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转载 肺癌是健康的无形杀手

杨继兵 主任医师 江苏省中医院 呼吸科
2017-10-17 114人已读
杨继兵 主任医师
江苏省中医院

世卫组织 WHO, 说肺癌是全世界癌症里的头号杀手,中国 美国 概莫能外,肺癌 多发 难治 死早 死快。江苏省中医院呼吸科杨继兵

Cancer is a leading cause of death worldwide, accounting for 8.8 million deaths in 2015. The most common causes of cancer death are cancers of:

1376346690_lung-cancer.jpg

肺癌的分型

一、鳞状细胞肺癌(鳞癌):这是在肺癌中最常见的一种类型,患者年龄大多数在50岁以上,男性占大多数。

二、小细胞肺癌发病率比鳞癌低,发病年龄较轻,多见于男性。恶性程度较高,生长快,早期即可出现淋巴和血行的广泛转移,对放射治疗和化学治疗虽较敏感,但在各型肺癌中预后最差。

三、腺癌:这一型在女性中比较多见,早期一般没有临床症状,生长较慢,但有时早期就可发生血行转移,淋巴转移发生较晚。

四、大细胞肺癌较少见,分化程度低,常在发生脑转移后才被发现。

五、类癌:占1%~2‰。此癌为分化好的神经内分泌癌,恶性程度低。

六、细支气管肺泡癌: 欧美占2‰~3‰,国内占20‰。为一种异源性肿瘤,可起源于细支气管Clara细胞、肺泡II型上皮细胞及化生的粘液细胞。

其他还有不典型类癌、大细胞神经内分泌、巨细胞神经内分泌癌、不能分类的神经内分泌癌、癌内瘤及成细胞瘤等。

由于小细胞肺癌的生物学行为表现为高度恶性,早期即发生广泛的转移,对化疗和放疗敏感,治疗原则有所不同,所以,从临床治疗角度考虑,目前世界上倾向于将肺癌划分为:

小细胞肺癌 SCLC 和非小细胞肺癌 NSCLC两大类。

GettyImages-147219202-59b7e4e6054ad90011fdf006.jpg


肺癌 肝转移

Lung cancer can spread to any region of the body, but most commonly spreads to the

liver, the lymph nodes, the brain, the bones, and the adrenal glands.

For people with non-small cell lung cancer, the spread of cancer to the liver would classify it as a stage 4 cancer.

With small cell lung cancer, it would be classified as an extensive stage.

 

预后 Prognosis

Small cell lung cancer (SCLC) is particularly challenging for patients and physicians because it is so aggressive (fast growing and spreading). Two-thirds of all patients with SCLC are diagnosed after the disease has already spread throughout the body. As a result, prognosis of SCLC is quite poor.

For SCLC patients that have limited disease, the average life-span in untreated patients is about 12 weeks. Limited disease is defined as SCLC cancer that is completely contained in one half of the chest and can be treated through a single radiation therapy port. With aggressive treatment, the average life-span of limited stage SCLC is 20 months. The 2-year survival rate in limited SCLC is 45% and the 5-year survival rate is 20% with treatment.

For extensive SCLC disease, that is, cancer that has spread beyond half the chest, the average life-span in untreated patients is about 6 weeks. With aggressive treatment, the average life-span is 12 months. The 2-year survival rate with extensive SCLC disease is less than 5%.

Non-Small Cell Lung Cancer 5-year Survival Rates
Stage                     Survival Rates
Stage IA                   49-75%                      
Stage IB                   45-55%                      
Stage IIA                 30-50%                      
Stage IIB                31-40%                      
Stage IIIA              14-35%                      
Stage IIIB               2-5%                      
Stage IV                ~1%


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杨继兵 主任医师

江苏省中医院 呼吸科

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