What should I do if pulmonary nodules have no symptoms?
N Haidu reporter Lin Baozhen correspondent Wu Yuhui
Usually there are no symptoms, even coughing frequently, but small nodules are found on CT of the lungs. At this time, some people think that the nodules are small and have no signs of malignant transformation, so they should be checked regularly; Some people are afraid of sleeping and go to surgery early; Others don't take pulmonary nodules seriously, don't do routine examinations, and one day they keep coughing, chest pain and shortness of breath, and then go for a reexamination. At this time, it is likely that the nodule has become cancerous and metastasized, and the opportunity for surgery has been lost. ...
Recently, the "20 17 Annual Report of Cancer Registration in Fujian Province" issued by Fujian Cancer Prevention Office shows that lung cancer ranks first in the cancer registration area in Fujian Province. Studies have shown that lung nodules are related to lung cancer. So, does a lung nodule have to be lung cancer? What should I do if I find small pulmonary nodules?
What is the probability of malignant nodules?
"Pulmonary nodules usually have no clinical manifestations and are mainly found through physical examination." Professor Deng and the chief physician of the Department of Respiratory Medicine of the First Affiliated Hospital of Fujian Medical University introduced that due to environmental pollution, occupational changes and other factors, as well as the popularization of chest CT scanning, especially the wide application of high-resolution CT scanning technology, the detection rate of pulmonary nodules has obviously improved.
Is lung nodule necessarily lung cancer? Professor Deng said that recent studies have shown that solitary pulmonary nodules are related to lung cancer. The detection rate of pulmonary nodules by traditional chest radiograph is only 0.2%, but it reaches 40%~60% in high-resolution CT, in which the diameter is less than 5 mm and the malignant degree of nodules is less than 65438 0%. The diameter is 5~ 10 mm, and the malignant rate is 6% ~ 28%. The diameter is more than 2 cm, and the malignant rate is 64%~82%. Therefore, more and more attention has been paid to pulmonary nodules.
Not all pulmonary nodules are "unwelcome". Once pulmonary nodules are found, we need to pay attention to them, but we don't have to be overly nervous. We can go to respiratory medicine and thoracic surgery in general hospitals or specialized hospitals, and doctors will choose appropriate treatment methods according to the specific conditions of patients.
According to two aspects of risk factor assessment
Professor Deng said that the malignant degree of pulmonary nodules should be evaluated first when they are found on CT. Risk factor assessment mainly includes two aspects:
The first is the clinical risk factors of patients, including: ① age: less than 45 years old is low risk, 45-60 years old is medium risk, and older than 60 years old is high risk;
② History of tumor: Not only lung cancer, but also people with a history of tumor are at high risk;
③ Smoking history: non-smokers are at low risk, smokers with less than 20 cigarettes per day are at medium risk, and smokers with more than 20 cigarettes per day are at high risk;
④ Smoking cessation history: those who quit smoking for more than 7 years are at low risk, those who have not quit smoking are at medium risk, and those who have not quit smoking are at high risk;
⑤ Other past history: Patients with chronic obstructive pulmonary disease are at moderate risk, and those with asbestos exposure history are at high risk.
Followed by the imaging features and malignant rate of nodules. For example, the diameter of nodules, the boundary of nodules, the incidence of ground-glass lesions and so on are closely related to the malignant rate of nodules.
Low-risk CT follow-up of high-risk surgery
For low-risk patients, doctors often recommend clinical CT follow-up; Those with moderate risk need further diagnosis, such as PET examination, CT-guided percutaneous lung biopsy and bronchoscopy. For high-risk patients, pathological biopsy is the first choice, and surgical resection is needed after pathological biopsy is confirmed.
Pathological biopsy is the "gold standard" for the diagnosis of benign and malignant solitary pulmonary nodules, and can also be used for radical surgical treatment of early non-small cell lung cancer. The choice of surgical methods can be determined according to the specific situation of patients. Thoracoscopic surgery is a common surgical method at present, and thoracotomy can also be chosen in some cases where thoracoscopic surgery is impossible.
Female lung cancer may be related to kitchen fumes.
It is recognized that the factors closely related to the etiology of lung cancer are: smoking, air pollution, occupational factors, chronic lung diseases, human internal factors and so on.
To stay away from lung cancer, we should start from the details, such as avoiding being in a dusty environment for a long time and doing a good job of protection for professional needs; Smoking less or not; In recent years, the incidence of lung cancer in non-smoking women has increased year by year. Related research shows that it is highly related to cooking oil fume. It is recommended to cook and fry food at low temperature and keep the kitchen ventilated. Exercise more and keep regular living habits.