原发性支气管肺癌的西医治疗(中文).ppt

原发性支气管肺癌 中国中医科学院广安门医院肿瘤科 张培彤 博士 Lung Cancer: What Causes It? Smoking Radiation Exposure Environmental/ Occupational Exposure Asbestos Radon Passive smoke Lung Cancer: Smoking Facts Tobacco use is the leading cause of lung cancer 87% of lung cancers are related to smoking Risk related to: amount smoked (pack years or cigs/day x yrs) age of smoking onset product smoked (tar/nicotine content, filters) depth of inhalation gender Lung Cancer: Screening No proven effective screening tool Chest X-ray commonly used Clinical trials: Low dose spiral chest CT scan Sputum analysis Chest X-ray 病理类型 鳞状细胞癌 变体（Variants） 乳头的（Papillary） 透明细胞（Clear cell） 小细胞（Small cell） 类基底的（Basaloid） Squamous cell carcinoma Although at one time the most frequent of all lung cancers, squamous cell carcinoma in North America has not seen the marked increase observed with adenocarcinoma, the latter tumor accounting for most of the recent increased incidence of lung cancer. Some of these differences may be related to the change from nonfiltered to filtered cigarettes and their relation to site of deposition of the carcinogens. Squamous cell carcinoma These tumors tend to be slow-growing, and it is estimated that up to 3 or 4 years are required from the development of in situ carcinoma to a clinically apparent tumor. 病理类型 腺癌 Acinar 乳头状的 Papillary 细支气管肺泡癌 Bronchioloalveolar carcinoma 非粘液（细支气管细胞/II型肺细胞）型 Nonmucinous (Clara cell/type II pneumocyte) type 粘液（杯细胞）型 Mucinous (goblet cell) type 粘液及非粘液混合（细支气管细胞/II型肺细胞和杯细胞）型，或不确定细胞型 Mixed mucinous and nonmucinous (Clara cell/type II Pneumocyte and goblet cell) type, or indeterminate cell type 伴有粘液形成的实体腺癌 Solid adenocarcinoma with mucin formation 混合亚型的腺癌 Adenocarcinoma with mixed subtypes 病理类型 腺癌 变体 Variants 高分化胚胎腺癌 Well-differentiated fetal adenocarcinoma 粘液（胶质）腺癌 Mucinous (colloid) adenocarcinoma 粘液囊腺癌 Mucinous cystadenocarcinoma 印戒腺癌 Signet ring adenocarcinoma 透明细胞腺癌 Clear cell adenocarcinoma Adenoc