UNG TH THANH QUAN

PGS TS LM HUYN TRN BM TMH HYD TP HCM

MC TIU
Bit

cch phn tng thanh qun v mt bnh hc. Chn on c ung th thanh qun Bit cch phn loi TNM theo UICC Hiu vai tr ca tuyn truyn phng v pht hin sm

AI CNG
. 2% / toan bo K . 20-30% K au mat co . ng th 2 sau K vom . 80% nam . 45-70 tuoi

Nhac lai giai phau

V phng din bnh hc

Thanh qun c chia lm 3 tng: Thng thanh mn Thanh mn H thanh mn

V phng din bnh hc khi nim b ming ging ca thanh qun

Hnh nh ni soi thanh qun

Sn thanh thit

Bng thanh tht Thanh tht Morgagni Dy thanh

Sn kh qun
Sn phu

3 tang thanh quan

Nguyen nhan- yu t thun li

. Thuoc la . 98% bn K TQ co hut thuoc la . Thuoc la + ru= tang nguy c
. Thng tn mn tnh : Bach san, sng hoa, papilloma, viem thanh quan mt,

Trieu chng c nng

Khan tieng: K thanh mon Kho th: K ha thanh mon Kho nuot: K b thanh thanh quan au len tai: K thanh thiet, xoang le.

Khc m c ln mu, hi: khi u hoi t

TRIU CHNG THC TH

NHN: hnh dng sn gip S nn bn ngoi : di ng mm mi ca thanh qun Du lc cc thanh qun ct sng Khoang gip mng thanh thit S trong hng vng y li, Khm hch c SOI THANH QUN GIN TIP : SOI THANH QUN TRC TIP

Phng tien chan oan

Kham TQ bang gng

Noi soi thanh quan

-ong soi mem -ong soi cng

Si dy thanh : K dy thanh

Si mu sau dy thanh

Si ng 3 ba np

Soi thanh quan trc tiep

Viphau thanh quan

Knh hien vi

Cac nhom hach

NHNG BILAN CN LM
NI SOI TON TH : SINH THIT: HNH NH HC: CT, MRI BILAN DI CN : gan, phi, xng BILAN TRC IU TR: BILAN DINH DNG

NI SOI TON TH
Soi thanh qun trc tip Soi thc qun Soi kh ph qun Soi vm, hng ming

SINH THIT - Giai phau benh

. Squamous cell carcinoma -keratinizing ( well- differentiated) -nonkeratinizing (poorly differentiated) . Adenocarcinoma: . Sarcoma rat hiem.

Computed tomography

MRI
(magnetic resonnace imaging)

Chan oan phan biet

1. papillome 2. Tuberculose 3. Angiome 4. polype BIOPSIE

PHAN LOAI TNM

T: the primary tumor N: the regional lymph nodes M: the distant metastasis

T ( khi u )
T1 : ung th ch gii hn 1 vng gii phu T2: ung th lan ra nhiu vng nhng cn khu tr trong lng thanh qun. T3: ung th lm c nh 1 na thanh qun T4 :ung th ph hu sn lan ra ngoi thanh qun

KHAM HACH CO

Hach di cam Hach di ham

Hach trc kh quan Hach canh kh quan Hach day canh di VI

Hach day canh tren

Hach day canh gia

Hach day gai Tam giac co sau

N ( hch )
N0: khng c hch N1: hch cng bn <=3cm. N2 :hch c kch thc 3-6cm. N2a: 1 hch cng bn 3-6cm. N2b: nhiu hch cng bn 3-6cm. N2c : hch bn i dn hoc hch c 2 bn N3: hch >=6cm.

M( DI CN )
M0:

khng c di cn xa M1: c di cn xa Mx: cha xc nh c

Phan loai theo giai oan

Theo UICC (Union Internationale Contre le Cancer) va AJC (American Joint Committee) . G 0: Tis N0 M0 . G I: T1 N0 M0 . G II: T2 N0 M0 . G III: T3 N0 M0 T1,T2,T3 N1 M0 . G IV: T4 N0,N1 M0 any T N2, N3 M0 any T any N M1

CAC PHNG PHAP IEU TR UNG TH THANH QUAN

1. Phau thuat: 2. Laser CO2 2. Xa tr: 50-55grays trong 7-8 tuan 3. Hoa tr: cysplatine+ 5fluoro-uracile

Tien lng

g sm (g I, II): tien lng tot. G muon (g III,IV): tien lng xau.

PHNG BNH : tuyn truyn v pht hin bnh sm

Khn ting ko di > 2 tun : phi soi thanh qun Nghi ng : phi sinh thit gii phu bnh