NOÄI SOI

UNG THÖ DAÏ DAØY

BS Traàn Ñình Trí

BV Chôï Raãy - Khoa Noäi Soi
 ÑAÏI CÖÔNG
• - Ñöùng haøng ñaàu K ñöôøng tieâu hoaù.
- Ñöùng haøng thöù 2 (Nam) vaø thöù 3 (nöõ) caùc
loaïi K cô theå.
• - Khoaûng 95% xuaát phaùt töø teá baøo bieåu moâ
-> Carcinoma.
• - Khoaûng 5% laø Lymphoma, Sarcoma…
• - K ôû baát kyø choå naøo cuûa daï daøy.
• (Bv Baïch Mai) Hang moân vò 62%
• Bôø cong nhoû 28%
• Taâm vò 7,5%
• Bôø cong lôùn 0,5%
Khoâng xaùc ñònh #2%
• - Hình aûnh ñaïi theå ung thö daï daøy:
• 1. Theå nhoâ cao (loài).
• 2. Theå loeùt (loûm).
• 3. Theå thaâm nhieãm.
• --> VAI TROØ CUÛA NOÄI SOI.
 MOÂ TAÛ TOÅN THÖÔNG
• Daïng nhoâ cao Daïng loõm
• 1.Vò trí 1.Vò trí
• 2.Kích thöôùc 2.Kích thöôùc
• 3.Cuoáng(coù,khoâng) 3.Hình daïng
• 4.Nieâm maïc beà maët 4.Ñaùy
• 5.Maøu 5.Bôø
• 6.Giôùi haïn 6.Giôùi haïn
• 7.NM xung quanh 7.NM xung quanh
 EARLY GASTRIC CANCER
ÑÒNH NGHÓA: EGC laø ung thö coù söï xaâm laán taïi choã
coøn giôùi haïn ôû nieâm maïc hay döôùi nieâm maïc, baát
keå ñaõ coù hay chöa coù di caên haïch vuøng.
m sm pm ss se
Mucosa
muscularis mucosa

Submucosa

Muscularis Propria

Serosa
 -Early Gastric Cancer-

Type 0: Caùc khoái u phaúng, coù theå hôi nhoâ leân hay
loõm xuoáng

Type 0 I Protruded type

Type 0 IIa Superficial elevated type
Type 0 IIb Flat type

Type 0 IIc Superficial depressed type

Type 0 III Excavated type

Type 0-IIa T1 M
well differentiated adenocarcinoma

<Key features>
Discolored elevation
Lack of vascularity
Type 0-IIa+IIc T1 M
well differentiated adenocarcinoma

<Key features>
Reddish mucosa
With mild irregularity
Lack of vascularity
Type 0-IIa T1 M
well differentiated adenocarcinoma

<Key features>
Irregular mucosa
Lack of vascularity
Type 0-IIc T1 M
signet-ring cell carcinoma

<Key features>
Color change (discolored)
Lack of vascularity
 Type 0-IIa T1 SM
well differentiated adenocarcinoma

<Key features>
Short Barrett’s oesophagus
Reddish elevation
BARRETT’S CANCER
 Type 0-IIc T1 M
well differentiated adenocarcinoma

<Key features>
Short Barrett’s oesophagus
Reddish mucosa
BARRETT’S CANCER
 UNG THÖ GIAI ÑOAÏN MUOÄN
-Advanced Gastric Cancer-

Polypoid tumors, sharply demarcated from

Type 1 the surrounding mucosa, usually attached on
a wide base

Ulcerated carcinomas with sharply

Type 2 demarcated and raised margins

Ulcerated carcinomas without definite limits,

Type 3 infiltrating into the surrounding wall

Type 4 Diffusely infiltrating carcinomas in which

ulceration is not marked feature

Type 5 Non-classifiable carcinomas that cannot be

classified into any of the above types
 Ung thư muoän (AGC)

Type 1 Type 2

Ulcerated carcinomas with

Sharply demarcated and
Polypoid tumor raised margins

M
SM
MP
S
 Ung thư muoän (AGC)

Type 2 Type 3

Ulcerated carcinomas with Ulcerated carcinomas without

Sharply demarcated and definite limits, infiltrating into
raised margins the surrounding wall

M
SM
MP
S
 Ung thư muoän (AGC)

Type 4 Type 4

M
SM Diffusely infiltrating carcinomas in which
MP ulceration is usually not marked feature
S
• Phaân bieät oå loeùt laønh tính vaø aùc tính

• Tính chaát Laønh Aùc

1.Hình daïng Troøn, baàu duïc Meùo moù,khoâng ñeàu
2.Ñaùy Saïch,ñoïng fibrin Baån, hoaïi töû.
• vaøng nhôït,maùu ñen
3.Bôø Ñeàu,troøn,phaúng Nham nhôû,goà cao,
• bôû deå chaûy maùu.
4.Neáp NM Ñeán saùt oå loeùt Caùch xa oå loeùt.
5.Nhu ñoäng Coøn, meàm maïi Maát, giaûm.
6.Chaûy maùu Ít coù, töø ñaùy Hay coù, töø bôø.
 SINH THIEÁT
• - Xaùc ñònh moâ hoïc.
• - Sinh thieát taát caû caùc toån thöông nghi ngôø.
• - Kích thöôùc moâ laáy 2-3mm.
• - Soá maåu laáy 5-8 maãu.
• - oå loeùt: Taïi bôø, noát haït, khoâng laáy ôû ñaùy.
• - U: Ñaøo saâu.
• * Chuù yù:
• CHUÙC CAÙC BAÏN THAØNH COÂNG