What are the diagnostic criteria for lung cancer? About the early symptoms of lung cancer

The lungs are the tropical rain forest in the human body. They supply oxygen to the human body and remove carbon dioxide from the human body. They are the source of human life. Without breathing, there is nothing. Therefore, the health of the lungs has a far-reaching impact. It is related to the normal functioning of the body. Good lungs can bring health to people. However, due to unhealthy living habits, lung cancer becomes inevitable. What are the symptoms of lung cancer?

1. Symptoms:

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 account for 27%. The symptoms are related to the location of the primary tumor. Central lung cancer manifests as irritating dry cough, shortness of breath, 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, shortness of breath 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 account for 32% of the first symptoms. 10% to 20% of lung cancer patients are accompanied by tumor-associated syndrome.

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. The enlargement of the tumor 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 small amounts of hemoptysis; for some patients, even one or two bloody sputums are of great reference value for diagnosis. Some patients may experience chest tightness, shortness of breath, fever, and chest pain due to larger 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 ipsilateral diaphragmatic paralysis

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 Lung cancer at the top of the upper lobe.

2. Diagnostic Criteria:

The diagnosis of primary bronchogenic lung cancer is based on symptoms, signs, X-ray findings, and sputum cancer cell examination (sputum examination). Different steps should be taken according to different situations during the diagnosis.

(a) X-ray negative, sputum negative

1. Asymptomatic patients with three high-risk factors (male, age ≥45 years, and smoking >400 cigarettes/year) should undergo 70-100 mm fluorescent microscopic X-ray or chest fluoroscopy and sputum cytology every six months.

2. Patients with hemoptysis and/or dry cough accompanied by the three major high-risk factors should undergo repeated sputum cytology examinations and receive regular anti-inflammatory treatment; fiberoptic bronchoscopy (bronchoscopy) and video fluoroscopy can be considered. If repeated sputum examinations or microscopic examinations are still negative, they should be reexamined every two months for one year.

(ii) X-ray negative, sputum positive

1. Exclude upper respiratory tract and esophageal cancer

2. Perform bronchoscopy and try to see the sub-sub-segment. If there is any suspicious local mucosal thickening, roughness or blood stains, brush, wash or puncture the bronchial wall mucosa to look for cancer cells. If the local area is uneven or obviously rough, consider taking a bite biopsy.

3. Perform TV fluoroscopy, change body position, and pay special attention to small nodules in hidden areas.

4. If the above examinations fail to find the lesion, sputum, electrodialysis and bronchoscopy should be repeated every two months. CT examination can also be performed, and sub-layering should be performed in suspicious areas. Regular reexamination should continue for no less than one year.

(III) X-ray positive, sputum negative

1. Patients with segmental or lobar pneumonia or obstructive pneumonia and suspected central lung cancer should undergo bronchoscopy, including transbronchial biopsy (TBB), or selective bronchography; and repeated sputum examination should be performed.

2. Local sectional films should be taken for masses or nodules. Transbronchial lung biopsy (TBLB), percutaneous lung biopsy, or aspiration for cytological diagnosis can be performed if conditions permit.

3. Perform sputum examinations at least twelve times continuously.

4. If repeated sputum tests are still negative but X-rays highly suspect lung cancer, exploratory thoracotomy and frozen section biopsy should be performed.

(IV) X-ray positive, sputum positive

1. Actively prepare for surgery.

2. When regional lymphadenopathy is suspected, AP and lateral oblique slice films can be taken. CT can be performed if necessary. For limited-stage small cell lung cancer, CT and AP and lateral oblique slice films, liver B-ultrasound, bone isotope scanning and bone marrow puncture biopsy smear examinations should be routinely used in large hospitals to facilitate the formulation of treatment plans.

3. Classification:

Lung cancer originates from the bronchial mucosal epithelium, and those confined to the basement membrane are called carcinoma in situ. The tumor can grow into the bronchial cavity and/or adjacent lung tissue, and can spread through lymphatic, blood or bronchial metastasis. The growth rate and metastasis of the tumor are related to its biological characteristics such as histological type and degree of differentiation.

The distribution of lung cancer is more common in the right lung than in the left lung, and more common in the upper lobe than in the lower lobe. Tumors can occur from the main bronchi to the bronchioles. Lung cancer that originates from the main bronchi and lobar bronchi and is located near the hilum of the lung is called central lung cancer; lung cancer that originates below the segmental bronchi and is located in the peripheral part of the lung is called peripheral lung cancer.

Lung cancer is generally divided into the following four types clinically.

1. Squamous cell carcinoma (also known as squamous cell carcinoma): the most common type of lung cancer. 2. Undifferentiated carcinoma. 3. Adenocarcinoma. 4. Alveolar cell carcinoma

IV. Others

Only with early diagnosis and early treatment can better results be achieved, so cancer prevention knowledge should be widely publicized to the public. Adults over 40 years old should undergo a chest X-ray survey every six months. Those who have suspicious symptoms such as persistent cough, blood in sputum, and lung shadows should undergo a series of detailed examinations to make a clear diagnosis. For nodules ≤5mm found in the survey, they should be rechecked every 3 months; nodules 6-10mm in size should be biopsied percutaneously. If biopsy is not possible, CT scans should be performed every 3 months; nodules >1cm should be biopsied.

Love life and pay attention to lung health. Do more aerobic exercise to strengthen lung function. Develop good living habits to protect your lungs. Smoke less and go to places full of smoke less often. Take in more oxygen from nature, give your lungs a healthy environment, prevent lung cancer, and truly breathe healthily. Let the tropical rainforest of your body become more luxuriant.