【作者】 刘广杰；

【导师】 孟宪利； 何明；

【作者基本信息】 河北医科大学 ， 外科学， 2008， 硕士

【摘要】 肺癌是全球最常见的恶性肿瘤之一,其死亡率位居恶性肿瘤首位。近年来肺癌发病率逐步升高,在我国,其发病率已由原恶性肿瘤的第6位跃居为第2位,在城市中死亡率占第一位,严重危害着人类健康。尽管肺癌的治疗手段日新月异,其5年生存率仅14.1%,60%的患者在诊断后1年内死亡。统计资料显示肺癌的预后与诊断时的临床分期密切相关,0期肺癌患者术后的5年生存率可达90%以上,Ia期患者术后5年生存率为60%,而Ⅱ-Ⅳ期患者总的5年生存率则从40%下降到5%以下。由此可见肺癌早期诊断直接影响着患者的预后。然而令人遗憾的是,目前肺癌早期诊断率仅15%,0期患者一般没有任何症状,确诊时还不到肺癌患者总数的0.6%,故提高肺癌早期诊断率争取“早期发现、早期诊断、早期治疗”,是降低死亡率的重要措施。到目前为止,人们已在肝癌、宫颈癌、前列腺癌、大肠癌等恶性肿瘤建立了筛选和早期诊断的方法,明显降低了其死亡率。但肺癌筛选仍是传统的X线胸片、痰脱落细胞及纤维支气管镜等检查方法,其应用于肺癌的筛查(尤其在高危人群中)并没有降低被筛选人群肺癌的死亡率,同时由于检测敏感性差、过程痛苦、患者耐受性差、不能早期动态监测等而受到限制。因此临床上要求有新的方法进行肺癌早期诊断,近年,肺癌的早期诊断已取得了许多新的进展,如螺旋CT(spiral computed tomography,SCT)和正电子发射体层成像(positron emission tomography,PET)、荧光支气管镜检(fluorescence bronchoscopy)、基因检测、与生物技术相结合的痰液检测、呼吸气体检测、胸部X线计算机辅助图像分析(computer-assisted image analysis of chest radiographs)等,提高了早期肺癌的诊断率,本文就此做一综述。更多还原

【Abstract】 Lung cancer is one of the most common malignant tumor, which morbility is increasing year by year, the crude mortality is at the first place of all. In China, the morbility has jumped to the second place from the sixth, and the mortality and case fatality are on the first place in towns, which has became the killer of peoples’ health. In spite of the prompot new therapy of the lung cancer, the five-year survival rate is mearly 14.1%, 80% of the patients are dying during one year after the diagnosis. The statistics information displays that the prognosis of the lung cancer is closely correlated with the clinical stage which is determined on the time of the diagnosis, the five-year survival rate of the stage 0 patient will up to more then 90%, the stager Ia’s is 60%, while the stageⅡ-Ⅳ’s descend fleetly from 40% to under 5%. It can be seen that the early diagnosis rate of lung cancer influences the prognosis directly. However, it is regretful that the early diagnosis reate of lung cancer is mearly 15%, the stage 0 patient has no symptom, it only occupys 0.6% of the total sufferers. Therefor, to increase the early diagnosis rate of lung cancer striving for“early discocery, early diagnosis, early treatment”is the significant means of depressing the fatality.As yet, people has established the screening and early diagnosis ways of liver、cervix、prostate and colon cancer, and cut down theirs mortality obviouslilly. While the screening methords of lung cancer remains traditionary X-ray、cytological examination of sputum、bronchofibroscopy and so on , as the detections procedure are complicated , time-consuming and can’t be monitor dynamically, their using on lung cancer early detection are confined. Previous screening trials on early lung cancer (typically in high-risk group) , such as traditional X-ray、cytological examination of sputum , didn’t lower the fatality of the crowd screened . Therefor, new methods are desired in clinic on lung cancer screening. In recent years , great progress has been made in lung cancer early detction , such as spiral CT, positron emissiontomography , laser-induced fluorescence endoscope, gene detection, cytological examination of sputum based on polymerase chainreaction, respiratial gas dection, computer-assisted image analysis of chest radiographs, they were used on lung cancer early detection and increase the early detection rate of lung cancer, this articles will make a overview based on what mentioned above:更多还原