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'In order to let readers better understand the treatment of lung cancer, Drug Mail (Iressa India Direct Shopping Network) will excerpt the article published in the "Chinese Journal of Oncology", China National Health Service and the "Annual Edition of Chinese Standards for the Diagnosis and Treatment of Primary Lung Cancer" formulated by the Family Planning Commission. This guideline was edited by Zhi Xiuyi (Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University), Shi Yuankai (Department of Internal Medicine, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College), and Yu Jinming (Department of Radiotherapy, Shandong Cancer Hospital). Medical workers can learn from it, and patients and their families can also have a brief understanding.
Overview of Lung Cancer
Primary lung cancer (hereinafter referred to as lung cancer) is one of the most common malignant tumors in my country. Data released by the National Cancer Registry Center in 2019 showed that in 2018, there were 10,000 new cases of lung cancer in my country (10,000 for men and 10,000 for women), ranking first among malignant tumors (1st among men and 10,000 among women), accounting for ).
The incidence rate of lung cancer is 10,000 (10,000 men and 10,000 women). During the same period, the number of deaths from lung cancer in my country was 10,000 (10,000 men, 10,000 women), accounting for 10,000 deaths from malignant tumors (10,000 men, 10,000 women). The mortality rate from lung cancer is 10,000 (10,000 men and 10,000 women).
Carrying out lung cancer screening among high-risk groups is beneficial to early detection of early-stage lung cancer and improves the cure rate. The sensitivity of low-dose (,) detection of early lung cancer is twice that of conventional chest X-ray, and it can detect early peripheral lung cancer at an early stage. Data from the International Early Lung Cancer Action Plan show that for peri-stage lung cancer that can be detected by annual screening, the expected annual survival rate after surgery is as high as .
The U.S. National Lung Cancer Screening Trial has proven that screening can reduce lung cancer mortality and is currently the most effective lung cancer screening tool. The technical guidelines for cancer screening and early diagnosis and early treatment pilots currently carried out in a few areas in my country recommend lung cancer screening for high-risk groups.
The risk assessment factors for lung cancer screening proposed in the National Comprehensive Cancer Network (,) guidelines include smoking history (current and past), radon exposure history, occupational history, cancer history, family history of lung cancer, and disease history (chronic obstructive pulmonary disease or tuberculosis), smoke exposure history (passive smoking exposure).
Lung cancer risk status grouping
1. The high-risk group is aged ~ years, has a history of smoking for 10 years, has a history of quitting smoking for 12 years (category) or is 2 years old, has a history of 100 years of smoking, and has risk factors other than passive smoking ( kind).
2. The intermediate-risk group is 6 years old, has a history of smoking or exposure to passive smoking for 1 year, and has no other risk factors.
3. The low-risk group has an age of 10 years and a smoking history of 10 years.
It is specifically pointed out that the guideline recommends lung cancer screening for high-risk groups, but does not recommend screening for low-risk and intermediate-risk groups.
In order to further standardize the diagnosis and treatment of lung cancer in my country, improve the level of diagnosis and treatment of lung cancer in medical institutions, improve the prognosis of lung cancer patients, and ensure medical quality and safety, the Medical Administration and Medical Administration Bureau of the National Health and Family Planning Commission commissioned the China Anti-Cancer Association The Cancer Clinical Chemotherapy Professional Committee has updated and formulated this specification based on the original Ministry of Health's "Standards for the Diagnosis and Treatment of Primary Lung Cancer (Edition)".
Clinical manifestations of lung cancer
1. Lung cancer may have no obvious symptoms in the early stage. When the disease develops to a certain extent, the following symptoms often appear
Irritating dry cough.
Blood in the sputum or bloody sputum.
Chest pain.
Fever.
Shortness of breath.
When respiratory symptoms last for more than a week and cannot be relieved by symptomatic treatment, especially if there is blood in the sputum, irritating dry cough, or the original respiratory symptoms worsen, you should be highly vigilant about the possibility of lung cancer.
2. When lung cancer invades surrounding tissues or metastasizes, the following symptoms may occur
Hoarseness may occur when the tumor invades the recurrent laryngeal nerve.
The tumor invades the superior vena cava, causing facial and neck edema and other manifestations of superior vena cava obstruction syndrome.
Tumor invasion of the pleura causes pleural effusion, which is often bloody and can cause shortness of breath.
Tumors invade the pleura and chest wall and can cause persistent and severe chest pain.
Lung cancer at the apex of the upper lobe can invade and compress the organs and tissues located at the entrance of the thoracic cage, such as the first rib, subclavian artery, vein, brachial plexus, cervical sympathetic nerves, etc., causing severe chest pain, venous distention, and edema in the upper limbs. , arm pain and upper limb movement disorders, ipsilateral upper eye and face drooping, miosis, enophthalmos, facial anhidrosis and other manifestations of cervical sympathetic syndrome.
The possibility of brain metastasis should be considered for recent neurological symptoms and signs such as headache, nausea, dizziness or blurred vision.
Persistent bone pain at the fixed site, elevated plasma alkaline phosphatase or blood calcium should consider the possibility of bone metastasis.
Right upper quadrant pain, hepatomegaly, elevated alkaline phosphatase, aspartate aminotransferase, lactate dehydrogenase or bilirubin should consider the possibility of liver metastasis.
During subcutaneous metastasis, the nodules can be palpated under the skin.
Haematogenous metastasis to other organs may cause symptoms corresponding to metastatic organs.
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