原发性支气管肺癌中英文对照

原发性支气管肺癌中英文对照定义Definition•原发性支气管肺癌简称肺癌，是起源于支气管粘膜或腺体的肿瘤。•Primarybronchogeniccarcinomaisabbreviatedtolungcancer,itderivesfrombronchimucosaorgland.Epidemiology•LungCancer–Worldwide:mostcommoncancer•2,000,000casesperyear–China:firstleadingcauseofcancerdeathinurbanarea–15%5-yearsurvival病因和发病机制Etiologyandpathogenesis•1吸烟•1SmokingLungCancer:SmokingFacts•Tobaccouseistheleadingcauseoflungcancer•87%oflungcancersarerelatedtosmoking•Riskrelatedto:–Amountsmoked–Ageofsmokingonset–Productsmoked(tar/nicotinecontent,filters)–Depthofinhalation–Gender–Riskgoesdownafter5yrscessation–At15years,80-90%riskreduction–Nevergetsto“neversmoker”risk20YearLagIfwhathappenedonyourinsidehappenedonyouroutside,wouldyoustillsmoke?•2职业致癌因子•2Occupationcarcinogenicfactor:Asbestos,Radon3空气污染•3Airpollution•（1）室外大环境污染•（1）Outdoorenvironmentpollution•（2）室内小环境污染•（2）Indoorenvironmentpollution•4电离辐射•4Ionizingradiation•5饮食与营养•5DietandnutritionVITAMINA•?•?•?•?•?•?•?•?•?•?•?•?•?•?•?•?•?•?•?•6其他因素•6Otherfactors•7遗传因素•7Hereditaryfactor•Tumorsuppressorgenes•*p53•Dominantoncogenes•*Kras•*Her-2/neu病理和分类Pathologyandclassification解剖学分类Anatomyclassification•1中央型肺癌•1Centrallungcancer•2周围型肺癌•2Peripherallungcancer组织学分类Histologyclassification•1小细胞肺癌•1Smallcelllungcancer,SCLC•（1）燕麦细胞型•（1）oatcelltype•（2）中间细胞型•（2）intermediatecelltype•（3）混合型•（3）mixedtype•Smallcellcarcinoma–Rareinnon-smokers–Largehilarmass–70%presentwithovertmetastasis–Verychemo-responsive…–WorstprognosisSmallcellcarcinoma•2非小细胞肺癌•2Non-smallcelllungcancer,NSCLC•（1）鳞状细胞癌（鳞癌）•（1）Squamouscellcarcinoma,SCC•（2）腺癌和支气管肺泡癌•（2）Adenocarcinoma，AC，andbronchoalveolarcarcinoma•（3）大细胞癌•（3）Largecellcarcinoma•（4）鳞腺癌•（4）Adeno-squamouscarcinoma•Squamouscellcarcinoma–Now2ndmostcommon(1stinChina)–Stronglylinkedwithsmoking–60-80%intheproximalairways(centraltype)–Cavitation–Tendencytospreadlocally/regionally–PrognosisslightlybetterthanAdenocarcinomaSquamousCellCarcinomaSquamousCellCarcinoma•鳞癌LungCancerPathology•Adenocarcinoma–Mostcommonpathology(2ndinChina)–“Non-smoker’slungcancer”–Women–Peripheral(75%)–AggressivemetastasesAdenocarcicomaLeftLowerLobeAdenocarcinomaAdenocarcinomaBronchoalveolarCellCarcinoma•BAC–Aerogenousandlymphaticspread–Leastassociatedwithcigarettesmoking–Usuallyperipheral•Localized,multi-nodularordiffuse–Slowmetabolism–Prognosis•Localizedvs.other•支气管肺泡癌•Largecellcarcinoma–Largeperipheralmasswithnecrosis–Malignantepithelialneoplasm–Poorly-differentiated–Aggressivemets–“It’sacancer…it’snotsmallcell…but…”LargecellcarcinomaLargecellcarcinoma10100d25～30187