Lung cancer treatment must be staged before treatment The treatment principles, treatment plans and prognosis of early stage lung cancer, middle stage lung cancer and late stage lung cancer are different, so the treatment of lung cancer must be staged before treatment. With the introduction of the seventh edition of lung cancer staging by the World Lung Cancer Association, we emphasize more that lung cancer must be staged before treatment. Now lung cancer is divided into: stage I, stage II, stage III and stage IV according to the new staging, and stages I to III are divided into stage IA, stage IB, stage IIA, stage IIB, stage IIIA and stage IIIB. Only patients before stage I to stage IIIA can benefit from surgical procedures. If preoperative cranial MRI, bone scan and abdominal CT are not done, and there are already brain metastasis, bone metastasis and abdominal metastasis, and surgery is still done, the patient will receive a knife for nothing; on the contrary, if a patient with trauma history is diagnosed as stage IV lung cancer just by bone scan showing that there is bone polymetabolism without thoracic spine MRI, the patient will lose the chance of radical treatment, so we must pay attention to clinical Therefore, we must pay attention to clinical staging and do a good job of clinical staging. The staging measures of lung cancer mainly include two aspects One is to examine the common metastatic sites of lung cancer, such as: fiberoptic bronchoscopy, which not only can biopsy or brush the film, which is important for diagnosing whether surgery can be performed, but also can understand whether the bulge is fixed and the bronchial pressure, which is a routine examination item for patients with proposed lung cancer (with the exception of contraindications). Frontal and lateral chest radiographs and CT films are important for intra-pulmonary and mediastinal metastatic lymph nodes, and cranial MRI or CT examination can detect brain metastases in time. Ultrasound examination shows the presence or absence of metastatic lesions by looking at the liver, retroperitoneal lymph nodes and adrenal metastases in all directions. These organs in the upper abdomen can be scanned down several levels to the adrenal plane during CT examination of the chest, which can be corroborated with ultrasound examination and more reliable. Bone metastasis is also a common metastatic site of lung cancer. Through isotope bone scan, isotope concentration can be detected, indicating the possibility of metastasis. Bone marrow metastasis is a different concept from bone metastasis, and can be clearly diagnosed by bone marrow aspiration or biopsy. Positron emission tomography (PET) examination is expensive and also has false positives. It is not yet popular in China and cannot be used as a routine examination. Mediastinoscopy has definite value for mediastinal lymph node metastasis, but it is an invasive test, which is not easily accepted by patients. The second aspect of lung cancer staging measures is to assess the functional condition of organs, which is important to the patient’s choice of next treatment. The main components include: detailed medical history and physical examination, liver and kidney function, pulmonary function, electrocardiogram, blood cell analysis, blood electrolytes, enzymology and tumor markers and other items. In the medical history, special attention should be paid to the extra-pulmonary symptoms of lung cancer, such as bone and joint symptoms, endocrine changes, etc. During physical examination, we should carefully check whether the lymph nodes in the neck and axilla are enlarged, and whether there is pressure pain in the lower tibia of the lower limbs. The diagnosis can be made by clinical physical examination of the metastases on the body surface. For small cell lung cancer, elevated tumor markers NSE and ProGRP have diagnostic and prognostic value, but cannot be used as a basis for staging. Other tumor markers such as CEA, LDH, CYFRA21-1 and TPA have even worse specificity and are not items for staging examination.