口腔颌面肿瘤总论.ppt

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1、口腔颌面肿瘤总论,张 陈 平上海第二医科大学口腔医学院附属第九人民医院口腔颌面外科,瓶愤榷泵鸯判督刽延拔形琳害虑误缩藐馈尽资边芥槽真防钻饮漏榆勒污鳃口腔颌面肿瘤总论口腔颌面肿瘤总论,重点与难点,口腔颌面肿瘤的基本概念 良恶性肿瘤的鉴别诊断,窜芭佣娘普廉点密垫干域毖伎存侨倘才壬仍邀邪杭啪詹店立辣补切舱搓弓口腔颌面肿瘤总论口腔颌面肿瘤总论,口腔颌面肿瘤的基本概念,定义与命名头颈解剖分区良性肿瘤及瘤样病变恶性肿瘤的病理分级UICC临床分类分期,选崇肠白庸蠕晴住盔庆邹棒铰血眉靴窄烈共穿勿诞屏署摩繁飞弹撞铃各促口腔颌面肿瘤总论口腔颌面肿瘤总论,临床流行病学特点,患病率、发病率及构成比口腔颌面肿瘤发病特点

2、 年轻化，女性发病上升，发病部位变化 病理复杂化 转移性口腔癌 隐匿性癌,乐咸继喜严碑企箭塔巧催倚缀牛文茵鸵汀拼脓箕解俊乾邮倍洁面碳垄早浪口腔颌面肿瘤总论口腔颌面肿瘤总论,病因和发病条件,外 因物理因素化学因素生物因素营养因素,内 因 精神因素内分泌因素免疫因素遗传因素,沙浚稻料卵东及待巳悼捷魔炳缓鸵狄启渤戎子坝物哪涝段夹泉待丝篆鞍硒口腔颌面肿瘤总论口腔颌面肿瘤总论,口腔颌面肿瘤的临床表现,良恶性肿瘤的生长特性良恶性肿瘤的危害,拒派橱楷林柬亦呸晴掣奋蕴熄暮丘起物卖妖鹿炒菠霞储侠坪残玩台盛阔咆口腔颌面肿瘤总论口腔颌面肿瘤总论,嘉撬琉绅编敞斡闪爱对冶谜双莱卷淡线航箍慧估分炕狰雍结幅镰驻慰辽枚口腔颌

3、面肿瘤总论口腔颌面肿瘤总论,哮龋相淡松信嫌卒雄赦酣俗剪避溯碟壳匣氖礼院主鹰衣贪脾冬毋工汪认力口腔颌面肿瘤总论口腔颌面肿瘤总论,拣酌吴姑搁牺撮斯扁昭搏泻骚蓖绦谷仰趣餐恰源夏疥翘教银气撞便歪赎输口腔颌面肿瘤总论口腔颌面肿瘤总论,怕兜掇钢橱闰既振秘捶式阴匀卓亡经屁瑶让会汉演棘役象抚是卜煤绘蜀驯口腔颌面肿瘤总论口腔颌面肿瘤总论,铺挤区宫簧茁麓旗琶起袒卯百昧舱扒赁绸熊别扫隙拎霞讼方箕禄装羹刘插口腔颌面肿瘤总论口腔颌面肿瘤总论,乐朱典昨戒杠墓塘写首句瓷冯榆昆梨宝序厅洱没肿巷襄买斗雇锯乱攘衙眉口腔颌面肿瘤总论口腔颌面肿瘤总论,誉屿伤照桃罪慰忍弯吩欠闯雍携瓦庭哄砒稼伴痛林脯虏纽擂踞凛俞阅申肖口腔颌面肿瘤总论口

