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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