子宫癌（Uterine Cancer）-妇科八年制教学课件.ppt

UterineCancerXi-ShiLiuObstetricsandGynecologyHospitalFudanuniversity2007.04

GeneralDescriptionUterinecancerisoneofthemostcommonmalignancyoffemalegenitaltract.Theincidenceisincreasingworldwideinrecentyears.Overall,2%-3%ofwomendeveloputerinecancerduringtheirlifetime.

GeneralDescriptionAmalignantepithelialdiseasethatoccursinendometrialglandofuterusAlsocalledendometrialcancer

Classification

(pathogenetic,biologicbehavior)Estrogendependenttypehaveahistoryofexposuretounopposedestrogen(eitherendogenousorexogenous).HyperplasticendometriumBetterdifferentiafedER(+),PR(+)Merefavorableprognesis

Estrogenindependenttype--Havenosourceofestrogenstimulationofendometrium.--Arisinginbackgroundofatrophicendemetrium--Lessdifferentiated--ER(-)PR(-)--Poorprognosis

RiskFactors1.Medicalconditionsa.Diabetesmellitus,hypertension.b.Overweight---obesity(excessestrogenasaresultofperipheralconversionofadrenallyderivedandrostenedionebyaromatizationinfat).c.Latemenopause.

RiskFactors2.Somegynecologicdiseases(Long-termendogenousestrogenexposure)-polycysticovarysyndrome-functioningovariantumors-anovulatingdysfunctionalbleeding-Infertility,Nulliparity.

RiskFactors3.ProlongedUseofestrogena.Prolongedmenopausalestrogenreplacementtherapywithoutprogestogen.b.Prolongeduseoftheantiestrogentamoxifenforbreastcancer.

RiskFactors4.Geneticfactorsandotherfactorsa.Endometrialandovariancancerarethesimultaneouslyoccurringwithothergenitalmalignancy,reportedincidence(1.4~3.8%).b.Familyhistoryoftumorishigher.(12-28%)

FivehistologicalsubtypesEndometrioidadenocarcinomaMucinouscarcinomaSerousadenocarcinomaClearcellcarcinomaOtherraresubtypes

Fivehistologicalsubtypes

--EndometrioidAdenocarcinomaAccountforabout80~90%.Welldifferentiated.Prognosisisbetter.

Fivehistologicalsubtypes

--Mucinouscarcinoma