Clinical manifestations of early symptoms of lung cancer

Lung cancer is a very common primary malignant tumor, and its incidence is very high, so people have to pay great attention to it. Here are some early symptoms of lung cancer:

There are usually no symptoms in the early stages. Almost two-thirds of lung cancer patients are already in the advanced stage (stage III or IV) when they seek medical treatment. 95% of patients have clinical examination results. Primary tumors, metastatic tumors, systemic symptoms or tumor-associated symptoms can all be the patient's first symptoms.

The first symptoms caused by the primary tumor accounted for 27%. The symptoms were related to the location of the primary tumor. Central lung cancer was manifested by irritating dry cough, breathlessness, repeated pneumonia in the same location, hemoptysis or asthma, recurrent laryngeal nerve, phrenic nerve compression symptoms or superior vena cava compression syndrome. Peripheral tumors are more common with symptoms such as chest pain, breathlessness or pleural effusion. Large peripheral lesions, central necrosis, and cavities eventually present similar manifestations to lung abscesses. Common symptoms of primary lung cancer are grouped.

Distant metastatic lesions cause the first symptoms in 32% of cases. Common distant metastatic sites include lymph nodes, adrenal glands, liver, bones, lungs, brain and chest wall. Some corresponding symptoms occur, indicating that lung cancer has reached the late stage, such as: tumors near the mediastinum can invade the phrenic nerve, causing ipsilateral diaphragm paralysis, and under fluoroscopy, the diaphragm position is elevated and abnormal respiratory movements are shown; invade the ipsilateral recurrent laryngeal nerve, causing hoarseness, ipsilateral vocal cord paralysis and fixation in the median position; compress the superior vena cava, causing edema of the head, face and upper limbs, and venous distension; invade the pleura, causing a large amount of blood in the pleural cavity. Fluid accumulation, aggravating the symptoms of shortness of breath, or directly invade the chest wall, causing severe chest pain; lung cancer at the apex of the upper lobe is located at the entrance of the thorax, also known as superior pulmonary sulcus cancer, which can invade and compress the brachial plexus, cervical sympathetic ganglia, and subclavian artery and vein, producing a series of special symptoms, such as numbness and pain in the ipsilateral upper limb, which gradually increases and becomes difficult to tolerate; atrophic changes in muscles and skin, distension and edema of the upper limb veins; and cervical sympathetic nerve syndrome such as ipsilateral ptosis, pupil constriction, enophthalmos, and absence of sweat on the face.

10% to 20% of lung cancer patients have tumor-associated syndromes. The most common symptoms are small cell lung cancer and squamous cell carcinoma. Common tumor-associated syndromes include pulmonary osteoarthritis syndrome (clubbing, bone and joint swelling and pain, periosteal hyperplasia, etc.), SIADH (syndrome of inappropriate antidiuretic hormone secretion), hypercalcemia, etc. There are also Cushing's syndrome, myasthenia gravis or male breast enlargement. About 16% of patients have neuromuscular symptoms, and some patients have skin diseases such as scleroderma and acanthosis nigricans.

The clinical manifestations of lung cancer are closely related to the location, size, compression, invasion of adjacent organs, and metastasis of the tumor. Tumors grow in larger bronchi, often causing irritating coughs. Tumor enlargement affects bronchial drainage, and secondary lung infection may cause purulent sputum. Another common symptom is bloody sputum, usually with blood spots, blood streaks, or intermittent hemoptysis. Even one or two bloody sputums in some patients are of great reference value for diagnosis. Some patients may experience chest tightness, shortness of breath, fever, and chest pain due to large bronchial obstruction caused by tumors.

When advanced lung cancer compresses adjacent organs and tissues or metastasizes to distant sites, it may cause:

①Compression or invasion of the phrenic nerve, causing paralysis of the ipsilateral diaphragm.

②Compression or invasion of the recurrent laryngeal nerve, causing vocal cord paralysis and hoarseness.

③ Compression of the superior vena cava causes venous distension in the face, neck, upper limbs and upper chest, subcutaneous tissue edema, and increased venous pressure in the upper limbs.

④ Invasion of the pleura may cause pleural effusion, which is mostly bloody.

⑤ The cancer invades the mediastinum and compresses the esophagus, which may cause difficulty in swallowing.

⑥ Upper lobe lung cancer, also known as Pancoast tumor or superior pulmonary sulcus tumor, can invade and compress organs or tissues located at the upper opening of the thorax, such as the first rib, supraclavicular artery and vein, brachial plexus, cervical sympathetic nerves, etc., causing chest pain, distension of the jugular vein or upper limb veins, edema, arm pain and upper limb movement disorders, ptosis of the upper eyelid on the same side,

A small number of lung cancers produce endocrine substances, which clinically present non-metastatic systemic symptoms: such as osteoarticular syndrome (clubbing, joint pain, periosteal hyperplasia, etc.), Cushing's syndrome, myasthenia gravis, male breast enlargement, multiple muscular neuralgia and other extrapulmonary symptoms. These symptoms may disappear after the resection of lung cancer.

Therefore, experts remind that if you feel that you have early symptoms of lung cancer, you should go to a regular hospital for examination and treatment as soon as possible. Early detection and early treatment can avoid delaying the disease and causing serious consequences.

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