???? ???? BA.RN

1
???? ?????
???? ???? BA.RN ???? ????? ?????? ???? ?????
???? ????????? ?? ?????
2
????????????

• ???? ???? ??? ???? ?????? ?????? ????? ???? ????
  ??????
• ? 70 ??????? ????? ?????? ???? ??????
• ??? ????? ???????? ?-5 ???? ????? ???? ???? ????
  (16)
• ???? ???? ???????? ???? ????? ???? ???? ?????
  ??????

3
2008 Estimated US Cancer Deaths
Men294,120
Women271,530
26 Lung bronchus 15 Breast 9 Colon
rectum 6 Pancreas 6 Ovary
3 Non-Hodgkin lymphoma
3 Leukemia 3 Uterine corpus 2 Liver
intrahepatic bile duct 2 Brain/ONS 25
All other sites
Lung bronchus 31 Prostate 10 Colon rectum
8 Pancreas 6 Liver intrahepatic 4bile
duct Leukemia 4 Esophagus 4 Urinary bladder 3
Non-Hodgkin 3 lymphoma
Kidney renal pelvis 3 All other sites
24
ONSOther nervous system. Source American Cancer
Society, 2008.
4
????? ?????

• ????? ????? ?????? ????? ????? (90)
• ?? ????
• ????? ?????? ?????
• ???? ????,???????,????.
• ?????
• ????? ????
• COPD
• ????? ?????

5
?????? ?????????? ???????? ????? ?????

• ????? ????? ???? ??? ????? (65-75)
• ???? ????? (60)
• ?????????
• ????? ???? ?? ????
• ??????? ?????? ?????? ?????? ???? ???? ??
  ?????????
• ???? ?????? ?? ??????
• ????? ????? ,???? ??????
• ,????? ,?????

6
????? ?????????? ?? ???? ????
???? ????
Percentages are approximate and relate to the
previous box linked by arrows e.g. NSCLC makes up
80 of all lung cancers adenocarcinomas
represent 40 of all NSCLCs etc.
7
NSCLC Sq. cell ca

• ??????? ?????? ????? ?????????????, ????? ??
  ?????
• ????? ???? ???????? ???????????? ????? ????????
• ??????? ?????? ???? ???? ?????? ?? ???? ????
  ??????
• ?? ?????? ???? ??????????
• ??? ??? ??? ??????
• ??? ????? ????
• ????????? ???????? ?????? ??????
• ????? ?? ???????
• ??????? ???????????- ???? ?????.

8
NSCLC Adeno ca

• ????? ????? ???? ????? ?????, ?????? ????.
• ????? ???? ???????? ?????, ???? ??? ????? ?????
• ??????? ?????? ????? ??????? ?? ????? ????????
  ????? (??? ?????)
• ??? ???? ??? ??????
• ????????? ????? ?????????
• ??????? ??????????? ????
• ??????
• ?? ?????
• BronchioloAlveolar ca

9
NSCLC Large cell

• 10-15 ???? ????? ?????
• ????? ???? ?????
• ??????? ???????????- ???? ?????? ?? ???????
  ??????

10
Nsclc stages I-IV

• I ????? ???,??? ??????? ??????,??? ??????
  
  
  (5ys-50-80)
• II ????? ???,?? ??????? ?????? ,??? ??????
• (5ys-30-50)
  
• IIIA ????? ????? ???? ?? ????? ??? ?? ???????
  ?????? ,??? ??????
  (5ys-10-40)
• IIIB ????? ????? ???? ?? ??????? ???? ??????
  (5-20)
• IV ????? ?? ??????
  (?? 5 5ys )

11
SMALL CELL LUNG CA

• ???? ?? OAT CELL (??? ????) ??? ???? ?????
• ???? ?????, ??????.
• 20 ????? ???? ????? ?? ???? SCLC
• ???? ??? ????? ?????, ????? ???.
• ???? ??? ????? ??????, ?????? ?????? ????? ????
  ??????
• ??? ???? ??????
• ?????? ???? ????
• ?????? ???? ??? ??????????
• ????????.

