肺癌

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　　肺癌是当前世界各国最常见的恶性肿瘤之一，在我国占恶性肿瘤的第二位。肺癌发病率居男性恶性肿瘤的首位，为女性恶性肿瘤的第三位，并且发病率有逐年上升的趋势。

　　肺癌是肺部最常见的恶性肿瘤，临床以咳嗽、胸痛、发热、气急为主，咯痰或稀或稠，甚则咯痰带血或为血痰。肺癌的多发于各级支气管，右肺比左肺多发，叶支气管比总支气管多发。肺癌的诊断一般临床症状结合X、CT、活体组织病检可以确诊。

　　肺癌一般分为中央型和周围型。肺癌按病理组织学分型可分为：鳞状细胞癌、腺癌、腺鳞癌、大细胞癌、类癌、小细胞癌、细支气管肺泡癌。肺癌按形态可分为：结节型，巨块型、弥漫型、支气管内息肉型。

　　肺癌临床表现

　　（一）、肺癌萌芽期：40岁以上患者，有慢性肺病包括慢性肺炎、支气管炎、肺气肿、肺结核等，久治无效，且病情进一步发展者。临床表现有顽固性咳嗽或呛咳，痰中带血或咯血，胸痛，长期低热，人渐消瘦等。
　　（二）、肺癌早期：临床表现较萌芽期为重，但症状还是以顽固性咳嗽或呛咳，痰中带血，咯血，严重胸痛或反而不痛，长期低热，人更消瘦等为主。
　　（三）、肺癌中晚期：呛咳严重，气急，痰中带血，咯血，胸痛严重或无痛，长期低热，人消瘦更为明显，或见胸腔积液，面部及四肢浮肿，小便不利等。

肺癌疼痛
　　一、肺癌疼痛的病因：

　　1）、肿瘤本身所致疼痛（主要指胸痛）：由于肿瘤侵犯或压迫胸膜，产生钝痛或隐痛，严重时出现剧烈的胸痛，呼吸或咳嗽时加重。
　　2）、肿瘤压迫致痛：肿瘤压迫肋间神经时，可引起肋间神经痛。压迫上腔静脉引起头痛、上肢水肿等。压迫臂丛神经引起相应部位疼痛、感觉异常、肌肉萎缩等。
　　3）、肿瘤转移致痛。
　　4）、肺源性骨关节增生致痛。
　　5）、肺癌引起皮肌炎致痛。
      6）、抗癌治疗致痛。

　　二、肺癌疼痛的机理：由多方面因素所致，癌细胞浸润或侵犯邻近血管、神经、淋巴管、软组织、内脏和骨组织，对其压迫或刺激，从而产生疼痛。肿瘤本身所产生的一些化学致痛物质、肿瘤的代谢产物、坏死组织分解产物等刺激痛觉感受器产生疼痛。

　　三、肺癌疼痛的常见部位：胸痛、肩背痛、上肢痛、颈项痛、头痛、腹痛、腰骶部痛、下肢痛等。

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==== 汉译英 ====

Lung cancer is currently the world, one of the most common malignant tumors, malignant tumors in China accounted for the second. Male cancer incidence rate of lung cancer ranks the first, the third female cancer, and incidence rates have increased year after year trend.

Lung cancer is the most common lung cancer, clinical with cough, chest pain, fever, shortness of breath mainly expectoration, or thin or thick, rather then the blood or blood sputum expectoration. Of lung cancer, mainly in the levels of bronchus, right lung, left lung more than the hair, leaves bronchus bronchus than the overall multiple. Clinical symptoms of lung cancer diagnosis in general combination of X, CT, tissues and disease can be diagnosed inspection.

Lung cancer is generally divided into the central type and peripheral type. Pathology of lung cancer by histological type can be divided into: squamous cell carcinoma, adenocarcinoma, adeno-squamous cell carcinoma, large cell carcinoma, carcinoid, small cell carcinoma, bronchioloalveolar carcinoma. Of lung cancer can be classified according to morphology: nodular type, giant blocks of type, diffuse type, endobronchial polypoid.

Clinical manifestations of lung cancer

(A), lung cancer embryonic period: 40 years old patients with chronic lung disease including chronic pneumonia, bronchitis, emphysema, tuberculosis, long rule is invalid, and the further development of those conditions. Clinical manifestations of intractable cough, or cough, bloody sputum or hemoptysis, chest pain, long-term low-grade fever, weight loss, etc. of people gradually.
(B), early stage lung cancer: clinical manifestations than the embryonic period is heavy, but the symptoms are coughing or choking with intractable cough, sputum with blood, hemoptysis, severe chest pain, or the contrary, it is not painful, long-term low-grade fever, weight loss, etc. are more dominated.
(C), lung cancer in advanced: choking, severe shortness of breath, bloody sputum, hemoptysis, chest pain, severe or painless, long-term low heat, people wasting even more obvious, or see the pleural effusion, face and limbs, edema, urine and other unfavorable .
Lung Cancer Pain
1, lung cancer, the cause of the pain:

1), the pain caused by tumor itself (mainly chest pain): As the Pleural tumor invasion or oppression, resulting in dull pain, or pain, severe sharp chest pain when breathing or coughing increased.
2), tumor compression caused by pain: tumor suppression intercostal nerve, can cause intercostal neuralgia. Oppression of the superior vena cava caused by headache, upper limb edema. The corresponding parts of brachial plexus compression caused by pain, paresthesia, muscle atrophy.
3), tumor metastasis-induced pain.
4), pulmonary hyperplasia caused by bone and joint pain.
5), lung cancer caused by pain-induced dermatomyositis.
6), pain caused by cancer treatment.

2, lung cancer, the mechanism of pain: from various factors, cancer invasion or violation of nearby blood vessels, nerves, lymphatic, soft tissue, internal organs and bone tissue, its repression or stimulation, resulting in pain. Tumor itself produced some of the pain caused by chemical substances, tumor metabolites, decomposition products such as tissue necrosis to stimulate the pain receptors to pain.

3, lung cancer, a common site of pain: chest pain, shoulder pain, upper limb pain, neck pain, headache, abdominal pain, lumbosacral pain, lower limb pain.