近来，雾霾频发，空气污染严重，让肺癌再次成为社会大众关注的焦点。近日，在一个高峰论坛会上，肿瘤专家表示，继烟草、草木灰之后，雾霾已经成为肺癌的第三大诱因。目前，我国肺癌的发病率和死亡率分列男性肿瘤的首位。而且肺癌的发病人群也呈现了年轻化的趋势。

recently,Frequent fog haze,Air pollution is serious,For lung cancer once again become the focus of public attention.In recent days,In a peak BBS meeting,Cancer experts said,The tobacco/After the plant ash,Smog has become the third largest cause of lung cancer.At present,Male tumors in our country the morbidity and mortality of lung cancer ranked the first.And the incidence of lung cancer also showed a trend of a younger crowd.

四五十岁的肺癌患者增多 Forty or fifty years, increase in the number of patients with lung cancer

　　肺癌是世界上发病率及死亡率最高的恶性肿瘤之一。据统计，5个恶性肿瘤患者中，就有一个人死于肺癌。在国内这种状况更令人震惊。据2012年发布的最新统计数据显示，肺癌发病率和死亡率分列男性肿瘤首位，女性肿瘤发病率的第二位和死亡率的第一位。

Lung cancer is one of the world's highest morbidity and mortality of malignant tumor.According to the statistics,Five (5) in patients with malignant tumor,There is a person died of lung cancer.In this situation more shocking inside the country.According to recent statistics released in 2012,Lung cancer incidence and mortality were male cancer first,Female cancer incidence of second and mortality in the first place.

　　值得注意的是，肺癌的发病率高、死亡率高，同时发病年龄也呈现年轻化的趋势。据统计，美国肺癌患者的平均发病年龄为67岁，而在我国，四五十岁的肺癌患者却越来越多。至于为什么患者出现年轻化的趋势，中国抗癌协会临床肿瘤学协作中心候任主任委员、广东省人民医院肿瘤中心吴一龙教授表示，一是吸烟的人数依旧很多，而烟草是肺癌的重要致病因素之一；二是在农村里，使用秸秆、稻草等做燃料形成的烟灰也是引起肺癌诱因。目前，城市空气污染严重，雾霾已经成为肺癌的第三大诱因。

It is worth noting,The high incidence of lung cancer/Mortality rate is high,At the same time also shows the tendency of younger onset age.According to the statistics,Patients with lung cancer in the United States the average onset age was 67,In our country,Lung cancer patients are more and more of their 40 s and 50 s.As for why patients younger trend,Collaboration of clinical oncology center of Chinese anti-cancer association committee, director of the president-elect/Guangdong province people's hospital cancer center Wu Yilong professor said,One is the number of smoking continues,Tobacco is one of the important pathogenic factors of lung cancer;2 it is in the countryside,The use of straw/Do fuels such as rice straw ash also causes lung cancer cause of formation.At present,Urban air pollution is serious,Smog has become the third largest cause of lung cancer.

“取组织”活检是 "Take organization"Biopsy is

确诊肺癌的“硬证据” Diagnosis of lung cancer"Hard evidence"

　　肺癌的发病率如此之高，然而公众对肺癌的认知却远远不足，对肺癌的诊断上存在众多误区，也缺乏应有的重视。同济大学附属上海市肺科医院周彩存教授表示，肺癌的临床表现不太具有典型性，有时很像感冒、发烧等症状，因此不太容易引起警惕，往往被患者忽略。临床上常见的主要症状包括：咳嗽、咯血、喘鸣、胸痛、阻塞性肺炎、体重下降等。一旦出现上述症状，应该要引起足够的重视，应及早就医。

The incidence of lung cancer are so high,The public's perception of lung cancer, however, enough,The many pitfalls in the diagnosis of lung cancer,Also lack of the attention they deserve.Shanghai pulmonary hospital affiliated tongji university Zhou Cai professor said,The clinical manifestation is not typical of lung cancer,Sometimes like a cold/Symptoms such as fever,So there is no cause for alarm too easily,Often overlooked by patients.Common symptoms include clinically:Have a cough/hemoptysis/stridor/Chest pain/Obstructive pneumonia/Weight loss, etc..Once appear afore-mentioned symptoms,Should cause enough attention,Should be as soon as possible go to a doctor.