12
Sclcstage

• ??? ??? ?????? ????? ????? ???? ?? ?????? ??????
  ????? ?? ??????
• ??????? ???
• ???? ?????? (Limited) ?????? ????? ????? ???
• ???? ?????? (extensive)- ????? ?????? ???????
  ,???? ??????? ?/?? ??????

13
??????? ??????? ?????? ?????? ????? ?????

• ?????? ?????
• ?????
• ??
• ???? ?????
• ???
• ?????

14
???? ?????

• ??? ????? ????? ????? ?????? ????? ?? ?????
• ?????? ???????? ?????? ?? ??????,????????
  ????????, ????? ?????? ?????, ????? ??????
• CT ???
• ????????????
• ??????? ??? (??? ????? ct).
• ?????????-??????????

15
(No Transcript)
16
fine needle aspiration cytology FNAC biopsy - A
thin needle is inserted into the lesion. Applying
suction with a syringe, fluid containing cells is
drawn from the lesion
17
????

• ????? ???? ???????? ?????
• ????? ?????
• ?????????? ???
• PET CT
• CT ???
• CT ?? ?? MRI

18
???? ???? ?? ?????? ????? ???? ????? ??? ????
19
???? ?????? ??????? ????? ?????

• ?????.
• ?????.
• ?????????.

20
?????

• ?????? ??? ?? ????? ????? ??? ??????? ?????,
  ?????? ????? ?? ?? ??? ????? ????? ?- Nsclc ,????
  I ,II ?? ?????.
• ? Sclc ?? ?????? ?? ?????? ??? ????? ??????
  ?????? ?????? ?????? ??? ????? ????? ?????????
  ??? ????.
• ????? ?????? ?????? ????? ???? (Lobectomy)???????
  ?????? ?? ?? ?? ?????(Pneumonectomy) .

21
?????

• ????? ?????? ?-sclc (??????? ???).
• 2. ????? ????? ???? ?????.
• 3. ??? ?? ????????? (?????, ???? ????? ???..).
• 4. ??? ?? ???.
• 5. ????? ??? ???????- ????? ????.
• 6. ????? ??? ?? ??????? ??????? ??? ?????
  ??????.

22
?????????

• ????? ???? ????? ????? (????? ????? ??????
  (neo-adjuvant)
• ???? ?????? ????? ???? ????? (??? II ?? ?????)
  (adjuvant).
• ????? ????? ?Sclc
• ?????? ???????? ???? ?? ???, ????? ????? ??
  ??????? ?????

23
???? ?????????

• ????????-???? ?????? ?? ??? ??? ????????. ???? II
  ?? ????? ??? ??? IV ???? ?????? ??????????? ??
  ???? ????.
• ??????- ???? ???? II ????? ??????? ???? IV ??
  ????? .
• ????? ???? ????? ?-squamous ca (??? IV )
• ????????-vp16 ???? ?- sclc (?-2 ??????)
• ??????-???? ????? ?-adeno ca (??? IV )

24
??????? ??????

• ?????? ,??????? (???????? )
• ?????? ????? ??????? ???? ?? ?????? ????? ??? ??
  (???? ???????)
• ?????- ????? ??????? (???? ???????)
• ??????? ????? ??????? (???? ?????)

25
?????? ???????

• ????? ?????? ??????????? ???????? ?? ????? ????
  ??????
• ????? ?????? ??? ?/?? ?? ?????
• ????? ?????? ???? ?????? ???? ?????? ??????
  ??????? ????? ??????? ??? ???????? ???? ??? ?????
• ???? ???? ????????? ??????? ????? ???? ????,
  ??????, ?????, ????? ?????, ???? ????? ???'
  ?????? ????? ??????????

26
???? ????? ??????

• ???? ?? ????? ?????????????? ???????, ??? ????
• ????? ????? ????? ??????
• ????? ????? ???? ????? ??? ????? ???? ??????,
  ?????? ???, ????? ????? ???? ???'

27

• ???? ?? ??????
• ?????? ?????