d恶性度最高最常见发病率(%)倍增时间不明显有关密切吸烟女性较轻老年男性好发年龄性别20～2533d30～35100d大细胞癌腺癌小细胞癌鳞癌鳞癌小细胞癌腺癌大细胞癌解剖分类中央型中央型周围周围生长方式管腔内管腔外管腔外转移晚早较早手术机会多少支气管肺泡癌瘢痕癌较大放化疗敏感临床表现Clinicalmanifestation原发肿瘤引起的症状和体征Symptomsandphysicalsignsduetoprimarytumor•1咳嗽•1Cough•2咯血•2Hemoptysis•3喘鸣•3Wheeze•4气急•4Breathlessness•5发热•5Fever•6其他•6Others肿瘤局部扩展引起的症状和体征Symptomsandphysicalsignsduetotumorlocalexpanding•1胸痛•1Chestpain•2呼吸困难•2Dyspnea•3吞咽困难•3Dysphagia:esophagealcompression•4声音嘶哑•4Hoarsevoice:laryngealnerveparalysis•5上腔静脉阻塞综合征•5Superiorvenacavaobstructionsyndrome•6Horner综合征，肺上沟瘤•6Horner’ssyndrome,Pancoast’stumor:Cervical/thoracicnerveinvasion•7臂丛神经压迫征•7Brachialplexuscompressionsyndrome肿瘤远处转移引起的症状和体征Symptomsandphysicalsignsduetotumordistantmetastasis•1脑、中枢神经系统转移•1Metastasizetobrain,centralnervoussystem•2肝转移•2Metastasizetoliver•3骨转移•3Metastasizetobone•4皮下转移性结节•4Subcutaneoulymetastaticnodus•5颈部或锁骨上淋巴结转移•5Cervicalorsupraclavicularlymphnodemetastasis肺癌作用于其他系统引起的肺外表现Manifestationoutoflungduetoothersystemsaffectedbylungcancer•1异位内分泌综合征•1Ectopicendocrinesyndrome,EES•（1）抗利尿激素分泌异常综合征•（1）Syndromeofinapprpriateantidiuretichormone(SIADH)secretion•（2）异位ACTH综合征•（2）EctopicACTHsyndrome•（3）神经肌肉综合征•（3）Neuromyopathicsyndrome•（4）高钙血症•（4）Hypercalcinemia•（5）其他：类癌综合征•（5）Others:Carcinoidsyndrome•2其他肺外表现•2Othermanifestationoutoflung•（1）多发性周围神经炎•（1）Multipleperipheralneuritis•（2）肌无力样综合征•（2）Eaton-Lambertsyndrome•（3）肥大性肺性骨关节病•（3）Hypertrophicpulmonaryosteoarthropathy,HPO•病人•正常人实验室和辅助检查Laboratoryandauxiliaryexamination胸部X线检查Chestradiograph•1中央型肺癌•1Centrallungcancer•2周围型肺癌•2Peripherallungcancer电子计算机体层扫描CT•Posteriorbasalsegmentofleftlowerlobe,AC•左上叶肺癌并左上叶不张•Leftupperlobecancercombiningatelectasis•Leftlowerlobecancercombiningobstructivepneumonia磁共振MRI痰脱落细胞学检查Sputumexfoliativecytologytest•SCC•AC•SCLC纤维支气管镜检查Bronchofiberscopy•SCC•SCLC•AC•LCC•核素闪烁显像•Nuclidescintigraphy•1骨γ闪烁显像•1Boneγscintigraphy•2正电子发射断层显像•2Positronemissiontomography(PET)•病理学检查•Pathology•癌标志物的检测•Cancermarktest•基因诊断•Genediagnosis•手术探查•Operationsresearch诊断和鉴别诊断Diagnosisanddifferentialdiagnosis诊断Diagnosis•早期诊断•Earlydiagnosis•症状•Symptom•体征•Physicalsign•检查•Examination鉴别诊断Differentialdiagnosis•1肺结核•1Pulmonarytuberculosis•Tuberculosis•Lungcancer•肺真菌病•Pulmonarymycosis•2肺炎•2Pneumonia•抗菌药物治疗有效，病灶吸收快而完全•Usually,antibacterialdrugtherapyiseffective,andfocusisabsorbedquicklyandcompletely.•3肺脓肿•3Lungabscess•4结核性渗出性胸膜炎•4Tuberculousexudativepleurisy临床分期Clinicalstage•IA:T1N0•IB:T2N0•IIA:T1N1•IIB:T2N1,T3N0•IIIA:T3N1,andT1-3N2•IIIB:anyT4,anyN3•IV:anymetastases治疗Treatment手术治疗Operationtreatment•1NSCLC