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Am J Med:患肺炎的重度吸烟者中肺癌发生率高达9%!

2016-01-13 Mechront 译 MedSci原创

在美国肺癌位居癌症死亡率首位,5年生存率只有17%。吸烟导致了约85%的肺癌病例,只有15%的患者能够做到早期诊断。新研究表明,对重度吸烟的社区获得性肺炎进行肺癌筛查,可能有助于肺癌的早期诊断,从而降低死亡率。患有肺炎的重度吸烟者是肺癌高危人群,应及早进行胸部CT筛查肺癌。肺癌是进展性疾病,只有在症状出现前识别肺癌进行早治疗才能有康复的机会。先前有研究表明,对重度吸烟者进行一年一次的低剂量CT筛查

在美国肺癌位居癌症死亡率首位,5年生存率只有17%。吸烟导致了约85%的肺癌病例,只有15%的患者能够做到早期诊断。新研究表明,对重度吸烟的社区获得性肺炎者进行肺癌筛查,可能有助于肺癌的早期诊断,从而降低死亡率。患有肺炎的重度吸烟者是肺癌高危人群,应及早进行胸部CT筛查肺癌。

肺癌是进展性疾病,只有在症状出现前识别肺癌进行早治疗才能有康复的机会。先前有研究表明,对重度吸烟者进行一年一次的低剂量CT筛查,可以降低肺癌死亡率。但是这需要超级大的资源,并且实际临床中该想法能都有效也不知道。Shepshelovich希望发展一种更现实、更具成本效益的肺癌筛查战略,尤其是针对高风险的人群。

shepshelovich博士和他的团队对381名因社区获得性肺炎住院的重度吸烟者进行了研究。获取患者的医疗档案、人口统计学资料、吸烟史、肺癌危险因素和肺炎解剖位置等相关数据。研究人员发现,381名患肺炎的重度吸烟者中31例(约9%)的患者在一年内被诊断为肺癌。入院时诊断为肺上叶肺炎的患者的肺癌发病率更高(23.8%)。75.8%的肺癌病灶位于肺炎区域。

不伴肺炎的吸烟者每年仅有0.5-1%的机会诊断为肺癌,而伴有肺炎的重度吸烟者肺癌诊断率高达约9%。落差之大应该引起足够的认识和警惕。

目前关于肺癌的诊断方法包括胸部X线检查、痰查肿瘤细胞等,但这些检查方法并不会改变死亡率。也就是说当意识到患上肺癌时,癌症已经存在较长时间。当前肺癌早期发现的数据只有15%左右,研究者希望对肺炎的吸烟者进行胸部CT筛查以提高早诊断率,进而早治疗,降低死亡率。

原始出处:


Daniel Shepshelovich,Hadar Goldvaser,et al.High Lung Cancer Incidence in Heavy Smokers Following Hospitalization due to Pneumonia.American Journal of Medicine, November 06, 2015


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    2016-01-14 lovetcm

    一是炎症会耽误肺癌的确诊,甚至有些治疗也因为炎症而推迟。二是炎症与肿瘤相互作用,促进肿瘤进展与转移

    0

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    2016-01-14 jiangxianchen

    老外的思路,服了

    0

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    2016-01-13 zhuzhuba1

    0

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