1、lBronchogenic carcinoma refers to the malignant tumor which grows in the bronchus.Originating from mucus or gland of bronchus.肺癌英文专题知识讲座10/12/20221lBronchogenic carcinoma has increased remarkable in incidence and mortality during half of the century and has become the most frequent visceral malignan
2、t diseases of men.The mortality of lung cancer hold the first place among all kinds carcinomas.肺癌英文专题知识讲座10/12/20222lThe cause of lung cancer is unknown.It is believed that there are following related factors.l1.Excessive cigarette smoking:Smoking index(Brinkman Index)is equal to cigarettes per day
3、smoking time(years).lPassive smoking is also a carcinogen factor.肺癌英文专题知识讲座10/12/20223l2.Atmospheric pollution.It was found that carcinogenic factor is benzpyrene.l3.Occupational factors.l4Radioactivity in the atmosphere.l5.Diets and Nutrition.l6.Chronic irritation.l7.Genetic factors.肺癌英文专题知识讲座10/12
4、/20224l1.According to the position of tumor arising from,it can be divided into two types.lCentral type:Tumor arises from main bronchus,lobar and segmental bronchus.Peripheral type:Tumor arises beyond segmental bronchus.肺癌英文专题知识讲座10/12/20225l2.According to cytology,it is convenient to classify into
5、four kinds of types.l(1).Squamous cell carcinoma.l(2).Small cell anaplastic carcinoma.l(3).Large cell anaplastic carcinoma.l(4).Adenocarcinoma(including alveolar cell carcinoma).肺癌英文专题知识讲座10/12/20226lAccording to the different principles of management,it is divided into two types.lSCLC:small cell lu
6、ng carcinoma.lNSCLC:non small cell lung carcinoma.肺癌英文专题知识讲座10/12/20227lThere are no symptoms of early lung cancer in some patients.lSymptoms caused by lung cancer are non-specific:perhaps an audible wheeze or a slight cough,symptoms of infection(fever,purulent sputum),of obstruction(wheezing,dyspne
7、a),or ulceration of bronchial mucosa(hemoptysis).肺癌英文专题知识讲座10/12/20228l1.Respiratory symptoms.l(1).Cough:l(2).Hemoptysis:l(3).Dyspnea.:l(4).Wheeze or stridor:l(5).Chest pain:l(6).Fever:肺癌英文专题知识讲座10/12/20229l2.Symptoms caused by the near organs or tissue involved by tumor.l(1).Dysphagia.l(2).Hoarsene
8、ss.l(3).Pleural effusion due to invasion of the pleura.肺癌英文专题知识讲座10/12/202210l(4).Horners syndrome.It is caused by invading the cervical sympathetic ganglia on the involved side the pupil is small ptosis of the up eyelids,retraction of the eyeball and no sweat of the face.l(5)Cardiac effusion肺癌英文专题知
9、识讲座10/12/202211l(6).Superior vena caval syndrome.Due to obstruction of the superior vena caval,the patient may have noticed that his collar is tight,the neck is enlarged and the jugular vein and the veins of anterior chest wall are distension and edema of the face.l3.Symptoms caused by metastasis.li
10、ver,skeleton,brain,supra clavicle lymph nodes.肺癌英文专题知识讲座10/12/202212l4.Paraneoplastic syndrome.Because tumor cell can secrete ectopic hormone，antigen or enzyme the patients with Lung Cancer sometimes may have some paraneoplastic syndrome Including:l(1)Collagen tissue disorder such as finger clubbing
11、,hypertrophic pulmonray osteoarthropathy。肺癌英文专题知识讲座10/12/202213l(2)Endocrine disorders including Cushings syndrome,syndrome of inappropriate antiduretic hormone secretion(SIADHS),l(3)Neuropathic or myopathic disorders including polyneuritis,cerebellar degeneration,mental abnormalitis etc l(4)others.
