1、Lung cancerMain pointer?Clinical manifestation?Diagnosis procedure?Differential diagnosis?Malignanttumorsarecancer.Theycaninvade and damage nearby healthy tissuesand organs.Cancer cells can also breakawayfromthetumorandenterthebloodstream or the lymphatic system.That ishow cancer spreads and forms t
2、umors inother parts of the body.The spread of canceris called metastasis.?Definition:Bronchogenic carcinoma is amalignant neoplasm of the lungarisingfrom the epithelium of the bronchus.?Lung Cancer Facts&FiguresLung cancer is especially common among men in North America,Europe,and Oceania.At the mom
3、ent,lung cancer rates are higher than ever before among the people of central and Eastern Europe.In Japan,lung cancer has increased tenfold in men and eightfold in women since 1950.In addition,Chinese women,many of whom are nonsmokers,have very high lung cancer rates.This phenomenon has been associa
4、ted with exposure to cooking oil vapors and other forms of air pollution in the indoor environments of China.?The trachea splits into right and left main stem bronchi.The main stem bronchi are the major air passages from the trachea to the lungs and are similar to the trachea in tissue composition.T
5、he main stem bronchi enter each lung and progressively branch off into paired subdivisions throughout the entire organ(the tracheobronchial tree).Causes?It is estimated that tobacco smoking causes 80%of lung cancer deaths in men and 75%of lung cancer deaths in women.The more cigarettes that are smok
6、ed each day and the younger the age at which smoking began,the greater the risk of lung cancer.?Competing risk factors such as secondhand smoke,asbestos,radon,occupational exposures,age,race,sex,and heredity also may play a role in lung cancer development(see Lung Cancer Risk Factors).Additionally,t
7、here are some studies suggesting that lung cancer may be prevented by dietary micronutrients such as carotenoids,vitamin C,vitamin E,and selenium.?EnvironmentalRisk Factors?Alcohol?Diet and Body Mass?Non-modifiable Risk FactorsAge Race SexTypes?squamous cell carcinoma,squamous epithelium of the lung
8、s or bronchi?adenocarcinoma,cancer of the glandular tissue?large cell carcinoma,cancer composed of large-sized cells?broncho-alveolar carcinoma Carcinoma(NSCLC)?Non-small cell lung carcinoma(NSCLC)includes squamous cell carcinoma,adenocarcinoma,and large cell carcinoma.(SCLC)?Small cell lung carcino
9、ma(SCLC)accounts for approximately 20%of all primary lung cancers?The histologic distinction between non-small cell lung cancer and small cell lung cancer is extremely important.There are substantial differences between the two groups in both treatment and prognosis.Symptoms?People often decide to v
10、isit the doctor only after they have been bothered by certain complaints over a period of time.Individuals who have lung cancer frequently experience symptoms such as:?Cough?Shortness of breath?Wheezing?Chest pain?Hemoptysis(bloody,coughed-up sputum)?Loss of appetite?Weight loss?Pneumonia(inflammati
11、on of the lungs)Othersymptomsthatareassociatedwithlungcancerinclude:?Weakness?Chills?Swallowing difficulties?Speech difficulties or changes(e.g.,hoarseness)?Finger/nail abnormalities(e.g.,clubbing,or overgrowth of the fingertip tissue)?Skin paleness or bluish discoloration Diagnosis?1.If sputum anal
12、ysis does not provide a definite diagnosis,more tests will be needed.?2.Bronchoscopy,a visual examination of lung branches using a flexible scope performed by a pulmonologist?3.X-rayX-RAY?Chest radiograph(X-ray)to see whether there are enlarged lymph nodes in the chest or a localized mass in the lun
13、gs.?CT scan,a computer-assisted technique that produces cross-sectional images of the body.?Magnetic resonance imaging(MRI)正常胸片正常胸片 右肺下叶背段癌右肺下叶背段癌肺癌胸片肺癌胸片右肺下叶周围型肺癌右肺下叶周围型肺癌楔型切除术（1）周围型肺癌CT片周围型肺癌胸片周围型肺癌胸片Staging?T=tumor size?N=node involvement?M=metastasis statusClick here for image enlargement.胸内淋巴结分
14、布胸内淋巴结分布Treatment?As is true of many cancers,the treatment of lung cancer depends upon a variety of factors.The most important factors are the pathologic type of tumor and its stage.Once a lung cancer has been staged,the physician and patient can discuss treatment options.?An individual then has a b
15、etter idea of the value of different forms of therapy.Other factors that are taken into account include the persons general health,medical problems that may affect treatment(such as chemotherapy),and tumor characteristics.?Surgical resection,or cutting away,of the tumor generally is indicated for di
16、sease that has not spread beyond the lung.Such resection may be conducted using a variety of techniques.?Recently,surgeons have developed other less invasive procedures for the removal of tumorous tissue.For example,video-assisted thoracic surgery(VATS),uses a video camera to help visualize and operate upon the lung within the chest cavity.?If the tumor is more aggressive and/or widespread,chemotherapy and radiotherapy(radiation therapy)also may be necessary.In addition to chemotherapy and radiotherapy,other treatments are now available for the management of lung cancer.
