肝癌 肝癌 (Liver cancer ) ●继发性或转移性肝癌 (metastasis liver cancer ) ●原发性肝癌 (primary carcinoma of the liver )肝癌的定义流行病学特征(epidemiology character)●发病率(incidence of a disease )●死亡率(death rate)●发病年龄(age of a disease)流行病学特征(epidemiology character)●男女比例(inverse proportion of man and woman)●自然生存期(nature survival time )●综合治疗的效果(五年生存率)(synthesis therapeutic effect )肝脏的解剖位置及功能●解剖位置(如图1-5)(dissection position )●功能(function )肝脏的血液供应 肝脏与其它内脏器官不同,有双重血液供应。 ●肝动脉(liver artery ) ●门静脉(portal vein )病因及发病机理( pathogeny and pathogenesis )●病毒性肝炎(virus hepatitis ) ●肝硬化(hepatocirrhosis )●黄曲霉毒素(aflatoxin )病因及发病机理( pathogeny and pathogenesis )●其它化学致癌物质(other chemic carcinogen)●寄生虫感染(helminth infection )●其它因素( other factor ) 遗传因素(heredity factor) 微量元素(microelement) 营养(nutrition)病理类型( pathology type )●按细胞起源可分为: 肝细胞型(liver cell type90%):约占 胆管细胞型(bile duct cell type) 混合细胞型(mix cell type)如图6-8病理类型( pathology type )●按肿块大小、数目及分布可分为: 结节型(node type) 巨块型(hugeness type) 弥漫型(permeate type)如图9-11病理类型( pathology type )●按肿块生长方式可分为: 膨胀型(bulge type) 浸润型(soakage type) 混合型(mix type) 弥漫型(permeate type) 特殊型(special type)病理类型( pathology type )●浸润和转移(soakage and metastasis ) 1 .肝内转移(inner metastasis of liver ) 2 .肝外转移(outer metastasis of liver ) A .血行转移(hemic metastasis ) B .淋巴转移(lymph metastasis ) C .种植转移(planting 临床表现( clinical representation )●症状(symptom ) ۞疼痛(pain) ۞黄疸(icterus) ۞恶性肿瘤的全身表现:发热、消瘦、乏力、食欲不振、腹...