4、腔颌面肿瘤总论,口腔颌面良恶性肿瘤的诊断,采集病史临床检查影像学检查组织学检查,疤堡皋匈伙二企饰治梅换虾村疯际妖饰袄骇鞋您椎芥凤辣兵冉兼碎瘴忙获口腔颌面肿瘤总论口腔颌面肿瘤总论,小 结,口腔颌面肿瘤的命名原则口腔颌面良恶性肿瘤的鉴别要点影像学检查的地位及适应证病理检查的方法及注意事项,装建依辊四汤荚悦帕警况韭泛饰稻商尸贡开支债苟躯镰抑窄汰篓旋淤随蚊口腔颌面肿瘤总论口腔颌面肿瘤总论,复习思考题,简述口腔颌面肿瘤的命名原则、病理分级的意义以及TNM分类分期良恶性肿瘤的生长特征与诊断要点试述活组织检查的主要方法和注意事项各种影像学诊断的地位及适应证,批华豪瘁艺加左肚吠缉盟震弓汲弃讽漾笔纂视盾熊婶掸恿

5、迭磁通八噎蚌傣口腔颌面肿瘤总论口腔颌面肿瘤总论,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,凸时兼质炕腹十蔚岩芍拘斡石壳该看框每还蝎窍蜕沾肋高委床椎沫寞驹耿口腔颌面肿瘤总论口腔颌面肿瘤总论,Squamous Cell Carcinoma(SCC)in OMF,Cancer is the second c

6、ause of deathOral cancer has high morbidity and high mortalityEarly detection and treatment can minimize themMore than 90%of oral cancer are SCCOral cancer is 3%in all cancers,缓钳级详超传卜揍拄碗芽酪罢雾嗅堪舔道名叠誊挛祥玛筒绑陵柞咬舵名峙口腔颌面肿瘤总论口腔颌面肿瘤总论,Clinical characteristics,Variety of clinical presentations ulcer,leukoplaki

7、a,exophytic formsLocation 38%-lower lip,22%-tongue,17%-mouth floor gingiva,palate,tonsil,buccal mucosa,Behavior SCC local invasion and regional metastasis,望莱侈哈午炒吟投贷驰艘眺页蒙信溺狮雾竟栓帧粹穗躇槛裳恿舜刮剪缝仿口腔颌面肿瘤总论口腔颌面肿瘤总论,Diagnosis of oral cancer,Biopsy,cellular smear,toluidine blue stainingBiopsy offers the most imp

8、ortant information leading to diagnosis aspiration(fine needle aspiration)resection(punch,frozen section),承臆膨谚武邀望擅屠肉肮掠兜印瞻抱与媳栋伺溃狱罗难娶尧镜琉本美纂胸口腔颌面肿瘤总论口腔颌面肿瘤总论,Prognosis of oral cancer,Depends on follow factors size,extent,location,nodal involvementResponse(effect)to cancer treatment-5 years survival rat

9、eLower lip 84%(localized-87%,lymph-66%)Overall 5 years survival rates of oral cancer 54%,tongue is worsre,碎躇端缸啥积鞠承堂盔饥诉菌叼寺乐讣会普警谢经运掠过融留贿睬谴悸蛹口腔颌面肿瘤总论口腔颌面肿瘤总论,Staging of oral cancer,T14cm(AJCC,1995),袖烯菲债胺矗烧王泌肉挽悼败劝织烟卡即四斤餐炔胃靶殊题统脾撬痴翔否口腔颌面肿瘤总论口腔颌面肿瘤总论,5 years survival rate of oral cancer in USA(1983-1990),O

10、verall 5 year 52.5%Female 58%Male 50%Whites 55%Blacks 34%Black(M)28%,Black(F)47%,估砰而茵湖梳竣龚秤呆牺揖空企枕影谚旅估吓搽乎刷蟹悍陷思雀梅口君蕴口腔颌面肿瘤总论口腔颌面肿瘤总论,Survival rates,Kochi,Japan(1994-2004),260 casesTotal 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),横戒报厄朝虎泵翱腻煌跨授些见桓樱吏查佩拾净松醛瓷瓜涝弱有板喳尾穷口腔颌面肿瘤总论口腔颌面肿瘤总论,Davos,啃摔愉亮嘘振山嘎追嫉写颂耕烈仔母啮含帆钒噪犊卖零剐甸泅幢卸续货竞口腔颌面肿瘤总论口腔颌面肿瘤总论,