What are the methods for diagnosing lung cancer in the elderly? 10 methods for diagnosing lung cancer in the elderly

Lung cancer is a disease whose symptoms are not very obvious in the early stages of the disease. This leads to many patients not being able to realize their condition in time. By the time it is discovered, the disease has often entered the late stage, which makes it very difficult to treat. Therefore, the following are several methods for diagnosing lung cancer in the elderly.

How are lung cancer diagnosed in the elderly?

1. X-ray examination: It is the main means of diagnosing lung cancer. In the early stage, there may be no abnormal signs in the X-ray manifestations of central lung cancer. When the tumor blocks the bronchus, the distal lung tissue becomes infected, and the affected lung segment or lobe shows signs of pneumonia. When the bronchial lumen is completely blocked by the tumor, the corresponding lobe or one side of the lung may become deflated.

The tomographic X-ray film may show the shadow of the mass protruding into the bronchial cavity, irregular and thickened tube walls, or narrowing and obstruction of the lumen. When the tumor invades the adjacent lung tissue and metastasizes to the hilar mediastinal lymph nodes, a mass in the hilar region may be seen, or the mediastinal shadow may widen with a wavy outline, irregular mass shape, uneven edges, and sometimes lobed. When the mediastinal lymph nodes compress the phrenic nerve, the diaphragm may be seen to be elevated, and paradoxical movement of the diaphragm may be seen on fluoroscopy. Enlarged metastatic lymph nodes under the tracheal carina may increase the tracheal bifurcation angle, and the adjacent anterior esophageal wall may also be compressed. In advanced cases, pleural effusion or rib destruction may also be seen.

The most common X-ray manifestation of peripheral lung cancer is a solitary round or oval mass around the lung field, with a diameter ranging from 1 to 2 cm to 5 to 6 cm or larger. The mass has an irregular outline, often showing small lobes or notches, with fuzzy and rough edges, often with short and thin burrs. In a few cases, calcification points are occasionally seen in the mass. When peripheral lung cancer grows and blocks the bronchial lumen, segmental pneumonia or atelectasis may occur. The central part of the tumor is necrotic and liquefied, and thick-walled eccentric cavities can be seen. The inner wall is uneven, and there is rarely an obvious liquid level.

The X-ray manifestation of nodular bronchioloalveolar carcinoma is a solitary spherical shadow with clear outlines; the X-ray manifestation of diffuse bronchioloalveolar carcinoma is an invasive lesion with blurred outlines, ranging from a small piece to a lung segment or an entire lung lobe, similar to pneumonia.

Computerized tomography (CT) can display thin-section images to avoid overlap between lesions and normal lung tissue. It has high density resolution and can detect early lung cancer in areas hidden by general X-ray examinations (such as the apex of the lung, above the diaphragm, beside the spine, behind the heart, mediastinum, etc.). It is very valuable in determining whether there is mediastinal lymph node metastasis and helps to formulate treatment plans.

Magnetic resonance imaging (MRI): also known as nuclear magnetic resonance imaging, has the advantages of easily distinguishing the mediastinum, hilar blood vessels from masses and lymph nodes, and multi-faceted imaging, which can better determine the tumor range and vascular involvement, and has good contrast resolution. However, due to the high air content in the lungs, the effect is not as good as CT, and it is expensive, so it is not widely used.

2. Sputum cytology: Cancer cells shed from the surface of lung cancer can be coughed up with sputum. Sputum cytology can confirm the diagnosis by finding cancer cells, with an accuracy rate of more than 80%. Especially in cases with bloody sputum, there is a greater chance of finding cancer cells in the sputum, and the patient should rinse his mouth and send the sputum for repeated examination.

3. Bronchoscopy: For central lung cancer, the tumor can be directly seen in the bronchial cavity, and a small piece of tissue can be taken for pathological section examination. The tumor surface tissue can also be brushed through the bronchus or the bronchial secretions can be aspirated for cytological examination.

4. Transthoracic puncture biopsy: The positive rate of obtaining histological diagnosis for peripheral lung cancer can reach more than 90%, and the method is simple. However, in rare cases, complications such as pneumothorax, pleural cavity infection or bleeding, and cancer cell spread along the needle track may occur.

5. Pleural effusion examination: After the pleural effusion is extracted and centrifuged, the precipitate is taken for smear examination to look for cancer cells.

6. Mediastinoscopy: It can directly observe the lymph nodes under the anterior tracheal carina and on both sides of the bronchial area, and can take biopsy tissue for pathological examination to determine whether lung cancer has metastasized to the hilar and mediastinal lymph nodes. A positive result indicates that the lesion is extensive and is not suitable for surgical treatment. The positive rate of central lung cancer is higher.

7. Thoracoscopic examination: A small incision is made through the chest wall to insert a thoracoscope or fiber bronchoscope to directly observe the extent of the lesion or take living tissue for pathological section examination.

8. Radionuclide lung scan: Lung cancer and its metastatic lesions have an affinity for radionuclides such as gallium 67 and mercury 197 chloride. After intravenous injection, radionuclide concentration images appear at the cancerous site, and the positive rate can reach about 90%. However, pneumonia and some other non-cancerous lesions can also show positive phenomena, so a comprehensive analysis must be combined with clinical manifestations and other data.

9. Biopsy of metastatic lesions: For patients with advanced lung cancer who have lymph node metastasis above the clavicle, neck, axilla, etc. or subcutaneous nodules, the lesion tissue can be removed for pathological section examination, or the tissue can be extracted by puncture for smear examination to confirm the diagnosis.

10. Thoracotomy: If the nature of the lesion cannot be determined after various examinations, and the possibility of lung cancer cannot be ruled out, thoracotomy should be performed if the patient's general condition permits. During the operation, a biopsy or corresponding treatment should be performed according to the lesion to avoid delaying the disease.

You know, time is extremely precious to every lung cancer patient. The more time you gain, the more chances of recovery. Therefore, I hope you can read carefully the above methods for diagnosing lung cancer in the elderly, and I sincerely wish all lung cancer patients can recover their health.