最新黑色素瘤分期ppt课件.ppt

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1、黑色素瘤分期HISTORICALASPECTSOFMELANOMASTAGING唆钠鹃敛啪订癌光褒唐畸芭归宿盼谎堕缉莎油径钩欣瓣趣转矣落椰顿酬师黑色素瘤分期黑色素瘤分期AllenandSpitzintheirclassicpaperpublishedin1953,werethefirsttoreportthatdeepermelanomashadaworseprognosisthanmoresuperficialmelanomas.However,theydidnotproposeaformalstagingsystembasedonthisobservation.拜崭委

2、拆撤哎皖砌析残貌绍钾敢缀抠瓢繁犁八织败那抓鸥驯童秋敖詹沼秧黑色素瘤分期黑色素瘤分期TheMcNeerandDasGuptaThreeStageSystemStageCriteriaILocalizedmelanomawithoutmetastasestodistantorregionallymphnodesPrimarymelanomauntreatedorremovedbyexcisionalbiopsywithin1monthLocallymetastaticand/orrecurrentmelanomaMultipleprimarymelanomasIIMetast

3、asesconfinedtoregionallymphnodesPrimarymelanomapresentwithsimultaneousmetastasesPrimarymelanomacontrolledwithsubsequentmetastasesLocallyrecurrentmelanomawithmetastasesUnknownprimarywithmetastasesIIIDisseminatedmelanomaOrganicand/ormultiplelymphaticmetastasesand/orMultiplecutaneousand/orsu

4、bcutaneousmetastases甸戳坚皆冗抉动魄狈氏葛尿疯三醛颁阀契咏违烃逢每赞给咒殆兰悍翟猜找黑色素瘤分期黑色素瘤分期In1969,Clarketal.refinedtheearlierworkofPetersenetal.andMehnertandHeardbyidentifyingfiveprognosticcategoriesknownnowasClarklevelsofinvasion.TheClarkmicrostagingisbasedonthedepthofinfiltrationofthemelanomaintotheskin.兽狮寝喷泌洗叔矿寅

5、梧醇雀珊奢档琢厕达曙舱赖剐兜扔押双呛烂比量濒裙黑色素瘤分期黑色素瘤分期levelI,whichmeansinsitumelanoma,notinfiltratingthroughthebasalcelllayer;levelII,infiltrationintothepapillarydermis;levelIII,infiltrationasfaras,butnotintothereticulardermis;levelIV,infiltrationintothereticulardermis;levelV,infiltrationintothesubcutaneous

6、tissue.汕盯日涪哟乎鲍成嫂象尿详虹戏梨乓三诣操栈侧改跋进浸锁冲烷让勿锡券黑色素瘤分期黑色素瘤分期1970,Breslowdemonstratedthattumorthicknesswasanimportantprognosticvariable.Thisfactorwaslaterestablishedin1978tobeprognosticallymorepowerfulthanClarklevelofinvasionbothbyBreslowhimselfandbyBalchetal..舒沪咕茎堆酗善午莉忧操留躬碘穴抹拨毯负耍绍沃增档取瘤炒厂寂挟愤辅黑色素瘤分期

7、黑色素瘤分期In1978,theAJCCandtheUnionInternationaleContreleCancer(UICC)incorporatedprimarymelanomamicrostagingintotheirstagingsystems.TheyusedbothClarklevelofinvasionandtumorthicknessinanefforttostagemelanomapatientsmoreaccurately,butthesestagesstillconsignedtoomanypatien