I. Overview
Lung cancer is the tumor with the highest incidence and mortality rate among human malignant tumors, and it is still increasing at the rate of 0.5% per year. 1,037,000 new cases of lung cancer were reported worldwide in 1998, and the number of lung cancer deaths was over 921,000 in the same period. This accounts for about 17.8% of all cancer mortality. The annual incidence of lung cancer in the United States is 80.6 per 100,000. In 1998, the number of deaths due to lung cancer in Shanghai was 2800, accounting for 25% of all cancer deaths. Thus, it can be seen that lung cancer is extremely harmful to human beings. To reduce its harm and threat, it is an important and effective measure to carry out a large-scale anti-smoking campaign and effectively implement primary prevention of lung cancer. Xin Zhou, Department of Internal Medicine, Xinjiang Cancer Hospital
II. Clinical manifestations
(1) Local symptoms: coughing is 54.7%, coughing blood or sputum blood is 18.9%, chest pain is 26.7%, and the above three are called early symptoms of lung cancer. Chest tightness and shortness of breath were 12.8%, mostly caused by airway obstruction. Advanced lung cancer complicated by large amount of pleural fluid or pericardial effusion may also cause chest tightness and shortness of breath.
(2) Systemic symptoms: obstructive infectious fever, cancerous necrotizing fever. In addition, the wasting symptoms include emaciation, fatigue, weakness, anemia, and loss of appetite, etc.
(c) The manifestations of mediastinal invasion: hoarseness due to the involvement of the recurrent laryngeal nerve, diaphragm paralysis due to the involvement of the phrenic nerve, superior vena cava syndrome due to the involvement of the superior vena cava, pericardial filling and arrhythmia due to the involvement of the pericardium and myocardium, malignant pleural fluid due to the involvement of the pleura and dysphagia due to the involvement of the esophagus.
(d) Manifestations of extra-pulmonary metastases: Most of the pleural metastases are adenocarcinoma, characterized by hemorrhagic pleural fluid, but non-hemorrhagic pleural fluid does not exclude cancer. The involvement of the superior vena cava can lead to enlargement and thickening of the head and neck, as well as anger and cyanosis of the veins in the upper chest. Brain metastases may show symptoms such as increased cranial pressure and headache; liver metastases may show loss of appetite, nausea, wasting, and discomfort in the liver area; bone metastases may show bone destruction and severe fixed pain. Bone metastases may show bone destruction and severe pain. In addition, pestle and mortar fingers and painful bone and joint enlargement may also appear.
Various tests
(a) Cancer marker tests: serum concentrations of CEA, NSE, CyFRA21-1, β2-M and other tumor markers are often measured in lung cancer for diagnosis, efficacy and prognosis determination. (CEA