口腔颌面部肿瘤总论口腔颌面肿瘤总论.pptx

,#,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,口腔颌面部肿瘤总论口腔颌面肿瘤总论,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第1页,重点与难点,口腔颌面肿瘤基础概念,良恶性肿瘤判别诊疗,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第2页,口腔颌面肿瘤基础概念,定义与命名,头颈解剖分区,良性肿瘤及瘤样病变,恶性肿瘤病理分级,UICC,临床分类分期,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第3页,临床流行病学特点,患病率、发病率及组成比,口腔颌面肿瘤发病特点,年轻化，女性发病上升，发病部位改变,病理复杂化,转移性口腔癌,隐匿性癌,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第4页,病因和发病条件,外 因,物理原因,化学原因,生物原因,营养原因,内 因,精神原因,内分泌原因,免疫原因,遗传原因,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第5页,口腔颌面肿瘤临床表现,良恶性肿瘤,生长特征,良恶性肿瘤,危害,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第6页,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第7页,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第8页,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第9页,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第10页,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第11页,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第12页,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第13页,口腔颌面良恶性肿瘤诊疗,采集病史,临床检验,影像学检验,组织学检验,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第14页,小 结,口腔颌面肿瘤命名标准,口腔颌面良恶性肿瘤判别关键点,影像学检验地位及适应证,病理检验方法及注意事项,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第15页,复习思索题,简述口腔颌面肿瘤命名标准、病理分级意义以及,TNM,分类分期,良恶性肿瘤生长特征与诊疗关键点,试述活组织检验主要方法和注意事项,各种影像学诊疗地位及适应证,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第16页,参考书目,邱蔚六主编,口腔颌面外科理论与实践,1998,年人民卫生出版社,李树玲主编,头颈肿瘤外科学,1993,年天津科学技术出版社,吴奇光主编,口腔组织病理学,1994,年人民卫生出版社,Stephen T.Sonis,Principles and Practice of oral medicine,1995,W.B.Saunders,Philadephia,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第17页,Squamous Cell Carcinoma(SCC)in OMF,Cancer is the second cause of death,Oral cancer has high morbidity and high mortality,Early detection and treatment can minimize them,More than 90%of oral cancer are SCC,Oral cancer is 3%in all cancers,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第18页,Clinical characteristics,Variety of clinical presentations,ulcer,leukoplakia,exophytic forms,Location,38%-lower lip,22%-tongue,17%-mouth floor,gingiva,palate,tonsil,buccal mucosa,Behavior,SCC,local invasion and regional metastasis,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第19页,Diagnosis of oral cancer,Biopsy,cellular smear,toluidine blue staining,Biopsy offers the most important information leading to diagnosis,aspiration(fine needle aspiration),resection(punch,frozen section),口腔颌面部肿瘤总论口腔颌面肿瘤总论,第20页,Prognosis of oral cancer,Depends on follow factors,size,extent,location,nodal involvement,Response(effect)to cancer treatment,-5 years survival rate,Lower lip 84%(localized-87%,lymph-66%),Overall 5 years survival rates of oral cancer 54%,tongue is worsre,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第21页,Staging of oral cancer,Stage I,T1N0M0,Stage II,T2N0M0,Stage III,T3N0M0,or any T with N1M0,Stage IV,Any T with N2/N3,Or any T/N withM1,T14cm,(AJCC,1995),口腔颌面部肿瘤总论口腔颌面肿瘤总论,第22页,5 years survival rate of oral cancer in USA(1983-1990),Overall 5 year 52.5%,Female 58%,Male 50%,Whites 55%,Blacks 34%,Black(M)28%,Black(F)47%,口腔颌面部肿瘤总论口腔颌面肿瘤总论,第23页,Survival rates,Kochi,Japan (1994-),260 cases,Total 5 yrs survival rate is,73.6%,T1,2 is 81.1%T3 is 73.3%T4 is 55.4%,Average 5 yrs survival in Japan is,65-70%,64.7%in Shanghai(1999),口腔颌面部肿瘤总论口腔颌面肿瘤总论,第24页,