肺癌

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    概述
    肺癌是最常见的肺原发性恶性肿瘤，绝大多数肺癌起源于支气管粘膜上皮，故亦称支气管肺癌。近50多年来，世界各国特别是工业发达国家，肺癌的发病率和病死率均迅速上升，死于癌病的男性病人中肺癌已居首位。40多年前，在中国因肺部疾病施行外科手术治疗的病人中，绝大多数为肺结核，次之为支气管扩张、肺脓肿等肺化脓性感染疾病，肺癌病例为数不多。

    吸烟是导致肺癌发生的一个很大的原因。
    有的人虽然自身并不吸烟，可是同事和家里人吸烟，有的还长期在含有大量汽车尾气的环境中工作，得肺癌的可能性增大。
    为什么部分“老烟客”不患肺癌呢?专家解释，目前发现有两个因素使得部分“老烟客”成为不患肺癌的“另类人群”。一方面，我们知道吸烟会损伤DNA，但这类人群DNA修复抗损伤功能正常。另一方面，这类人群的抗氧化解毒功能正常，对烟草中的致癌物能够分解代谢掉。所以，这些“另类人群”可能侥幸躲过肺癌这关。
    另外，温馨提醒：有以上危险因素的人们，请警惕肺癌的一些早期信号，主要有以下7个方面：
    (1)咯血：三分之一至二分之一的患者有此症状，多为偶发性的痰中带血丝，以此为首发的患者约有三分之一;
    (2)胸痛：三分之一至五分之三的患者出现胸痛;
    (3)发热：阻塞性肺炎或癌性热引起发热;
    (4)肺外症状：骨关节病变、异位内分泌综合症。因此，要提高对这些症状的警觉性，一旦有类似情况应及时去医院就诊。可以通过胸部X光检测、痰脱落细胞学检查、纤支镜检查、CT、磁共振、经皮肺穿、淋巴结活检、胸腔穿刺检查、肿瘤标记物等方法。早期肺癌诊断对治疗效果的好坏起到很大的作用。
    (5)肿瘤转移引起的症状，约占10%;
    (6)胸闷气短：十分之一至二分之一有此症状;
    (7)咳嗽：以咳嗽为始发症状的患者约为二分之一至三分之二。

    体征
    1、局限性哮鸣音为局限性哮鸣音，多为吸气阶段出现，咳嗽后并不消失。
    2、声音嘶哑淋巴结转移压迫或侵犯喉返神经时出现。
    3、上腔静脉综合症肿瘤压迫或侵犯上腔静脉，静脉回流受阻，产生头面、颈、上肢水肿，上胸部静脉曲张并水肿，伴头晕、胸闷、气急等症状。
    4、Horner’s综合征肺尖癌压迫或侵犯颈交感神经节时，出现患侧眼球凹陷，上睑下垂、瞳孔缩小、眼裂狭窄、患侧上半胸部皮肤温度升高、无汗等。
    5、肩臂疼痛 肺尖癌压迫或侵犯臂丛神经时，出现该侧肩部及上肢放射状灼热疼痛。
    6、膈神经麻痹膈神经受侵时出现气急胸闷
    7、吞咽困难纵隔淋巴结肿大压迫食管所致，压迫气管可致呼吸困难。
    8、心包受侵 心包受侵时出现心包积液，气急，心律失常，心功能不全等。
    9、胸膜转移可见胸痛，癌性胸水等。
    10、肺癌转移肺癌的血行转移常见部位依次是骨、肝、脑、肾、肾上腺、皮下组织等，另外肺癌内转移也较常见。临床随转移部位不同而有相应的症状、体征。
    11、肺外体征常见有四肢关节疼痛或肥大、杵状指，多发性神经炎，重症肌无力，库欣病、男性乳房增生肥大、高钙血症、精神异常等。

    相关新闻
8种致癌坏习惯        抽烟啥情况要注意
肺癌早发现早治疗   癌症早期症状

==== 汉译英 ====

Outline
Lung cancer is the most common primary lung cancer, most lung cancer originated in the bronchial epithelium, it is also known as lung cancer. Nearly 50 years, the world countries, especially industrialized countries, lung cancer incidence and mortality are rising rapidly, men who died of cancer lung cancer ranks first. 40 years ago, in China for the purposes of surgical treatment of lung disease patients, the vast majority of tuberculosis, followed by as bronchiectasis, pulmonary abscess and other suppurative lung diseases, lung cancer a few.

