2010 11 20 ( ) 09:50

http://www.hudong.com/wiki

-
1
2
3
4

5
6

[2]

B CT

1 4cm

3
4

5
2

6
7

9(36 )B (SPECT)

36 1

1
1

2
1
2
3
3
4
5

6
7

8
9[3]


http://baike.baidu.com/view/135778.htm

benign tumor

B CT

benign tumor

malignant tumor

91

"
"

""


"
"

""

1. 4cm

2.

3.
4.

5.
2
6.
7.

8.

9.(36 )B (SPECT)

36 1

1?
1
?
2

3
?

4
2?
1?
2?
3
3
4
5

6
7
8
9

3cm

()
()

(1);
(2)
;

(3)

(1)
(2)
3738
(3)

(4)

1%27%

25%30%
40%50%
30%35%

cancermalignant neoplasm

invasion

DNA

DNA
5

carcinoma
CelsuscarcinosCancer
oncos

oncology
19 20 [5]
1170

yn 1950 ]
i
1961
i

gm

sarcoma
lymphomaleukemia
mesothelioma
glioma

germinoma
choriocarcinoma

Solid tumor[3]

=+
=++
-oma
[12]
leiomyoma-oma
neuroblastomalymphoma melanoma

ductal carcinoma of the breast mammary ductal carcinoma

hepatocarcinoma
liposarcoma

oncos
swelling carcinos

carcinos


humor
theory

16 17
Wilhelm Fabry

Francois de la Boe Sylvius

Nicolaes Tulp

18

Alexander Monro 60 2
19 asepsis
19
William Coley

19

20

DNA

Sticker's sarcoma


carcinogenesis DNA

tumor suppressor genes

mitogens

DNA
DNA
DNA DNA
p53
p53

p53
p53 p53

SCO2 SCO2Synthesis of Cytochrome c

p53

Oxidase 2 c
p53

SCO2 p53

DNA DNA

Knudson two-hit hypothesis

DNA

(haploinsufficiency)

gain-of-function mutations
loss-of-function mutations

dominant negative effect p53

p53
- Li-Fraumeni syndrome
Retinoblastoma proteinRb
APC adenomatous polyposis coli
BRCA1 BRCA2
DNA






DNA

Philadelphia chromosome

DNA DNA DNA

DNA

15% human papillomavirus

[32] B T human T-lymphotropic
virus
[33] acutely-transforming
slowly-transforming viral-oncogenevonc

prognosis p53

[25]

immortalitization

contact inhibition

clonal evolution DNA

23

DNA

sporadic
:
BRCA1 BRCA2
multiple endocrine neoplasia1 2a 2b

p53
soft-tissue sarcoma
Gardner Syndrome
APC

hyperplasia
dysplasia

carcinoma in situin situ

progression

1775 Percivall Pott

1926 -Janet Lane-Claypon

500 500
Richard Doll
Austin Bradford Hill 1956

British doctors study1968 London

Medical Research Center

50

cancer incidence
50 X

1 25%
0.5%

()

epidemiologic transition
1

(33%)
(13%)
(10%)
(7%)
(5%)

(31%)
(10%)
(10%)
(5%)
(4%)

(32%)
(12%)
(11%)
(6%)

(4%)

(27%)
(15%)
(10%)
(6%)
(6%)

ALLAcute Lymphoblastic Leukemia
neuroblastoma Wilms' tumor
rhabdomyosarcoma retinoblastoma
osteosarcoma Ewing's sarcoma

80%

20% 10%

CARET study
80 90 - 80,000

DNA DNA

Tamoxifen
Tamoxifen estrogen receptor
1977
(FDA) 20

50%

cis-retinoic acid

primary head and

neck cancer

Finasteride 5-
5-alpha-reductase inhibitor
COX-2 proinflammatory

: hepatomegaly

:

[3]

differential diagnosis

cytogenetics

(American Joint Committee on

CancerAJCC)

TNM
(clinical stagingcTNM) (surgical stagingsTNM)
(pathological stagingpTNM)TNM


(International Union Against CancerUICC)
TNM
T Tumor Developement
TX
T0
Tis
T1-T4
N Nymph Affect
NX
N0
N1-N3
M Migration
MX
M0
M1


IA
T1
IB
T2
IIA T1
IIB T2
T3
IIIA T3
T1-3
IIIB T4
T
IV
T

N0
N0
N1
N1
N0
N1
N2
N0-2
N3
N

M0
M0
M0
M0
M0
M0
M0
M0
M0
M1

cancer screening

false positive

fecal occult blood testingcolonoscopy

pre-malignant polyps

15
testicular self-examinationtesticular cancer
digital rectal exam

overdiagnosis

incontinence


incidentaloma

mastectomy prostatectomy

primary tumorstaging

adjuvant therapy
palliative treatment


DNA

Total Body
Irradiation

peripheral blood stem cell
autologous transplantation

T (CTL)


2005
16 18 HPV type 1618

Herceptintrastuzumab mylotarggemtuzumab ozogamicin

intravesical BCG immunotherapy
superficial bladder cancer

interleukin
renal cell carcinoma

(dendritic cell)
T (helper T cell)
T (CTL)

external beam radiotherapy EBRT brachytherapy

solid tumor

targeted therapy 1990

imatinib gefitinib

small peptidic structures

oxycodoneantiemetics

palliative


Dichloroacetate DCA

alternative medicine

grape diet
cabbage diet
megavitamin therapy
laetrile B17

()

(American Cancer Society)

(Lance Armstrong Foundation)
(BC Cancer Agency)
(Macmillan Cancer Relief)
(Terry Fox Foundation)
(Cancer Research UK)
(Canadian Cancer Society)
(International Agency for Research on Cancer, IARC)
(The Cancer Council Australia)
(National Cancer Institute, US)