惡性黑色素瘤PPT課件演示文稿目前一頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)惡性黑色素瘤PPT課件目前二頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)Whatismalignantmelanoma?Malignantmelanoma,alsoknownasmelanoma,istheoriginofepidermalmelanocyteornevusofmalignanttumors.

Thediseasecanbeseenatanyage,moreseeninmiddle-agedandolder,womenslightlymorethanmen.

目前三頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)MelanomatriggersandcausesAirpollutionTopursuebeautyThelackofmedicineknowledgeImmunedeficiencyAbusingtheestrogendrugsMalignanttransformationofblackmoleRacialgeneticfactorsTraumaandchronicstimulationfactors

目前四頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)AirpollutionHarmfulultravioletlightandsomeharmfulmaterialintheairmakeadifferenceofhumanskin,causingmelanocyteabnormalexpression,triggermelanoma.

目前五頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)

Manypeopleinordertopursuethecleanskintousechemical

cosmetics,skinpollutioncausedbychemical,evensomeonewithchemicalmordantpurifyskinamole,stimulatestheexcessiveproliferationmelanocyte.Topursuebeauty目前六頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)RacialgeneticfactorsMalignantmelanomaoccurinthewhiterace.Fortheincidenceofworldeachyeartolessthan1~2/10million,butAustralia'sQueenslandannualincidenceof16/10millionpopulation,itistheworld‘sleadinghighincidenceofmalignantmelanoma.AfricaandAsianpeoplerarelyhavethesickness.目前七頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)PrimarysitesMalignantmelanoma90%occursintheskin,themostcommonintheback,metal-studded,leg,foot,toe,nailbed,scalpandsoon;afewoccursinvulvae,digestivetractandeyes.目前八頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)Eyelesions

andOrallesions脈絡(luò)膜黑色素瘤口腔黑色素瘤目前九頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)◆Generallyspeakingmolessurfaceissmooth,melanomaofsurfaceiscoarser.Ifthesurfaceissmooth,andsuddenlybecomescoarseor,weshouldpayattentiontoit.

Clinicalcharacteristics

目前十頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)◆Ulcerationnotonlyisoneoftheimportantmelanomaclinicalmanifestationswhichisdifferentfrommole,butalsohasthemeaningofprognosisthannoulcer.◆Patientsofmalignantmelanomagenerallyaretheold;theyouthorchildrenmelanomaarerare.目前十一頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)EarlyclinicalperformanceColor:amoleincreaseinsize,pigmentordarkerorlighter,amoledeepen,shiny,appearcolorchanged.Edge:amoletoradiateoutinmolesexpansion,appeararoundunevenindentedchange;becomeirregularorappearsatelliteformsmallamole,orseveralbirthmarkfusion,thesurfaceconcavo-convexinequality.Surface:rough;Oftencoarseandaccompaniedbyscaleformorflakedesquamation.Sometimeshavethedrainageoroozeblood,higherlesionscanface.目前十二頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)Lesionssurroundingskin:canappearedemaorloseskinglossorbecomewhite,gray.Kakesthesia:amolewithoutitchingordiscomfortpain.regionallymphnodeenlargement,faintlyvisibleblue-black

.早期臨床表現(xiàn)目前十三頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)Late-stageclinicalmanifestations＊Specialtype：asmallnodularlesionsite,theboundaryclear,nocoated,tan-whiteorgrey-blue,qualityofamaterialissolid.＊

Frecklestype:morefromtheprimarylesionsmalignantfreckles;surfacewasflat;theedgegreatirregularity;theepidermisoftumorblockwithfrecklessamples,thistypeoftenoccuronelderlyfacialfreckleslesions,whichisrelativelyrare.

目前十四頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)＊Spreadtype:itsappearanceisshalloweczemakind,anditsjaggededgeisirregular,withblack,greyandpinkdisorderlycoloronthesurface.

