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1、2023/3/28,Lung cancer,2023/3/28,Definition,Background,Malignant neoplasmarising frombronchial epithelium,2023/3/28,Historical note,100 years ago 200 cases reported1895 Roentgen diagnosis possible1904 Sauerbruch negative-pressure cabin 1912 Davies first lung lobectomy1941 Zhang Jizheng pneumonectomy,
2、2023/3/28,Epidemiology,Morbidity,19th century rare disease Before 1950s be risingRecent 50 years increased sharply,leading cause of cancer death,2023/3/28,Etiology,Occupational exposure,Lung cancer,Air pollution,Lung infection,Genetic factors,Smoking,2023/3/28,Oncogenes and Tumor suppressor genes,Re
3、turn,2023/3/28,Pathology,Lung carcinogenesisAnatomic locationHistological classificationInvasion and MetastasisTNM staging,2023/3/28,Lung carcinogenesis,columnar epithelium,squamous metaplasia,carcinoma in situ,metastatic carcinoma,infiltrating carcinoma,Injury,Risk factors,Return,2023/3/28,Anatomic
4、 location,Right,CentralPeripheral,Left,UpperMiddlelower,Upperlower,Return,2023/3/28,Histological classification of lung cancer,Return,2023/3/28,Return,2023/3/28,Return,2023/3/28,Return,2023/3/28,Invasion and Metastasis,Local infiltrate,Bronchial lumen,Direct extension,2023/3/28,Lymphatic metastasis,
5、Pulmonary hilum nodes,Cervical nodes,Mediastinum nodes,Intrapulmonary nodes,2023/3/28,Distant metastasis,Lung cancer,Bone,Brain,Other,Liver,Pv,Return,2023/3/28,TNM staging,T-Primary TumorN-Lymph nodeM-Metastasis,2023/3/28,Primary Tumor,2023/3/28,Primary Tumor,2023/3/28,Lymph node,2023/3/28,Metastasi
6、s,M0no distant metastasisM1distant metastasis,2023/3/28,Return,TNM staging,2023/3/28,Clinical presentation,Early stageAdvanced stageParaneoplastic Syndromes,2023/3/28,Early stage,No symptomCoughPneumonic symptomsHemoptysisDyspneaWheezing and Stridor,2023/3/28,Advanced stage,Mediastinal invasionPleur
7、al effusionsPancoasts tumorMetastatic symptoms,Phrenic nerve invasion Hoarse voice Superior vena cava syndrome pericardial effusions Dysphagia,2023/3/28,Paraneoplastic Syndromes,Cushings syndromeSIADH HypercalcemiaGynecomastiaClubbing and Hypertrophic pulmonary osteoarthropathyPeripheral neuropathy,
8、2023/3/28,Diagnosis,History and Physical examinationNoninvasive laboratory testingInvasive examinations,2023/3/28,Noninvasive laboratory testing,Sputum CytologyChest Radiograph Computed TomographyMagnetic Resonance ImagingRadionuclide Scanning,Bone scans,PET,2023/3/28,Invasive examinations,Transthor
9、acic needle aspirationBronchoscopy Cervical mediastinoscopyLymphatic nodes biopsyThoracoscopyThoracotomy,2023/3/28,Differential Diagnosis,Pulmonary TuberculosisPulmonary InfectionBenign Lung TumorsMediastinal Lyphoma,2023/3/28,Pulmonary Tuberculosis,Tuberculoma,Lung cancer,2023/3/28,Miliary Tubercul
10、osis,Bronchioloalveolar carcinoma,2023/3/28,Pulmonary Infection,Lung cancer,Pulmonary abscess,2023/3/28,Pneumonia,Obstructive atelectasis,2023/3/28,Benign Lung Tumors,Hamartoma,Bronchial Tumor,2023/3/28,Mediastinal Lymphoma,2023/3/28,Treatment,Surgical interventionRadiotherapyChemotherapyothers,Chen
11、ese medicineImmunotherapy,2023/3/28,Surgical intervention,Pulmonary resectionLymph nodes dissection,Systemic lymph nodes dissectionSlective lymph nodes dissection,2023/3/28,*Wedge resection*Segmental resection*Lobectomy*Pneumonectomy*Sleeve lobectomy*VATS*Extended resection,Return,2023/3/28,Radiotherapy,Palliative radiotherapy,Postoperative radiotherapy,Tumor unresectable,Lymphatic metastasis Incomplete resection,2023/3/28,Chemotherapy,Introduction chemotherapy,MVP,NP TP EP GP,Adjuvant chemotherapy,2023/3/28,
