How to diagnose lung cancer? Doctor: There are three "magic weapons" to diagnose lung cancer

Today a colleague asked me, "Why are there so many cases of lung cancer now?" I said, "Lung cancer has always been the number one cancer in our country, but it was ignored by many people in the past."

Lung cancer is the most common cancer and many people are afraid of it. So what tests can be done to detect lung cancer? How is lung cancer diagnosed?

There are three magic weapons for diagnosing lung cancer. The diagnosis technology of lung cancer has been greatly improved with the progress of various medical technologies. Not only are the methods becoming more and more abundant, but the accuracy is also getting higher and higher. In the past, people relied on an ordinary chest X-ray and chest film to diagnose lung cancer. The misdiagnosis rate was very high. Many early lung cancers were unfortunately missed, causing many patients to lose the best treatment opportunity. With the development of science and technology, there are now three magic weapons for lung cancer diagnosis: accurate imaging diagnosis technology; minimally invasive pathological diagnosis technology; and rapidly developing blood auxiliary examinations.

Precise imaging diagnostic technology has greatly improved the detection rate. Compared with traditional chest X-rays and chest radiographs, the emergence of low-dose spiral CT has greatly improved the detection rate of lung cancer. To give a simple example, in the past, many people would sift sand when building a house. If the tumor is compared to stones in the sand, our imaging examination method is compared to a sieve for sifting sand. Our examination is to sift the stones out of the sand. Traditional chest X-rays or chest radiographs are like a sieve with a mesh diameter of 2-3 cm, so many stones will be missed, while our low-dose spiral CT is better than a sieve with a diameter of only 2-3 mm, so it can well separate stones from sand.

Last year, our hospital replaced chest X-rays with chest CT scans in its employee health checkup package. Twenty lung cancers were found among the 2,000-plus employees in the hospital. Because they were found early, surgery was basically equivalent to cure. If we had used the traditional examination methods, these people might have missed the best time for treatment.

In addition to low-dose spiral CT, the emergence of PET-CT has also played a good auxiliary role in the diagnosis of lung cancer. PET-CT uses positron-emitting radionuclides to label human metabolites such as glucose as imaging agents, and finally makes a diagnosis by reflecting its metabolic changes through the uptake of imaging agents by lesions. In simple terms, the working principle of PET-CT is that benign and malignant tumors have different "likings" for glucose, and this characteristic is used to judge the benign and malignant nature of lung tumors. It is especially effective for some metastatic tumors.

Minimally invasive pathological diagnosis technology is safer. Pathology is the "gold standard" for lung cancer diagnosis. Even if the imaging manifestations resemble lung cancer, they may be wrong. In the end, the diagnosis still depends on pathology. Current pathological diagnosis technologies mainly include fiberoptic bronchoscopy, CT-guided percutaneous lung puncture biopsy, and thoracoscopic lung tumor biopsy.

Central lung cancer through fiberoptic bronchoscopy: Fiberoptic bronchoscopy is the most commonly used examination and treatment method in thoracic surgery, especially for central lung cancer, through fiberoptic bronchoscopy, biopsies can generally be obtained. Fiberoptic bronchoscopy is an endoscope that passes through the nasal cavity and then into the patient's respiratory tract. If the patient's tumor grows in a relatively large bronchus, fiberoptic bronchoscopy can successfully detect it and obtain tumor tissue for diagnosis.

Peripheral lung cancer is diagnosed through CT-guided percutaneous lung puncture biopsy: If the tumor grows around the lung, the fiberoptic bronchoscope cannot find it. In this case, we generally use CT-guided percutaneous lung puncture biopsy. In layman's terms, with the help of a CT machine, a very thin puncture needle is inserted through the chest wall to the lung tumor, and then the tissue is grabbed for pathological diagnosis.

Thoracoscopic lung tumor biopsy: If neither fiber bronchoscopy nor CT-guided percutaneous lung puncture biopsy can obtain a biopsy, a thoracoscopic lung tumor biopsy can be used. Two 1-2 cm holes are made in the chest cavity, and the tumor is removed for pathological examination under the visual television using video-assisted thoracoscopy technology.

Blood testing technology is a good aid for cancer diagnosis. When a person has cancer, tumor cells synthesize and release certain biological substances, or the body produces certain substances in response to tumor tissue. We detect these increased substances through blood tests, which are called tumor markers. For example, CEA may increase in patients with lung adenocarcinoma, squamous cell antigen (SCC) may increase in patients with squamous cell carcinoma of the lung, and neuron-specific enolase (NSE) may increase in patients with small cell lung cancer. Therefore, it is recommended that people over 50 years old have tumor marker tests when they have a health check-up. Generally, abnormally increased values ​​must be taken seriously!

Summary: There are three magic weapons for lung cancer diagnosis: accurate imaging diagnosis technology; minimally invasive pathological diagnosis technology; and rapidly developing blood-assisted examinations. Through these three magic weapons, early diagnosis and early treatment have greatly improved the cure rate of lung cancer.