　　周彩存说，对于肺癌的诊断，医生或患者要问三个问题：第一，是不是癌症？医生一定要在病人身上取一些标本来进行活检，比如淋巴结取一些组织来做检查，一定要找到癌细胞才能确诊是肺癌，千万不要以为只要是做了CT或PET就能确诊；第二，是什么类型的癌？肺癌有小细胞肺癌、大细胞肺癌、鳞癌、腺癌之分。而每一类肺癌的治疗方案是完全不同的；第三，肺癌有无扩散？这还需要做脑部的MR，甚至还要做PET-CT，如果癌症已经扩散了，治疗方案又不同了。

Zhou Cai save said,For the diagnosis of lung cancer,Doctors or patients to ask three questions:The first,Is cancer?The doctor must take some samples for biopsy in patients,Such as lymph nodes take some organization to do the inspection,Cancer cells is to diagnose lung cancer must be found,Don't think that as long as it is to do the PET or CT can diagnose;In the second,What type of cancer?Lung cancer are small cell lung cancer/Large cell lung cancer/Squamous cell carcinomas/Adenocarcinoma of the points.And each kind of the treatment of lung cancer are completely different;In the third,Lung cancer has spread?This also need to do brain MR,Even to do PET - CT,If the cancer has spread,Treatment is different again.

　　专家最后向记者强调的是，肺癌的临床诊断必须依据临床表现和各种影像学结果进行综合分析，但最后的确诊必须取得细胞学或病理组织学的证据。任何没有细胞学或病理组织学证据的诊断，都不能诊断为肺癌，因而取组织活检被称为诊断肺癌的“硬证据”，因而在场的专家们均鼓励怀疑肺癌的病人应接受活检检查。

Experts finally emphasized to the reporter,The clinical diagnosis of lung cancer must be based on clinical manifestations and carries on the comprehensive analysis of various imaging results,But in the end, must obtain a cytological diagnosis or histologic evidence.Any cytology or histologic evidence of diagnosis,Cannot be diagnosed with lung cancer,So take a biopsy is called the diagnosis of lung cancer"Hard evidence",And the experts are present to encourage suspicion of lung cancer patients should be examined by biopsy.

非小细胞肺癌患者 Patients with non-small cell lung cancer

大多数要化疗 Most want to chemotherapy

　　近30年来，肺癌的临床治疗效果并不理想。陆舜说，肺癌的治疗进步不大，在80年代，肺癌的5年生存率为13%，如今也只有17%，在30年期间仅仅提高了4%，可以说总体上，肺癌的治疗结果的确很让人无奈。

For nearly 30 years,Lung cancer clinical practice effect is not ideal.Liu Shun said,The treatment of lung cancer progress is not big,In the 80 s,The 5-year survival rate of lung cancer was 13%,And only 17% now,Only increased by 4% during the 30 years,In general, so to speak,The treatment outcome of lung cancer is really let a person helpless.

　　那么，到底是什么原因使得肺癌的治疗效果不理想呢？上海交通大学附属胸科医院陆舜教授说，首先肺癌的早期率发现比较低，临床上大约60-70%的病人就诊的时候就已经是晚期了，不能做手术，无法根治，治疗效果肯定不好。其次，以前对肺癌的分型不够清晰，只分非小细胞肺癌和小细胞肺癌来治疗。现在专家们发现非小细胞肺癌中又细分为腺癌、鳞癌和大细胞癌等。

then,What is reason that make the lung cancer treatment effect is not ideal?Chest hospital affiliated to Shanghai jiaotong university professor Liu Shun said,First of all found early lung cancer rate is low,About 60-70% of the patients are clinically, it was already late,Not do surgery,Cannot effect a radical cure,Treatment effect is not good.The second,Used for the classification of lung cancer is not clear,Only points treated non-small cell lung cancer and small cell lung cancer.Now experts found in non-small cell lung cancer and subdivided into adenocarcinoma/Squamous carcinoma and large cell carcinoma, etc.

　　周彩存教授指出，在临床中进行诊断时，仅仅诊断为非小细胞肺癌是不够的，一定要有组织学分型，最好还有分子分型。比如对晚期非小细胞肺癌患者，一定要根据组织学类型并结合分子生物学特征来制订治疗方案。中山大学附属肿瘤医院教授张力还指出，化疗仍然是非小细胞肺癌治疗的基石。因此，对于绝大部分的患者(临床上85%的肺癌患者是非小细胞肺癌)，只要身体条件允许，都要在整个治疗过程中进行化疗，合理使用化疗和靶向药物，才能获得最大的生存获益。张华

Zhou Cai professor pointed out,In the clinical diagnosis,It is not enough to a diagnosis of non-small cell lung cancer,You must be type organization credits,Best and molecular classification.Such as in patients with advanced non-small cell lung cancer,Must according to the histological type and combined with molecular biological characteristics to make the treatment plan.Professor at sun yat-sen university tumor hospital affiliated tension also pointed out,Chemotherapy is still the cornerstone of small cell lung cancer treatment.so,For the vast majority of patients(Clinical go up 85% of the patients with lung cancer are small cell lung cancer),As long as the body conditions allow,Chemotherapy in the treatment process,Rational use of chemotherapy and targeted agents,To obtain the greatest survival benefit.Zhang hua