Smoking is a cause of lung cancer and a big reason.
Although some people do not smoke themselves, but colleagues and family smoking, and some long-term in the presence of a large number of automobile exhaust in the work environment may increase the likelihood of lung cancer.
Why do some "old smokers" do not suffer from lung cancer? Expert explained that there are two factors found to make some "old smokers" is not suffering from lung cancer to become the "alternative crowd." On the one hand, we know that smoking can damage DNA, but these people anti-DNA damage repair function was normal. On the other hand, this population of antioxidant detoxification function properly, the carcinogens in tobacco can catabolism off. Therefore, these "alternative crowd" may be lucky enough to escape the lung on to this.
In addition, the warm reminder: there are more people in risk factors, please some of the early warning signals of lung cancer, mainly in the following seven areas:
(1) hemoptysis: one-third to one half of patients have this symptom, mostly sporadic blood stained sputum, this is starting about one-third of patients;
(2) chest pain: one-third to three-fifths of patients with chest pain;
(3) fever: obstructive pneumonia or cancer of heat caused by fever;
(4) pulmonary symptoms: bone and joint disease, ectopic endocrine syndrome. Therefore, to raise awareness of these symptoms, if there is a similar situation to the hospital in time. Can be detected by chest X-ray, sputum cytology, bronchoscopy, CT, MRI, percutaneous lung wear, lymph node biopsy, pleural biopsy, tumor markers and other methods. Early diagnosis of lung cancer treatment played a significant role in good or bad.
(5) symptoms caused by tumor metastasis, accounting for about 10%;
(6), chest tightness, shortness of breath: one-tenth of one from there this symptom;
(7) cough: cough as the initial symptom in patients with about half to two-thirds.

Signs
1, for the limitations of limitations wheeze wheeze, inspiratory periods, mostly, do not disappear after coughing.
2, hoarseness oppression or violation of the recurrent laryngeal nerve lymph node metastasis occurs.
3, superior vena cava syndrome, or violations of tumor compression on the vena cava, venous obstruction, resulting in the head, face, neck, upper extremity edema, varicose veins and edema on the chest, accompanied by dizziness, chest tightness, shortness of breath and other symptoms.
4, Horner's syndrome in apical cancer cervical ganglion oppression or violation occurs when the eye ipsilateral depression, ptosis, miosis, narrow eye fissure, ipsilateral half of the chest skin temperature, so no sweat.
5, shoulder and arm pain, oppression or violation of apical lung cancer when the brachial plexus, shoulder and upper extremity to which the radial side of burning pain.
6, phrenic nerve paralysis occurs when the phrenic nerve involvement chest tightness, shortness of breath
7, dysphagia, esophageal compression caused by mediastinal lymph node enlargement, compression of the trachea can lead to breathing difficulties.
8, pericardial invasion invasion occurs when the pericardium pericardial effusion, shortness of breath, arrhythmia, cardiac insufficiency, etc..
9, pleural metastases were found chest pain, such as malignant pleural effusion.
10, the blood of lung cancer metastasis lung metastasis are common sites were bone, liver, brain, kidney, adrenal, subcutaneous tissue, while the transfer is also more common in lung cancer. With the transfer of clinical sites corresponding to different symptoms and signs.
11 common pulmonary signs have joint pain or hypertrophy, clubbing, multiple neuritis, myasthenia gravis, Cushing's disease, male breast hypertrophy, hypercalcemia, mental disorders.