Lung cancer is a malignant tumor occurring in the mucosal epithelium of bronchus, also called primary bronchial cancer, which is one of the most common malignant tumors at present. In recent 50 years, the incidence rate of lung cancer has increased significantly, and the incidence rate and mortality rate of lung cancer in countries all over the world are on the trend of increasing significantly, and the incidence rate of lung cancer has taken the first place among male patients in industrial cities such as Beijing, Shanghai, Guangzhou and other mining areas in northeast, north and southeast coast of China. Most of the lung cancer patients are men, and the ratio of men to women is about 4-8:1, but in recent years, the incidence rate of women has increased significantly, and the ratio of men to women has decreased to about 2:1, and the age of incidence is mostly above 40 years old, and the age of 50-60 years old has increased significantly. The global incidence of lung cancer was 591,000 cases in 1975, 896,000 cases in 1985, and 1,230,000 cases in 2000, representing an increase of 109,6% between 1975 and 2000. Early diagnosis of lung cancer is an effective way to improve the treatment effect. Its early manifestations are as follows
Cough is usually the first symptom of lung cancer, which is mainly due to the stimulation of bronchial mucosa by tumor or its secretions.
Hemoptysis and bloody sputum is one of the first symptoms, accounting for 35.9%, which is characterized by intermittent and repeated small amounts of bloody sputum.
Fever accounts for 21.2% of the first symptoms. Clinically, we often see patients with lung cancer starting with fever or so-called infection and treated with the diagnosis of “intrapulmonary infection” after X-ray fluoroscopy, and temporary effect can be obtained, but the shadow in the lung will not disappear completely when the X-ray is reviewed.
4. Chest tightness and chest pain Usually, there may be irregular chest tightness, pressure or dull pain. Peripheral type lung cancer patients with chest pain, back pain, shoulder pain, upper limb pain and intercostal neuralgia as the first symptoms account for 24% of the patients, which cannot be easily treated as “periarthritis of shoulder”, “cervical spondylosis” and “intercostal neuritis”. It should not be easily treated as “periarthritis of shoulder”, “cervical spondylosis” or “intercostal neuritis”.
5.Shortness of breath About 6-6% of patients have shortness of breath and chest tightness due to large bronchial obstruction.
6.Tumor side signs It is not uncommon for lung cancer to cause tumor side signs, which may appear before the discovery of lung cancer or appear simultaneously with lung cancer. Common tumor side effects include.
(1) Acanthosis nigricans, which is mainly manifested as thickening and pigmentation of the skin of axillae or flexural surfaces of limbs, palms and soles of the feet can also be involved, and sometimes the oral mucosa also has the above changes;
(2) Hyperplasia of the vegetative nerves is characterized by unilateral sweating or flushing of the chest or upper extremities, mostly in association with carcinoma of the apical lung or the superior pulmonary sulcus;
(3) Dermatomyositis mainly manifests as muscle weakness, more severe in the muscles of the pelvic girdle than in the scapular girdle, and the face often has butterfly-shaped symmetric skin erythema;
(4) Pulmonary osteoarthritis mainly manifests as pestle and mortar finger and long bone periostitis;
(5) Disseminated intravascular coagulation often occurs as subcutaneous petechiae and hematomas, and patients with squamous lung cancer may sometimes have purpura and callus on the palms and soles of the feet;
(6) Skin pigmentation is mainly manifested in exposed parts of the body, nipples, lips, cheek mucosa, vulva and other parts of the skin;
(7) Gynecomastia often suggests ectopic gonadotropin production, which is more common in small cell lung cancer.
7.Sputum cytology examination Primary lung cancer originates from tracheal and bronchial epithelium, thus tumor cells will be shed in the lumen and discharged with sputum, which has been widely used in the diagnosis of lung cancer.
8.X-ray examination The main manifestations are.
(1) Isolated lesions in the lung field, which are lobulated and may have short burr shadows at the edges;
(2) limited emphysema, which is an early sign of central lung cancer;
(3) Obstructive pneumonia: a relatively early sign of a segmental or lobar bronchial origin;
(4) Pulmonary atelectasis: due to further tumor enlargement, combined with inflammatory edema or secretions obstructing the lumen.
9.CT examination can detect the lesion at an earlier stage compared with X-ray, and is an important tool for correct staging of lung cancer and establishing treatment plan.
10.Bronchoscopy is an effective means to diagnose lung cancer, which can observe the location and scope of tumor and obtain tissues for pathological examination to distinguish the pathological types of lung cancer.
The treatment methods of lung cancer mainly include surgical therapy, radiotherapy and drug therapy, as well as the combined application of these three methods. In recent years, biological therapies have also been developed as adjuvant treatment.
For all types of lung cancer, if the lesions are small, confined to the bronchial lung, no distant metastasis has been detected, and the patient’s general condition is good, surgical therapy should be used, and radiotherapy and drug therapy should be applied in combination according to the pathological type and the situation found at surgery. In small cell carcinoma, distant metastasis occurs at an early stage, so it is difficult to be cured by surgery.