痰细胞学检查对肺癌诊断有很大帮助。尤其是中央型肺癌，癌肿向支气管腔内生长，病人往往容易出现咳嗽、咳痰等症状，还可能有间歇或持续性痰血。如果痰标本收集方法得当，3次以上的系列痰标本可使中央型肺癌的诊断率提高到80%，周围型肺癌的诊断率达50%。如果患者的痰量不多，可通过吸入加温的10%-15%生理盐水或20%丙烯乙二醇导痰。如果咳出的痰中混有恶性细胞，有经验的细胞病理学家可对85%-95%的痰标本作出细胞类型诊断。

    Sputum cytology examination is of great help to diagnosis of lung cancer.Especially in the central type lung cancer,To the bronchial lumen tumor growth,Patients are often prone to cough/The symptom such as coughing up phlegm,There may be intermittent or continuous spit blood.If the sputum specimens collected in the right way,More than 3 times series sputum specimens can increase the diagnostic rate of central type lung cancer by 80%,The diagnosis of peripheral lung cancer by up to 50%.If patients with sputum volume is not much,Can heat through inhalation of 10% - 15% normal saline or a 15% propylene glycol sputum.If you cough up phlegm in mixed with malignant cells,Experienced pathologists cells can be made to the 85% to 95% of sputum specimens cell type.

    除了对肺部疾病的诊断有作用以外，痰的不同性状也是中医治疗肺癌的一个重要参考标志。关于肺癌的病因病机，《杂病源流犀烛》论述得较为中肯。文中说道：“邪积胸中，阻塞气逆，气不得通，为痰……为血，皆邪正相搏，邪既胜，正不得制之，遂结成形而有块。”由此可见，痰结是胸中形成结块的病机。不仅痰结于肺是肺癌的病理基础，痰结也贯穿于肺癌由原发到转移的整个病程。

    Besides the useful to the diagnosis of lung disease,Sputum different character is also an important reference symbol of Chinese medicine treatment of lung cancer.About the etiology and pathogenesis of lung cancer,[Miscellaneous disease origin rhinoceros candle]Deals are more to the point.The paper said:"Evil in product breast,Blocking QiNi,Gas can not pass,For phlegm...For the blood,All evil is muscle,And both win,Are not of the,Hence formed a shape and block."Thus it can be seen,Phlegm is the pathogenesis of breast form agglomerate.Not only sputum in lung is the pathological basis of lung cancer,Phlegm and also through transfer from primary to the whole course of lung cancer.

    在中医辨证分型的框架下，肺癌大体分为肺郁痰热、气虚痰湿、阴虚痰热、气阴两虚四个常见的临床证型。故而，治疗肺癌除了运用手术、化疗、放疗等方法以外，还可根据肿瘤的不同阶段，合理利用中医综合治疗手段，有机地与西医综合治疗手段相结合而达到减毒增效、防止复发和转移、有效缓解癌痛的目标，提高患者生活质量，延长生存期。

    In the framework of traditional Chinese medicine,Lung cancer can be divided into lung phlegm heat/Blood stasis phlegm wet/Yin deficiency phlegm heat/Qi and Yin deficiency of four common clinical syndrome.so,Surgical treatment of lung cancer in addition to the application/chemotherapy/Radiation therapy, and other methods,Can also according to the different stages of tumor,Reasonable utilization of comprehensive treatment of traditional Chinese medicine,Organically combined with western medicine comprehensive treatment and attenuated synergistic/Prevent the recurrence and metastasis/Effective pain relief,Improve the patients quality of life,Prolong survival.

    张学俊（解放军上海455医院中医肿瘤科副主任医师）

    Zhang Xuejun(The people's liberation army 455 hospital in Shanghai Chinese medicine of doctor of vice director of oncology department)