子宫内膜癌专题知识.ppt

子宫内膜癌专题知识

corpusuteri子宫体cervix子宫颈StructureofuterusendometriummyometriumSerouslayer

Prevalencefourthmostmalignancyinwomen（女性恶性肿瘤中第四位）ranksthirdinthemalignanttumorsoffemalereproductivesystem（女性生殖系统恶性肿瘤中第3位）

Epidemiology55-69years75%postmenopausal绝经后25%pre-menopausal绝经前(5%40years)

Riskfactors*unopposedestrogenexposureendogenous~ovariangranulosacelltumorexogenous~estrogentreatment*obesityhypertensionendometrialcancertriaddiabetes子宫内膜癌三联症*anovulationcycles无排卵月经

DaysProliferativephasesecretoryphasemenseovaryendometriumestrogenestrogen/progestroneovulationEffectofestrogen/progesteronefunctionuponendometrium

EndometrialHyperplasia

andEndometrialCancerSimplehyperplasiawithnuclearatypiawithout~Complexhyperplasiawithnuclearatypiawithout~

SimplehyperplasiaComplexhyperplasia

单纯增生过长复杂性增生过长

NuclearAtypia(核异型性）Nuclearenlargement核增大Increaseinnuclear/cytoplasmratio核/浆百分比增大Prominentnucleoli核仁明显Coarseabundantchromatin染色体粗大

RiskofHyperplasiato

EndometrialCarcinoma____________________________________________TypesofHyperplasiaProgressingtoCancer(%)__________________________________________Simple(cystic)withoutatypia1Complex(adenomatous)withoutatypia3Simplewithatypia8Complexwithatypia29___________________________________________hyperplasiawithnuclearatypiaisconsideredthepre-malignantdiseases

Pathology

DiffuselesionsFocallesion

Histologicaltypes

typeIestrogen-dependentEndometrioidadenocarcinoma（宫内膜样腺癌）80~90%,G1typeIIestrogen-independenth