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1、妇产科课件子宫内膜癌英文Endometriodcancer---ContentsIncidenceRiskfactorsClassificationSymptomsPathologyFIGOStagingDiagnosisTreatmentWHOCancerReportGlobalcancerratescouldincreaseby50%to15millionby2020Endometrialcanceristhe4thmostcommoncancerinwomenNewDiagnosedcases:142,000Diedcaseseachyear:42,00
2、0incidence~2-3%Averageage:60sEndometriumCarcinoma 2009ClassificationStageCharacteristicStageI*TumorconfinedtothecorpusuteriIA*NoorlessthanhalfmyometrialinvasionIB*InvasionequaltoormorethanhalfofthemyometriumStageII*Tumorinvadescervicalstroma,butdoesnotextendbeyondtheuterus**StageIII
3、*Localand/orregionalspreadofthetumorIIIA*Tumorinvadestheserosaofthecorpusuteriand/oradnexae#IIIB*Vaginaland/orparametrialinvolvement#IIIC*Metastasestopelvicand/orpara-aorticlymphnodes#.IIIC1*•PositivepelvicnodesIIIC2*•Positiveparaaorticlymphnodeswithorwithoutpositivepelviclymphnodes
4、StageIV*Tumorinvadesbladderand/orbowelmucosa,and/ordistantmetastasesIVA*Tumorinvasionofbladderand/orbowelmucosaIVB*Distantmetastases,includingintra-abdominalmetastasesand/oringuinallymphnodesStageI(73%)ConfinedtouterusStageII(11%)CervixinvolvedStageIII(13%)Uterineserosa,adnexae,posi
5、tivecytology,vaginalmetastases,pelvic/aorticnodemetastasesStageIV(3%)Bladder,bowel,inguinalnode,distantmetastasisEndometrialCancer:FIGOSurgicalStageEndometrialCancerPrognosis:SurvivalbyStage:Stage%5yrsurvivalIA91IB88IC81IIA77IIB67IIIA60IIIB41IIIC32IVA20IVB5SurvivalbyGrade:Grade%5yrs
6、urvival192287374Overall5YrSurvival84%StageandGradearethemostimportantprognosticfactorsAlteredoncogene/tumorsuppressorgeneexpressionisnowbeingevaluated(molecularstagingconcept)AggressiveHistologicSubtypes(Clear-cell,Serous)Increasingage(over65)VascularinvasionAneuploidyAlteredoncogen
7、e/tumorsuppressorgeneexpression(“molecularstaging”concept-p53,PTEN,microsatelliteinstability,MDR-1,HER2/neu,ER/PR,Ki67,PCNA,CD31,EGF-R,MMRgenes)Race?EndometrialCancer:PoorPrognosticFactorsMolecularGeneticsPTENmutations:32%Tumorsuppressorgene(chrom10)PhosphataseEarlyeventincarcinogen
8、esisAssociatedwith:
