卵巢癌 ovarian cancer狄文课件

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1、OvarianCancerDIWENM.D.,Ph.D.,Professor&ChairmanDepartmentOfObstetrics&GynecologyRenjiHospitalAffiliatedtoSJTUSchoolofMedicineGeneralIntroductionOvariantumorsarecommonestbetween30and60.Theyareparticularlyliabletobeortobecomemalignant.Intheirearlystages,theyareasy

2、mptomaticandpainless.Theymaygrowtoalargesize.1.4%lifetimeriskofovariancancer2006-11-1七年制2OvarianCancerRiskFactorsFamilyhistoryOvariancancerBreastcancerColoncancerGeneticfactorsOlderageCaucasianMoremenstrualcirclesduringlifetime(Ovulationinduction)2006-11-1七年制3Ov

3、arianCancerIncidenceNearly25%ofallovarianneoplasmaremalignant.Approximately80％ofthemareprimarygrowthsoftheovary.Theremainderbeingsecondary，usuallycarcinomata.2006-11-1七年制4OvarianCancersymptomsLackofanyspecificsymptoms,ovariantumorsareoftenlargebythetimethedoctor

4、isconsulted.Menstrualfunctionisseldomupset,andanyirregularityisattributedtothepatient’s‘timeoflife’.2006-11-1七年制5OvarianCancersymptomsIncreasedabdominalsize2006-11-1七年制6OvarianCancersymptomsPressuresymptomsGastro-intestinalsymptoms(Bloating)Urgetourinateplevicpa

5、in(adullpaininthelowerabdomen)Verylargetumorsmaycauserespiratoryembarrassmentandedemaorvaricositiesinthelegs,andacharacteristic‘ovariancachexia’develops.2006-11-1七年制7OvarianCancerCLINICALFEATURESOFOVARIANTUMOURS2006-11-1七年制8OvarianCancerCLINICALFEATURESOFOVARIAN

6、TUMOURS2006-11-1七年制9OvarianCancerCLINICALFEATURESOFOVARIANTUMOURS2006-11-1七年制10OvarianCancerGeneralRuleAnexperiencedexaminerwillrecognizeanovariantumormainlybecauseovariantumoris,inthecircumstances,themostlikelydiagnosis.Allabdominalswellingsshouldbesubjectedtou

7、ltrasoundandX-rayexamination.DIFFERENTIALDIAGNOSIS2006-11-1七年制11OvarianCancerDIFFERENTIALDIAGNOSIS2006-11-1七年制12OvarianCancerASCITESAfluidthrillmaybeelicitedfromanovariancyst,andascitesandtumormaycoexist;butasarulethedistinctionshouldbeeasilymade.DIFFERENTIALDIA

8、GNOSIS2006-11-1七年制13OvarianCancerUterineFibroidsAlargemidlineintramuralfibroidmaybeimpossibletodistinguishfromasolidovariantumoruntiltheabdomenisopenedandanentirelydi