＊Nodulartype:tumornodulesareoutoftheskinsurface;thecolorisdarkbrown,grayredandrarelycolorless.Bumpsurfaceisshownmorecauliflowershape,polypoidorbacteriashape,oftenhappenulcers.目前十五頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)PathologicaltypeSuperficialexpandabletype:about70%,itisvisibleatsurfaceanywhere;goalongthesurfacetoexpand,andthenexpandtothedepth,calledthe"verticaldevelopment".

目前十六頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)nodulartype:about15%,verticaldevelopment;penetratetosubcutaneoustissue;pronetolymphnodemetastases;evenmoredeadly.目前十七頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)Ephelidestype:about5%,itprimaryoccurinoldpeoplefacialskinwhereblackfreckleslongstand;thistypedohorizontalgrowthandenlarge2cm~3cmormorearound.目前十八頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)Extremityblackmoletype:about10%thathappensatpalms,foot,nailbedandmucousmembranes.目前十九頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)Treatment☆Surgicaltreatment:earlycircumscribedprimaryfocishouldbecarriedoutextensively;thescopeshouldbeapartfromtheprimaryfoci3～

5cm;theprimaryfocishouldbeexcisedtosubcutaneoustissueandmusclemembrane;whentouchthelymphnodeenlargement,generallyspeakingshouldmakelymphnodeclean;aftertheoperation,adjuvantchemotherapyandimmunetherapyisnecessary

.目前二十頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)☆Biologicalimmunetherapy:biologicalimmunetherapyviathevariousbiologicalagentsandbiotechnologymeanstoenhanceimmunityandanti-cancerabilitytosuppressandkillcancercells;atpresent,immunecellssuchasDCcells,CIKcellhaveappliedtoclinicaltherapy,whichgainsgoodeffects;biologicalimmunetherapyisthemosteffective,securityadjuvanttherapies.人類黑色素瘤抗原目前二十一頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)Radiotherapy:Inadditiontosomeveryearlyfrecklestypeofmalignantmelanomaareeffective,otherprimaryfocigenerallyhavepoorcurativeeffect.Sowedidnotuseradiationtherapytocuretheprimaryfoci,andmetastasisadoptradiotherapy.目前二十二頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)☆Endocrinetherapy:

anti-estrogendrugsmakesomecasesevenotherdrugtreatmentfailurecasesgetcurativeeffect,andmaketheillnesstoalleviate.目前二十三頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)☆Chemicaltreatment:

⒈Singledrug:

⑴)亞硝脲類藥物:havecertaineffectofmelanoma.⑵氮烯咪胺(DTIC):DTIChasmadethetreatmentofmelanomaforwardonestep,becomethemostwidelyuseddrugs.Eachdosefor350mg/m2,repeat6days,28daysforoneperiodoftreatment,efficientrateis35%.

目前二十四頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)⒉Combination:combinationcanimprovetheefficient,reducetoxicityreaction.⑴DAVcase(DTIc、ACNu、VCR):thefirstchoiceformelanomachemotherapyregimens.

Thepreparationmethod:DTIcloo~200mg,5ACNUl00mgivd1VCR2mgivd1~21days,eachivd1repeated1time.

目前二十五頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)⑵DDBTcase(DTIC、DDP、BCNU、TAM)

Method:DTIC220mg/m2,I.V.d1~3/3w,DDP25mg/m2,i.v.gttd1~3w,BCNUl50mg/m2,I.V.d1/6w,TAM10mgPO,2/d.Efficientrateis52.5%.⑶CBDcase(CCNU、BLM、DDP)

Method:CCNU80mg/m2,oral,d1/6w,BLMl5u/m2,I.V.d3~7/6w,DDP40mg/m2,I.V.d8/6w.Efficientrateis48%.

目前二十六頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)2010melanomafieldprogressreview

melanomatreatmentfinallyusherasilverlining

﹡ResistancetoCTLA-4singleresistanceagainstgeneticmutationsand(B-RAFandC-KIT)smallmoleculartargeteddrugs,whichprolongthesurvivalofadvancedmelanomapatientsandachieveremarkablebreakthrough.Itispossibleforthetreatmentofadvancedmelanomapatientsbringthoroughrevolution.目前二十七頁(yè)\總數(shù)二十九頁(yè)\編于八點(diǎn)﹡