1、本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Begins when cells in the lung grow out of control and form a tumor本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Etiology and pathogenesisCigarette smokingOther factors include air pollutions Nowadays It is reported that tuberculosis is associated wit
2、h the incidence of lung cancer 本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Classifications According to anatomy:(1)Central lung (2)peripheral lung cancer本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。According to histologic classification:Small ce
3、ll lung cancer(SCLC)and Non-small cell lung cancer(NSCLC).NSCLC includes Squamous cell carcinoma,large cell carcinoma,adenocarcinoma,adenosquamous carcinoma.本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Small cell lung cancer(SCLC)Oat-cell carcinoma SCLC grows very rapidly and is very aggressive.S
4、oon after the original cell becomes cancerous,it quickly multiplies to form a tumor.These cells swiftly spread to distant sites in the body SCLC belongs in a group of tumors derived from neuroendocrine cells that are responsible for the production and secretion of specific peptide product.they may r
5、elated to paraneoplastic syndrome.本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Cells are oval or vaguely spindle-shaped,have scant cytoplasm本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Squamous cell carcinoma the most frequent form of the tumor(3
6、0-50 percent of all cases bronchial epithelium and growth in situ It is related to cigarette smoking Cavitation can occure in the distal to the obstructing mass Central location本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Intercellular bridges and cellular pleomorphism本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模
7、仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。squamous cell carcinoma usually occurs near the bronchi,the tumor can cause cough(sometimes a cough that is tinged with blood),shortness of breath,wheezing,and pneumonia in the area between the tumor and the edge of the lung it caus
8、es symptoms early in the disease 本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。adenocarcinoma areas of scarring is associated with the occurrence of adenocarcinoma.Peripheral adenocarcinomas are usually well-circumscribed,grey-white masses that rarely cavitate.It arises from the submucosal glands,
9、located in peripheral airways and alveoli Female 本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。large cell carcinoma本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。large nuclei,prominent nucleoli,abundan
10、t cytoplsma本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。usually located peripherally can be quite large and not infrequently cavitate本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。gh Shortness of breath Chest pain Loss of appetite Coughing up phlegm Hemoptysis(coughing up blood)If cancer has spr
11、ead,symptoms include bone pain,difficulty breathing,abdominal pain,headache,weakness,and confusion本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Due to primary lesions:cough,dyspnea,hemoptysis,sputum,wheezing,weight loss,fever,pneumonia Due to local extension:chest pain,hoarseness,superior vena cav
12、a syndrome,horners syndrome,dysphagia,pericardial effusion,pleural effusion,diaphragm paralysis Only 5-15 percent of patients are asymptomatic when discovered to have bronchogenic carcinoma.本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Regionnal spread to hilar and mediastinal nodes may cause dysp
13、hagia due to esophageal compression horseness due to recurrent laryngeal nerve compression horners syndrome due to sympathetic nerve involvement elevation of the hemidiaphragm from phrenic nerve compression.本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Superior sulcus,or pancoasts tumor may involv
14、e the brachial plexus,resulting in a c7-t2 neuropathy with pain,numbness,and weakness of the arm.Cardiac involvement is seen in About 20-25 percent of patients 本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Extrapulmonary manifestations.Including metastasis to other organs,such as brain,central ner
15、vous system,skeleton system,liver,adrenal glands and lymph nodes ects.Paraneoplastic syndromes are remote effects of tumor.They lead to metabolic and neuromuscular disturbances unrelated to the primary tumor,metastases,or treatment.They may be the first sign of the tumor.They do not indicate that a
16、tumor has spread.本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Physical examinations Usually in early stage,most of the patients with lung cancer have no positive physical findings.General findings include abnormal percussion,breath sounds changes,moist rales(when pneumonia happens)Digital clubbin
17、g,superior vena cava syndrome,horners syndrome(unilaterally constricted pupil,enophthalmos,narrowed palpebral fissure and loss of sweating on the same side of the face.本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Physical examinations Endobronchial obstruction may result in a localized wheeze Lob
18、ar collapse may result in an area of decreased breath sounds and dullness to percussion.本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。ll have a tumor in the lung,a chest x-ray or CT scan of the chest is performed The diagnosis must be confirmed with a biopsyThe location(s)of all sites of cancer is
19、 determined by additional CT scans,PET(positron emission tomography)scans,and MRI(magnetic resonance imaging)It is important to find out if cancer started in the lung or somewhere else in the body.Cancer arising in other parts of the body can spread to the lung as well 本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；
20、如有不当之处，请联系网站或本人删除。Chest X-ray It is the most important method to find lung cancerThe most frequent finding is a mass in the lung field本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。On chest X-ray,seconda
21、ry manifestations include lobar collapse,pleural effusion,pneumonitis,elevation of the hemidiaphragm,hilar and mediastinal adenopathy,and erosion of ribs or vertebrae due to metastases.本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作
22、为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Obstructive atelectasis本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Lung cancer on CT CT is the most useful in evaluating patients with pulmonary and mediastinal masses.It is also useful for detecting multiple metastases.CT can show a mass to be located in which lobe
23、of lung field and the size of the mass.It also shows the nodule in the mediastinum.Sometimes,when a mass locate behind the heart,chest X-ray cant detect it.CT can detect some secret sites of lung cancer.本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。B
24、ronchoscopy本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Rigid and flexible scope Biopsy and selective washings Larger samples than flexible scope Exact location Lobectomy Pneumonectomy Unresectable Sleeve本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人
25、删除。Transthoracic lung biopsy It may be utilized when tumor located in peripheral airway.Transthoracic needle with guidance by CT can be used to detect lesions located near the chest wall 本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Video Assisted Th
26、oracic Surgery Diagnosis of pleural disease Wedge resection 本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Mediasteinoscopy&Mediasteinotomy本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Diagnoses unrese
27、ctable disease Eliminate N2 disease from surgical resection本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。ThoracotomyIf the methods mentioned above are not useful for detecting the cell type of lung cancer,thoracotomy may be used本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Staging of lung cancer
28、 本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Small cell lung cancer has often metastasized at the time o
29、f diagnosis.TNM staging is not suited to small cell lung cancer.本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。TreatmentIncluding:A:Surgery B:Chemotherapy C:Radiation therapy D:Some other therapy immunologic therapy,Chinese traditional therapy本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。SurgeryN
30、on-small cell lung cancer:patients with stage I and II are considered candidates for surgical resection,with stage III cancer may be candidates for surgery with postoperative radiation of the mediastinum.本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。
31、SurgeryWe must measure pulmonary function before surgical therapy.Forced vital capacity greater than 2 liters and a forced expiratory volume in the first second(FEV1)of greater than 50 percent of the forced vital capacity predict that a patient can tolerate the consequences of pneumonectomy.本文档所提供的信
32、息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。ChemotherapyNon-small cell lung cancerMVP:MMC 6-8mg/m2(1),VDS 3mg/m2NP:VP-16(d1,d8).DDP 100mg/m2(d1)GP Small-cell lung cancer it is highly responsive to chemotherap
33、y.EP regimen VP-16 100mg/m2 d1d3.DDP 100mg/m2 d1.GP本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。ChemotherapyAggressive chemotherapy produces complications and symptoms in all patients.All experience anemia,leukepenia and opportunistic infection other complications include nausea,vomiting possible
34、 cadiotoxicity,hemorrhagic cystitis and peripheral neuropathy.本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Radiation therapyIt is of proven benefit in controlling bone pain,spinal cord compression,superior vena cava syndrome and bronchial obstruction.本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。
