicalStagingDiagnosisTr
4、eatmentPreventionHigh-RiskFactorsforHCCHepatitisvirusinfection（HBV，HCV）－CirrhosisAflatoxinB1ingestionDrinkingwaterpollution（Microcystin,Nodularin）Alcoholabuse（WestcountriesandNorthChina）GeneticsusceptibilityChemicalcarcinogenParasitesNaturalHistoryofHCCEpidemiologyEtiology&Pathogenes
5、isPathologyClinicalManifestationClinicalStagingDiagnosisTreatmentPreventionPathology（MacrostructuralFeature）Eggle分型（1901）巨块型，结节型，弥漫型我国肝癌病理协作组分型（1982）块状型：≥5cm（巨块型≥10cm）结节型：<5cm(小癌型：单个或相邻2个结节直径之和<3cm)弥漫型：全肝散布结节Okuda分型（1984）膨胀型，浸润型，混合型，弥漫型，特殊型小癌型结节型巨块型巨块型Pathology（CytologicalFeature)Hep
6、atocellularcarcinoma(HCC,80-90％)Cholangiocellularcarcinoma(5-10%)Mixed（cholangiohepatocellular）carcinoma(5-10%)FibrolamellarHCCHepatoblastomaPathology--MetastasisBloodflow>Lymphatic>Directspread,Infiltration>ImplantationPortalVein－IntrahepaticspreadHepaticVein－Systemicmetastasis（Lung
7、,Adrenalgland,Bone,Lymphnodes,Brain,Stomach,Colon……）EpidemiologyEtiology&PathogenesisPathologyClinicalManifestationClinicalStagingDiagnosisTreatmentPreventionClinicalManifestation－Symptoms（Moderateandlatestage）Hepatalgia－肿瘤增大迅速、结节破裂Anorexia－肝功损害，胃肠道压迫Hypodynemia,Athrepsy－代谢产物，厌食，恶病质A
8、bdominaldist