12、肺癌英文专题知识讲座10/12/202214lThe appearance on the x-ray film depends on the position,size and stage of the tumor 1.Peripheral type:It may be various such as infiltrative or nodular,lobulated or umbilicus sign,liner protrusions from the shadow into the surrounding lung,cavitation which is often eccentric
13、irregular in the inner wall owing to the necrosis of the neoplasm.肺癌英文专题知识讲座10/12/202215l2 Central typel(1)Direct appearance:Unilateral enlargement of the hilar shadow due to the tumor itself or enlarged lymph nodes.l(2)Indirect appearance:Including local emphysema;obstructive pneumonia either lobal
14、 or segmental;obstractive atalectasis(collapse)lobe or segment.肺癌英文专题知识讲座10/12/202216l(1)Some small lesion,lesion behind of cardiac or blood vessel,and pathology located in apical of lung can be found by CT which cant be found by chest x-ray.l(2)Lymph nodes along hilar or mediastina can be found by
15、CT.肺癌英文专题知识讲座10/12/202217Fig1 Atelectasis,Right upper lobeFig1 Atelectasis,Right upper lobe肺癌英文专题知识讲座10/12/202218 Fig3 Mass With Fuzzy,Right Upper LObeFig3 Mass With Fuzzy,Right Upper LObe肺癌英文专题知识讲座10/12/202219 Fig4 Mass In right Fig4 Mass In right Lobe,Lateral portionLobe,Lateral portion肺癌英文专题知识讲座1
16、0/12/202220 Fig5 Cavitating Bronchial Carcinoma Fig5 Cavitating Bronchial Carcinoma 肺癌英文专题知识讲座10/12/202221lCytologic examination of bronchial secretions(or sputum)may reveal exfoliated malignant cells recognizable to the pathologist who is specially trained for such work.The sputum must to be fresh,
17、send on time,repeat(4-6 times).肺癌英文专题知识讲座10/12/202222lBronchoscope may verify the existence of tumor,of Central type,and cytologic diagnosis of lung cancer should be obtained though FBCl.Blind biopsy may be help to the diagnosis of the tumor beyond the range of bronchoscope vision肺癌英文专题知识讲座10/12/202
18、223Fig 1 Normal TracheaFig 2 Normal Carina肺癌英文专题知识讲座10/12/202224Fig 3 Squamous Cell Carcinoma,TracheaFig 4 AdenocarcinomaLeft Lingular Bronchus肺癌英文专题知识讲座10/12/202225Fig 5 AdenocarcinomaRight Truncal IntermedusFig 6 Extrinsic Pressure Trachea肺癌英文专题知识讲座10/12/202226l1.Biopsy with fiberoptic bronchoscop
19、e;2.Transthoracic neddle biopsy with CT directed or B type ultrasonic;l3.Biopsy with thoracoscopy;l4.Biopsy with medistinoscopy;l5.Exploratory thoracotomy.肺癌英文专题知识讲座10/12/202227l1.Symptom-free:General investigation of high risk group(male,morn than 40 years old,cigarette consumption 20/per day).Taki
20、ng a x-ray film and examining sputum for cancer cell every half year lEarly stage of the bronchogenic carcinoma Refers to the tumor is still located at the bronchus,no invade the hilar lymph nodes,pleura as well as distant metastases,its diameter is often 3cm.肺癌英文专题知识讲座10/12/202228lDiagnosis procedu
21、re:l1.X-ray film(-)and sputum for cytology(-)FBC(-)follow up once a month/year.l2.X-ray film(+)and sputum for cytology(+)FBC to identify the cancer cell type CT,MRI therapy.肺癌英文专题知识讲座10/12/202229lDiagnosis procedure:l3.X-ray film(-)and sputum for cytology(+)ruling out the tumor of upper respiratory
22、tract first FBC.l4 X-ray film(+)and sputum for cytology(-)FBC(-)lung biopsy.肺癌英文专题知识讲座10/12/202230l1.Solitary nodule:Tuberculoma,Benign Tumorl2.Cavitation:Lung Abscess,Tuberculosis,l3.Enlargement of hilar shadow:Hamartomal4.Others:Pleural Effusion,Widening Of Mediatinal.肺癌英文专题知识讲座10/12/202231l1.Rres
23、ection by operation;l2.Radiotherapy;l3.Chemotherapy;l4.Immunotherapy;l5.Traditional Chinese medicine therapy etc.lThe therapeutic principle of lung cancer is comprehensive:rescect the tumor as far as possible then combine with other treatments;other treatments first then operation depending on the c
24、ytologic type,position,size and stage of the tumor.肺癌英文专题知识讲座10/12/202232lSCLC:l Chemotherapy ,operation.l Chemotherapy,radiotherapy.lNSCLC:l Operation.l Most:operationchemotherapyl Small parts:radiotherapy.肺癌英文专题知识讲座10/12/202233l:Operation+chemotherapy;l radiotherapy+chemotherapy.l:chemotherapy+radiotherapy(relieve some symptoms,such as pain,dyspnea,obstruction etc).肺癌英文专题知识讲座10/12/202234肺癌英文专题知识讲座10/12/202235
