子宫肿瘤-妇产科课件

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1、Carcinomaoftheuterus子宫肿瘤DepartmentofObstetricsandGynecology妇产科ZhangWei张蔚Endometrialcarcinoma子宫内膜癌Cervicaltumors宫颈肿瘤Cervicalintraepithelialneoplasia(CIN)宫颈上皮内瘤样变Cervicalcancer宫颈癌Carcinomaoftheuterus子宫肿瘤Cervicalintraepithelialneoplasia(CIN)宫颈上皮内瘤样变Definition：Cervicalintraepit

2、helialneoplasia(CIN)isapremalignantconditionofthecervix.Itisusuallyasymptomaticandisdetectedbyroutinecytologicalscreening.ThedegreeofseverityisgradedCINⅠ、ⅡtoCINⅢ定义:宫颈上皮内瘤样变是宫颈组织的癌前病变。一般没有症状,通常在常规的细胞学筛查时发现。根据严重程度分为CINⅠ、CINⅡ、CINⅢTBStypesatypicalsquamouscells(ASC)不典型鳞状上皮Low-gr

3、adesquamousintraepitheliallesion(LSIL)轻度鳞状上皮内病变High-gradesquamousintraepitheliallesion(HSIL)重度鳞状上皮内病变AetiologyTheareaofpreviouslyexposedcolumnarepitheliumthatundergoessquamousmetaplasiaisknownasthetransformationzone(TZ)病因学原始鳞柱交接部和生理鳞柱交接部间的区域称为移行带Itisthepredilectionsiteofcer

4、vicalcarcinoma移行带为宫颈癌好发部位Ectropionandtransformationofthetransformationzone移行带区的外翻和转化transformationmechanism转化机制squamousmetaplasia鳞状上皮化生squamousepithelization鳞状上皮化TheriskfactorsforCINandcervicalcarcinomaCIN和宫颈肿瘤的危险因素Youngageatfirstintercourse初次性生活的年龄过小Numberofsexualpartners性

5、伙伴的数目Smoking吸烟Pooruptakeofscreeningprogramme筛查过少Long-termuseofthecontraceptivepill长期服用避孕药Exposuretotumorpromotershasagreaterinfluenceonimmaturecells不成熟的细胞暴露于致癌因素会对其产生很大的影响Increasestheriskofcervicalcancerfour-fold;theriskremainselevatedinex-smokers吸烟的妇女患宫颈癌的危险性会提高4倍；曾经吸烟的妇女患

6、宫颈癌的危险性仍然存在Pilltakersdonotnecessarilyusebarriermethods-increasingexposuretoseminalfluids服用药物而没有使用屏障的方法，会增加精液的刺激Male-relatedriskfactors与男性相关的危险因素Thenumberofthepartner'sprevioussexualrelationshipsisrelevant与以前性伙伴的数目有关Cervicalcancerriskincreasedifpartnerhaspenilecancer性伙伴患阴茎癌会

7、增加患宫颈癌的危险性Cervicalcancerriskincreasedifpartner’sprevioussexualcontacthadcervicalcancer性伙伴的前性伴患宫颈癌也会增加患宫颈癌的危险性Immunosuppressant免疫抑制Riskincreasedwithimmunesuppressedrenaltransplantpatients,andinHIV-positivewomen免疫抑制、肾移植、HIV阳性妇女患宫颈癌危险性增加HPVinfectionHPV感染Mainlysubtype16主要是16型Sc

8、reeningforCINisbasedonacervicalsmear-samplingsurfacecellsfromthecervixwithaspatula