Ovariancarcinom卵巢肿瘤

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1、Ovariancarcinom卵巢肿瘤DepartmentofObstetricsandGynecology妇产科ZhangWei张蔚卵巢女性内生殖器Difficulttobedetectedinearlierperiod不易早期发现The5－yearsurvivalofOvariancarcinomaislow(25%-30%)卵巢恶性肿瘤5年存活率较低PurposeandRequestClinicalmanifestations临床表现2Diagnosisandtreatment诊断及治疗3Histologicaltypes组织学分类1Histologicaltypes组织学分类Ma

2、lignancy恶性Benign良性Borderline交界性Histologicaltypes组织学分类Epitheliatumors上皮性肿瘤Germcelltumors生殖细胞肿瘤Sexcordstromaltumors性索间质肿瘤Lipidcelltumor脂质细胞瘤Gonadoblastoma性腺母细胞瘤非卵巢特异性软组织肿瘤No-classifiedtumors未分类肿瘤Metastasestumors转移性肿瘤Tumour-likecondition瘤样病变Clinicalmanifestations临床表现Ovarybenigntumor卵巢良性肿瘤Slow－moving

3、,mostlyasymptomaticinearlierperiod;Compressionsymptommaybefoundwhentumoraugmentation发展缓慢，早期多无症状，肿块增大可出现压迫症状[,eisimptə'mætik]adj.无症状的Ovarymalignancytumor卵巢恶性肿瘤Frequentlyasymptomaticinearlierperiod,OncesymptomsoccurrenceMostinclude:abdominaldistension,abdominalmassandascites早期常无症状，一旦出现常表现为：腹胀﹑腹部肿块和

4、腹水[ə'saiti:z]n.腹水Complications并发症Torsionofpedicle蒂扭转Rupture破裂Infection感染Canceration恶变Diagnosis诊断Ultrasound超声检查Tumormarker肿瘤记标物Abdominoscope腹腔镜检查Radiologicaldiagnosis放射学Cytologicalexamination细胞学Tumormarker肿瘤记标物AFPendodermalsinustumor卵巢内胚窦瘤HCGchoriocarcinoma绒毛膜癌CA125Ovarianepithelialcancer卵巢上皮癌性激素G

5、ranularcellcarcinoma颗粒细胞癌Differentiate良性肿瘤和恶性肿瘤鉴别鉴别内容良性肿瘤恶性肿瘤病史病程长，生长缓慢病程短，迅速增长包块部位及性质单侧多，囊性，光滑，活动双侧多，实性或囊性，不规则，固定，后穹窿性结节或包块腹水征多无常有腹水，可能查到恶性细胞一般情况良好可能消瘦，恶病质B型超声为液性暗区，边界清晰，有间隔光带液性暗区内有杂乱光团、光点，界限不清CA125(>50岁)<35IU/ml>35IU/mlRouteofmetastasis转移途径Directmetastasis直接蔓延Abdominalmetastasis腹腔转移Lymphaticmet

6、astasis淋巴转移Hematogenousmetastasis血行转移[mə'tæstəsis]n.转移FIGOstagingofovarianneoplasmsStageDefinitionIgrowthlimitedtotheovaries肿瘤局限于卵巢Iaoneovaryinvolved局限单侧卵巢Ibbothovaryinvolved局限双侧卵IcⅠaorbwithrupturedcapsule,tumoronthesurfaceofcapsule,positiveperitonealwashingsormalignantascitesⅠa或Ⅰb肿瘤伴以下任何情况：包膜破裂，

7、卵巢表面有肿瘤，腹水或腹腔液中洗液中含有恶性细胞Ⅱextensionoftheneoplasmfromtheovarytothepelvis卵巢肿瘤向盆腔内转移Ⅱaextensiontotheuterusandtubes蔓延到子宫和输卵管Ⅱbextensiontootherpelvictissues蔓延到其他盆腔组织StagedefinitionⅡcⅡaorⅡbwithrupturecapsule,positiveperitonea