講課肺癌英文

1、lung cancer begins when cells in the lung grow out of control and form a tumoretiology and pathogenesiscigarette smokingother factors include air pollutions nowadays it is reported that tuberculosis is associated with the incidence of lung cancer classifications according to anatomy: (1)central lung

2、 (2) peripheral lung cancer according to histologic classification: small cell lung cancer(sclc) and non-small cell lung cancer(nsclc). nsclc includes squamous cell carcinoma, large cell carcinoma, adenocarcinoma, adenosquamous carcinoma.small cell lung cancer(sclc)oat-cell carcinoma sclc grows very

3、 rapidly and is very aggressive. soon 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

4、 specific peptide product.they may related to paraneoplastic syndrome. cells are oval or vaguely spindle-shaped ,have scant cytoplasm squamous cell carcinoma the most frequent form of the tumor(30-50 percent of all cases bronchial epithelium and growth in situ it is related to cigarette smoking cavi

5、tation can occure in the distal to the obstructing mass central location intercellular bridges and cellular pleomorphism 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 t

6、he area between the tumor and the edge of the lung it causes symptoms early in the disease 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 submu

7、cosal glands,located in peripheral airways and alveoli female large cell carcinoma large nuclei,prominent nucleoli,abundant cytoplsma usually located peripherally can be quite large and not infrequently cavitategh shortness of breath chest pain loss of appetite coughing up phlegm hemoptysis (coughin

8、g up blood) if cancer has spread, symptoms include bone pain, difficulty breathing, abdominal pain, headache, weakness, and confusion due to primary lesions: cough, dyspnea, hemoptysis, sputum, wheezing, weight loss, fever, pneumonia due to local extension: chest pain,hoarseness,superior vena cava s

9、yndrome, horners syndrome, dysphagia, pericardial effusion,pleural effusion, diaphragm paralysis only 5-15 percent of patients are asymptomatic when discovered to have bronchogenic carcinoma. regionnal spread to hilar and mediastinal nodes may cause dysphagia due to esophageal compression horseness

10、due to recurrent laryngeal nerve compression horners syndrome due to sympathetic nerve involvement elevation of the hemidiaphragm from phrenic nerve compression. superior sulcus, or pancoasts tumor may involve the brachial plexus, resulting in a c7-t2 neuropathy with pain, numbness, and weakness of

11、the arm. cardiac involvement is seen in about 20-25 percent of patients extrapulmonary manifestations. including metastasis to other organs, such as brain, central nervous system, skeleton system, liver,adrenal glands and lymph nodes ects. paraneoplastic syndromes are remote effects of tumor. they l

12、ead 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 tumor has spread.physical examinations usually in early stage, most of the patients with lung cancer have no positive physical

13、 findings. general findings include abnormal percussion, breath sounds changes, moist rales (when pneumonia happens) digital clubbing, superior vena cava syndrome, horners syndrome(unilaterally constricted pupil, enophthalmos,narrowed palpebral fissure and loss of sweating on the same side of the fa

14、ce.physical examinations endobronchial obstruction may result in a localized wheeze lobar collapse may result in an area of decreased breath sounds and dullness to percussion.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 biopsy

15、the location(s) of all sites of cancer is 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

16、the lung as well chest x-ray it is the most important method to find lung cancerthe most frequent finding is a mass in the lung fieldon chest x-ray, secondary manifestations include lobar collapse, pleural effusion, pneumonitis, elevation of the hemidiaphragm, hilar and mediastinal adenopathy, and e

17、rosion of ribs or vertebrae due to metastases.obstructive atelectasislung 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 of lung field and the size of t

18、he 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. bronchoscopy rigid and flexible scope biopsy and selective washings larger samples than flexible scope exact location lobect

19、omy pneumonectomy unresectable sleevetransthoracic 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 video assisted thoracic surgery diagnosis of pleural disease wedge resection m

20、ediasteinoscopy & mediasteinotomy diagnoses unresectable disease eliminate n2 disease from surgical resectionthoracotomyif the methods mentioned above are not useful for detecting the cell type of lung cancer,thoracotomy may be usedstaging of lung cancer small cell lung cancer has often metastas

21、ized at the time of diagnosis.tnm staging is not suited to small cell lung cancer. treatmentincluding: a:surgery b:chemotherapy c:radiation therapy d:some other therapy immunologic therapy, chinese traditional therapysurgerynon-small cell lung cancer: patients with stage i and ii are considered cand

22、idates for surgical resection, with stage iii cancer may be candidates for surgery with postoperative radiation of the mediastinum. 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 percen