妇产科精品课件-子宫肿瘤（英文）.ppt

Uterine Cancer Xi-Shi Liu Obstetrics and Gynecology Hospital Fudan university 2009.09 General Description Uterine cancer is one of the most common malignancy of female genital tract. The incidence is increasing worldwide in recent years. Overall,2%-3% of women develop uterine cancer during their lifetime. General Description A malignant epithelial disease that occurs in endometrial gland of uterus Also called endometrial cancer Classification(pathogenetic,biologic behavior ) Estrogen dependent type have a history of exposure to unopposed estrogen (either endogenous or exogenous). Hyperplastic endometrium Better differentiafed ER(+),PR(+) Mere favorable prognesis Estrogen independent type -- Have no source of estrogen stimulation of endometrium. --Arising in background of atrophic endemetrium --Less differentiated --ER(-)PR(-) --Poor prognosis Risk Factors 1. Medical conditions a. Diabetes mellitus, hypertension. b. Overweight---obesity (excess estrogen as a result of peripheral conversion of adrenally derived androstenedione by aromatization in fat). c. Late menopause. Risk Factors 2. Some gynecologic diseases ( Long-term endogenous estrogen exposure ) - polycystic ovary syndrome - functioning ovarian tumors - anovulating dysfunctional bleeding - Infertility, Nulliparity. Risk Factors 3. Prolonged Use of estrogen a. Prolonged menopausal estrogen replacement therapy without progestogen. b. Prolonged use of the antiestrogen tamoxifen for breast cancer. Risk Factors 4. Genetic factors and other factors a. Endometrial and ovarian cancer are the simultaneously occurring with other genital malignancy ,reported incidence (1.4~3.8%). b. Family history of tumor is higher.(12-28%) Five histological subtypes Endometrioid adenocarcinoma Mucinous carcinoma Serous adenocarcinoma Clear cell carcinoma Other rare subtypes Five histological subtypes--Endometrioid Adenocarcinoma Account for about 80~90%. Well differentiated.