Jimborean G, Gabor M, Szilai D
Clinica Pneumologie Târgu-Mureş.
Pneumologia. 2001 Jul-Sep;50(3):148-53.
We studied 171 patients with pulmonary and pleural tumours, in 1999. Within this group we had 87.7% primary lung cancers, 8.8% pulmonary methastatic tumors and 3.5% pleural mesothelioma. The primary lung cancer is more frequent in men (male-female ratio = 8.4) and in patients living in rural area; it involved persons over 40 years only. The chronic tobacco use is the main risk factor we found among these patients (80%). All the patients showed symptoms linked to delayed diagnosis. Radiology was characteristic in 100% of the cases, showing typical aspects of lung tumours and complications and contributed to staging. The bronchoscopy was the main procedure in diagnosis (80.1%), allowing the microscopic confirmation and contributing in staging. The thoracic computed thomography was performed in 30.4% of the cases. We had a late case finding (56.7% in the stage III, 26% in the stage IV) allowing the surgical treatment in only 15.2% of the cases. The early diagnosis of lung cancers would be possible by "oncological screening", combining clinical aspects with data from radiology and bronchoscopy in high-risk persons (heavy smokers, contacts with cancer producing substances). Performing bronchoscopy and computed tomography in all patients with lung cancer would allow the histological diagnosis and the proper staging for a proper treatment. The education against smoking will allow the decrease of the lung cancer in the future.
1999年，我们对171例肺和胸膜肿瘤患者进行了研究。在这组患者中，原发性肺癌占87.7%，肺转移性肿瘤占8.8%，胸膜间皮瘤占3.5%。原发性肺癌在男性中更为常见（男女比例为8.4），且在农村地区患者中更为常见；仅累及40岁以上人群。我们发现这些患者中主要的危险因素是长期吸烟（80%）。所有患者均表现出与诊断延迟相关的症状。100%的病例放射学表现具有特征性，显示出肺肿瘤及并发症的典型特征，并有助于分期。支气管镜检查是主要的诊断方法（80.1%），可进行显微镜确诊并有助于分期。30.4%的病例进行了胸部计算机断层扫描。我们的病例发现较晚（Ⅲ期占56.7%，Ⅳ期占26%），仅15.2%的病例能够接受手术治疗。通过“肿瘤筛查”，将临床症状与高危人群（重度吸烟者、接触致癌物质者）的放射学和支气管镜检查数据相结合，有可能实现肺癌的早期诊断。对所有肺癌患者进行支气管镜检查和计算机断层扫描，将有助于进行组织学诊断和准确分期，从而进行恰当的治疗。开展控烟教育将有助于未来降低肺癌发病率。
