口腔頜面腫瘤總論

1、口腔頜面腫瘤總論重點(diǎn)與難點(diǎn)口腔頜面腫瘤的基本概念 良惡性腫瘤的鑒別診斷口腔頜面腫瘤的基本概念定義與命名頭頸解剖分區(qū)良性腫瘤及瘤樣病變惡性腫瘤的病理分級(jí)UICC臨床分類分期臨床流行病學(xué)特點(diǎn)患病率、發(fā)病率及構(gòu)成比口腔頜面腫瘤發(fā)病特點(diǎn) 年輕化，女性發(fā)病上升，發(fā)病部位變化 病理復(fù)雜化 轉(zhuǎn)移性口腔癌 隱匿性癌病因和發(fā)病條件外 因物理因素化學(xué)因素生物因素營(yíng)養(yǎng)因素內(nèi) 因 精神因素內(nèi)分泌因素免疫因素遺傳因素口腔頜面腫瘤的臨床表現(xiàn)良惡性腫瘤的生長(zhǎng)特性良惡性腫瘤的危害口腔頜面良惡性腫瘤的診斷采集病史臨床檢查影像學(xué)檢查組織學(xué)檢查小 結(jié)口腔頜面腫瘤的命名原則口腔頜面良惡性腫瘤的鑒別要點(diǎn)影像學(xué)檢查的地位及適應(yīng)證病理檢查

2、的方法及注意事項(xiàng)復(fù)習(xí)思考題簡(jiǎn)述口腔頜面腫瘤的命名原則、病理分級(jí)的意義以及TNM分類分期良惡性腫瘤的生長(zhǎng)特征與診斷要點(diǎn)試述活組織檢查的主要方法和注意事項(xiàng)各種影像學(xué)診斷的地位及適應(yīng)證參考書(shū)目邱蔚六主編口腔頜面外科理論與實(shí)踐1998年人民衛(wèi)生出版社李樹(shù)玲主編頭頸腫瘤外科學(xué)1993年天津科學(xué)技術(shù)出版社吳奇光主編口腔組織病理學(xué)1994年人民衛(wèi)生出版社Stephen T. Sonis, Principles and Practice of oral medicine, 1995,W.B.Saunders,Philadephia Squamous Cell Carcinoma (SCC) in OMFCan

3、cer is the second cause 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 cancersClinical characteristicsVariety of clinical presentations ulcer, leukoplakia, exophytic formsLocation 38

4、%-lower lip, 22%-tongue, 17%- mouth floor gingiva, palate, tonsil, buccal mucosa, Behavior SCC local invasion and regional metastasis Diagnosis of oral cancerBiopsy, cellular smear, toluidine blue stainingBiopsy offers the most important information leading to diagnosis aspiration (fine needle aspir

5、ation) resection (punch, frozen section)Prognosis of oral cancerDepends on follow factors size, extent, location, nodal involvementResponse (effect) to cancer treatment - 5 years survival rateLower lip 84% (localized-87%, lymph-66%)Overall 5 years survival rates of oral cancer 54%, tongue is worsreS

6、taging of oral cancerStage IT1N0M0Stage IIT2N0M0Stage IIIT3N0M0or any T with N1M0Stage IVAny T with N2/N3Or any T/N withM1T12cm, 2cm T24cm (AJCC, 1995)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%Survival ratesKochi, Japan (1994-2004), 260 casesTotal 5 yrs survival rate is 73.6% T1,2