Sift and check lung cancer: CT is more effective than the X-ray Do every year once over 40 person

Sift and check lung cancer: CT is more effective than the X-ray Do every year once over 40 person
Sift and check lung cancer: CT is more effective than the X-ray Do every year once over 40 person
Do at least every year once over 40 person The high-risk group should do it once in recent years in half a year, treating a plurality of fields such as breast cancer, gastric carcinoma, cancer of colon, cervical cancer makes certain progress one after another, the patient has been lengthened in varying degrees in life cycle. However, the lung cancer patient that the morbidity comes out at the top has not obviously changed in life cycle. The statistics show, the lung cancer patient of life cycle of 5 only has 10%- 15%. Main reason its, lie in to diagnose, have difficulty in early days lung cancer, when most patient go to a doctor, in later period in, influence the result of treatment and size in life cycle directly. In our country, the usually early lung cancer treatment costs about several ten thousand yuan, and may get and cure; And in can reach more than ten Wan to hundreds of thousands yuans later period lung cancer therapeutic expenses, and the therapeutic effect is obviously lower than the former. So, if want to get the upper hand in the struggle with lung cancer, it is a key to examine and manage early early. All the time, sift and check lung disease (including lung cancer) with chest X-ray photograph Employ the most general physical examination project. But the latest research shows, sift checking lung cancer is more effective with CT. Publish one research of " the the intersection of New England and medical magazine " claim, have lung cancer to be high to endanger 50,000 more than people of factor, assign the intersection of CT and group and the intersection of chest and the intersection of X-ray photograph and group to at random in this year, the former makes low dosage spiral CT of chest 3 times every year, the latter takes chest 3 times and inclines the location X-ray photograph every year. Find CT sift check, reduce 20% relatively mortality of lung cancer, and X-ray photograph sift can lower the mortality of lung cancer by 6.7% to consult only after the 5 year. Sift, check on to diagnose, superior to the intersection of chest and X-ray photograph in early days lung cancer in view of CT, propose, make one the intersection of chest and CT at least every year over person the 40, high-risk group ( Including there is family's history of lung cancer, smoking etc.) Should make chest CT once in half a year. Generally speaking, CT to most sensitive lung cancer around type, enhanced CT 90% to 3 more than sensitiveness of pathological change, can be up to 95% as to the sensitiveness of more than 1 centimetre of pathological changes. If happen at the central lung cancer of the mucous membrane of bronchus, early CT can not often see the focus, diagnose at this moment that depends on bronchus mirror and phlegm liquid and checks even more. So, if the patient belongs to high-risk group such as the long-term smoker,etc., yes symptoms such as coughing, blood silk phlegm, spitting blood,etc. repeatedly, but CT has not found the focus, should do phlegm liquid checking and bronchus mirror to help to diagnose. Find that there are suspicious and focal patients in the lung as to CT, define its property is very important, further check and include: 1. Through having a blood test, sift and check the tumour mark thing. 2.Resist inflammation treatment for 2 weeks, then reexamine CT. 3.If focus see, reduce, tuberculosis, make PET-CT and pathology to check in order to further diagnose clearly at the same time answer. The optional way includes pathology's checking: Phlegm liquid check, puncture, not fine to prop up mirror by leather lung and ultra information in charge of mirror,etc. in the bronchus, need to do surgery to treat and concurrently diagnose if necessary. Find the little focus in some patient lungs, possess the dangerous factor of lung cancer again, resist inflammation to be invalid, except arrange behind the tuberculosis, should highly suspect lung cancer, in difficult to define pathology cases, should consider doing the operation. As to this, a lot of patients are difficult to understand, in fact have a lot of bitter lessons in this respect. Have one 60 -year-old woman once, have, cough symptom, find first 1 centimetre size tubercle at the lung. After resisting the inflammation treatment, cough, disappear, the local doctor tells her OKly, have not further checked. Less than one year, patient begin, feel suffocated, not weak and appetite drop, another check, lung cancer had already been spread all over, arrived in later period, and lost the chance of the operation by mistake, could well imagine finally. Certainly, do not say the lung in every case finds small tubercle needs the operation. Some patients do not possess the dangerous factor of lung cancer, tubercle is isolated, is smaller than 5 millimetres, smooth in the border, and check regularly and have no change, can examine and observe at the same time. With the progress of the detection technique of molecular biology, more better lung cancer monitoring means will appear in the future, help people to eliminate lung cancer in sprouting. (author is a chief physician of thoracic surgery of BJ Union Hospital)


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