肺癌

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　　5月31日是世界无烟日，吸烟是肺癌最重要的危险因素。在我国，肺癌发病率已高居首位。遗憾的是，肺癌预后总体上不理想，一个关键原因是早期发现比较困难，而且容易与部分肺部疾病混淆。
　　肺部疾病是引起肺癌的因素之一，但绝不是最直接的因素。肺部既往疾病包括肺结核、肺炎、肺脓肿等。哈尔滨医科大学附属第四医院呼吸内科专家余世寰教授介绍，由于肺癌早期无特异症状，大多为干咳，或有少量白色泡沫痰，易被误认为是感冒或支气管炎，容易被忽视。那么，该如何辨别肺部疾病与肺癌呢？
　　哮喘：近日多家国际机构联合发表的一项调查显示，哮喘病人患上肺癌的几率比普通人高58%，其中女性哮喘病患者肺癌的发病率比普通人群高78%，男性哮喘病患者肺癌的发病率比普通人群高51%。
　　肺炎：支气管肺炎一般起病较急，发热等感染症状比较明显，经抗菌药物治疗后症状迅速消失，肺部病变也较快吸收。但若炎症吸收缓慢或反复出现，应做深入检查。
　　肺结核：对于中年以上的肺结核病人，在肺结核病灶部位等呈现块状阴影，经抗结核药物治疗肺部病灶未见好转，块影反而增大或伴有肺段或肺叶不张，一侧肺门阴影增宽等情况时，都应引起结核与肺癌并存的高度怀疑，必须进一步做痰细胞学检查和支气管镜检查等。
　　肺脓肿：肺癌中央部分坏死、液化形成癌性空洞时，Ｘ线征象易与肺脓肿混淆，但肺脓肿病例常有吸入性肺炎病史。急性期有明显的感染症状，痰量多、呈脓性、有臭味。Ｘ线片上空洞壁较薄，内壁光滑，有液平面，脓肿周围的肺组织或胸膜常有炎性病变。
　　对此，余世寰教授认为，哮喘病与肺癌可能有共同的发病机制，引发哮喘的慢性炎症可以产生过多的自由基，自由基是人体内活性很强的原子或原子团，能够对人体内其他物质进行氧化，它不仅破坏遗传物质，而且也能促使癌症形成和发展。另外，哮喘病和肺癌存在着共同的外部诱因，如吸烟等。
　　对于女性哮喘患者，专家建议更应该提高警惕，定期复查。X线检查是诊断肺癌最常用的重要手段，应每隔半年接受一次检查，如果同时合并其他典型症状，则应通过支气管镜检查确诊，以期及时发现病灶，早期诊断，提高生存率。

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May 31 is World No Tobacco Day, smoking is the most important risk factor of lung cancer. In China, lung cancer rates highest in the first place. Unfortunately, lung cancer in general is not satisfactory, a key reason is that early detection is difficult, and easily confused with some pulmonary diseases.
Lung disease is one of the factors causing lung cancer, but not the most direct factor. Previous lung diseases, including tuberculosis, pneumonia, pulmonary abscess, etc.. Fourth Affiliated Hospital of Harbin Medical University, Department of Respiratory Medicine expert Professor Yu Shihuan, due to non-specific symptoms of early lung cancer, mostly dry cough, sputum or a small amount of white foam, easily mistaken for a cold or bronchitis could easily be overlooked. So, how to identify lung diseases and lung cancer do?
Asthma: Recently a number of international organizations jointly published a survey of people with asthma suffer from lung cancer is 58% higher than average, with female incidence of asthma in patients with lung cancer 78% higher than the general population, male lung cancer patients with asthma The incidence of 51% higher than the general population.
Pneumonia: bronchial pneumonia generally more acute onset, fever and other more obvious signs of infection, antibiotic treatment after symptoms disappear quickly, lung disease is also rapidly absorbed. However, if the absorption of slow or recurring inflammation, should be done in-depth examination.
Tuberculosis: the middle of the tuberculosis patients, tuberculosis lesions in the area to present a massive shadow, after anti-TB drugs in treatment of lung lesions did not improve, but increase or block video segment or lobe with lung atelectasis, the side of the lung when the shadow was widened so the door should lead to the coexistence of tuberculosis and lung cancer was highly suspected, further examination and sputum cytology do bronchoscopy and so on.
Lung Abscess: the central part of lung cancer, necrosis and liquefaction of the formation of cancer when empty, X-ray findings easily confused with lung abscess, pulmonary abscess cases, but often a history of aspiration pneumonia. Obvious acute symptoms of infection, sputum quantity, was purulent, with the smell. X-ray film over the wall thin, smooth wall, a liquid surface, the surrounding lung abscess or pleural inflammation often.
In this regard, Professor Yu Shihuan that asthma and lung cancer may have a common pathogenesis, trigger asthma, chronic inflammation can produce excessive free radicals, free radicals are highly active in the human body atoms or atomic groups, to other substances on the human body oxidation, which not only undermine the genetic material, but also can lead to cancer formation and development. In addition, asthma and lung cancer there was a common external incentives, such as smoking.
For female patients with asthma, experts suggest more should be vigilant, regularly. X-ray diagnosis of lung cancer is the most important means used should be receiving a check every six months, if combined with other typical symptoms at the same time, it should be confirmed by bronchoscopy in order to detect lesions, early diagnosis, increase the survival rate.