1. NOÄI SOI
UNG THÖ DAÏ DAØY
BS Traàn Ñình Trí
BV Chôï Raãy - Khoa Noäi Soi

2. 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…

3. • - 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.

4. 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

5. m sm pm ss se
Mucosa
Submucosa
Muscularis Propria
Serosa
muscularis mucosa
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.
EARLY GASTRIC CANCER

6. Protruded type
Superficial elevated type
Superficial depressed type
Flat type
Excavated type
Type 0: Caùc khoái u phaúng, coù theå hôi nhoâ leân hay
loõm xuoáng
Type 0 I
Type 0 IIa
Type 0 IIb
Type 0 IIc
Type 0 III
-Early Gastric Cancer-

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

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

9. Type 0-IIa T1 M
well differentiated adenocarcinoma
<Key features>
Irregular mucosa
Lack of vascularity

10. Type 0-IIc T1 M
signet-ring cell carcinoma
<Key features>
Color change (discolored)
Lack of vascularity

11. Type 0-IIa T1 SM
well differentiated adenocarcinoma
<Key features>
Short Barrett’s oesophagus
Reddish elevation
BARRETT’S CANCER

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

13. -Advanced Gastric Cancer-
UNG THÖ GIAI ÑOAÏN MUOÄN
Polypoid tumors, sharply demarcated from
the surrounding mucosa, usually attached on
a wide base
Ulcerated carcinomas with sharply
demarcated and raised margins
Ulcerated carcinomas without definite limits,
infiltrating into the surrounding wall
Diffusely infiltrating carcinomas in which
ulceration is not marked feature
Non-classifiable carcinomas that cannot be
classified into any of the above types
Type 1
Type 4
Type 3
Type 2
Type 5

14. Ung thư muoän (AGC)
Type 1
M
SM
MP
S
Type 2
Polypoid tumor
Ulcerated carcinomas with
Sharply demarcated and
raised margins

15. Type 2 Type 3
Ulcerated carcinomas with
Sharply demarcated and
raised margins
M
SM
MP
S
Ulcerated carcinomas without
definite limits, infiltrating into
the surrounding wall
Ung th muoän (AGC)ư

16. Type 4 Type 4
M
SM
MP
S
Diffusely infiltrating carcinomas in which
ulceration is usually not marked feature
Ung th muoän (AGC)ư

17. • 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.

18. 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:

20. • CHUÙC CAÙC BAÏN THAØNH COÂNG