• Women with two affected first class relative: risk rate for ovarian cancer is 7%
• A member of HOCS: risk rate for ovarian cancer is 20%--50%
• BRCA1 &BRCA2 gene associated with HOCS
Histopathology
• Malignant Germ Cell Tumor of the Ovary include a number of specific histological types:
• Dysgerminoma • Yolk-Sac Tumor (endodermal sinus tumor) • Teratomas • Choriocarcinoma • Mixed germ cell tumor
ovarian cancer. When present, symptoms tend to be nonspecific • GI tract complaints: such as nausea, abdominal cramping, or change in bowel habits,are often the early symptoms of advanced stage disease. By this time, the disease may be widely disseminated throughout the peritoneal cavity • Abdominal distention: big mass, omental cake, ascites intestinal obstruction
Epidemiology and Genetic Factors
• Prevention & protective factors for ovarian cancer appear to be conditions associated with fewer lifetime ovulations 1. Use of oral contraceptive pills 2. Shorter duration of reproductive years 3. Conditions of chronic anovulation 4. History of breastfeeding 5. Multiparity
Epidemiology and Genetic Factors
• Family history is the strongest risk factor for ovarian cancer
• Women with one affected first class relative: risk rate for ovarian cancer is 5%
Histopathology
• Epithelial ovarian cancer, usually classed simply as adenocarcinoma, include a number of specific histological types:
• Serous adenocarcinoma • Muconous adenocarcinoma • Endometrioid adenocarcinoma • Malignant Brenner tumor (transitional cell) • Clear cell adenocarcinoma
Symptoms
• Postmenopausal bleeding may occur from endometrial hyperplasia stimulated by estrogen from a ovarian tumor.
• Virilization is found in 50% of patients who have an androgen-secreting Sertoli-Leydig-cell tumor.
Histopathology
• Malignant Tumor of the Gonadal stroma: • Granulosal-cell tumors
Adult type Juvenile type • Sertoli-cell tumors • Leydig-cell tumors • Sertoli-Leydig-cell tumors • Sex cord tumor with annular tubules
ቤተ መጻሕፍቲ ባይዱ
Spread of ovarian cancer
• Local spread • Intra-abdominal spread • lymphatic spread • hemtogenous spread
Symptoms
• Symptoms are most often absent with early stage
• Colicky pain is associated with torsion of a mobile ovarian tumor.
• Constant pain may be experienced with the distention of hemorrhage into a tumor
卵巢癌的诊断和治疗(医大讲 课)
卵巢癌的危险因素
年龄
生产史和激素水平
家庭史
危险因素
与子宫内膜、结肠、乳腺癌的关系
Epidemiology and Genetic Factors
• High risk factors: 1. More than 40yrs. 2. Caucasian race (white) 3. Late menopause. 4. Infertility 5. Positive family history of CA ovary 6. BRCA gene