Hello,
everyone. I am Dr. Huang Fei from the Department of Internal Medicine of the First People’s Hospital of Jiujiang City. Today, I will give you a popular science about lung squamous cell carcinoma. Lung squamous cell carcinoma, also known as squamous cell carcinoma of the lung, is a common type of lung cancer. It originates from the squamous cells in the epithelium of bronchial mucosa, and these cancer cells have unique morphology and biological behavior. In lung cancer, the incidence of lung squamous cell carcinoma is higher, especially in elderly men, which is closely related to smoking and other factors. Smoking is the most important pathogenic factor of lung squamous cell carcinoma. Nicotine, tar and other carcinogens in cigarettes can directly damage the DNA of bronchial mucosal epithelial cells, leading to cell gene mutation, thus triggering the production and proliferation of cancer cells. The risk of lung squamous cell carcinoma in long-term heavy smokers is several times or even tens of times higher than that in non-smokers. Moreover, the greater the amount of smoking and the longer the smoking years, the higher the risk of disease. Air pollution, including harmful substances in industrial exhaust and automobile exhaust, such as sulfur dioxide and nitrogen oxides, will increase the possibility of lung squamous cell carcinoma if exposed to these polluted environments for a long time. In addition, the incidence of lung squamous cell carcinoma is relatively high among occupational groups exposed to carcinogens such as asbestos, arsenic, chromium and nickel for a long time, such as miners and construction workers. Some chronic lung diseases, such as tuberculosis and chronic obstructive pulmonary disease (COPD), can lead to chronic inflammation of lung tissue for a long time. Under the repeated stimulation of inflammation, bronchial mucosal epithelial cells are prone to abnormal proliferation and malignant transformation, and then develop into lung squamous cell carcinoma. Cough is the most common early symptom of lung squamous cell carcinoma, mostly irritating dry cough, no or little sputum. This is because the tumor stimulates the bronchial mucosa. With the progress of the disease, cough may be aggravated, or even persistent cough, which seriously affects the quality of life of patients. When tumor tissue invades the blood vessels under the bronchial mucosa, it can cause hemoptysis. The amount of hemoptysis can be more or less, less with blood in sputum, more with big mouth hemoptysis. Hemoptysis is one of the typical symptoms of lung squamous cell carcinoma, which needs to be paid great attention to by patients. Chest pain occurs in some patients because the tumor invades the pleura or chest wall. The nature of chest pain is diverse, which can be dull pain, dull pain or stabbing pain, and the degree of pain varies from person to person. Chest pain may become progressively worse as the tumor grows and invades. When the tumor blocks the bronchus, resulting in pulmonary ventilation dysfunction, or when the tumor invades the lung tissue in a large area, affecting gas exchange, patients will have expiratory dyspnoea. Shortness of breath may initially occur only after activity, and as the disease progresses, expiratory dyspnoea may also be felt at rest. In addition, patients with lung squamous cell carcinoma may also have fever, weight loss, fatigue and other systemic symptoms, which are related to the consumption of body energy and inflammatory response caused by tumors. Chest X-rays can detect mass shadows in the lungs, but may not be sensitive to smaller tumors. Chest CT scan can more clearly show the size, location, shape of the tumor and the relationship with the surrounding tissues, which is an important means for the diagnosis of lung squamous cell carcinoma. In addition, PET-CT examination can be used to determine whether the tumor has metastasis, which is of great significance for the staging of the tumor. For central lung squamous cell carcinoma, bronchoscopy can directly observe the lesions in the bronchus, and can take tissues for pathological examination to make a definite diagnosis. It is the “gold standard” for the diagnosis of lung squamous cell carcinoma to observe the morphology of cancer cells under the microscope through tissue specimens obtained by bronchoscopic biopsy. Sputum cytology can assist in diagnosis by checking whether there are cancer cells in the sputum coughed up by patients. For peripheral lung squamous cell carcinoma, percutaneous lung biopsy can be performed under the guidance of ultrasound or CT to obtain cytological or histological specimens for diagnosis. Surgical resection of the tumor is the treatment of choice for early lung squamous cell carcinoma. Surgical methods include lobectomy, pneumonectomy, etc. The specific surgical plan should be determined according to the size, location of the tumor and the patient’s physical condition. The purpose of the operation is to remove the tumor tissue as completely as possible while preserving the normal lung tissue to maintain the patient’s respiratory function. Radiotherapy uses high-energy radiation to kill cancer cells, which can be used to reduce the size of tumors before surgery, so that patients who can not be operated on can receive surgery; it can also be used to eliminate residual cancer cells after surgery, reducing the risk of recurrence. Radiotherapy can relieve symptoms, such as hemoptysis, chest pain and expiratory dyspnoea, in inoperable patients with advanced squamous cell lung cancer. Chemotherapy is the use of chemicals to kill cancer cells or inhibit the growth of cancer cells. Commonly used chemotherapy drugs are cisplatin, carboplatin, paclitaxel and so on. Chemotherapy can be used to shrink tumors before surgery, as well as adjuvant therapy after surgery or palliative treatment for advanced patients. However, while chemotherapy drugs kill cancer cells, they also cause some damage to normal cells, which may lead to nausea, vomiting, alopecia, bone marrow suppression and other adverse reactions. With the development of medical research, targeted therapy has also been applied in the treatment of lung squamous cell carcinoma. Targeted drugs can specifically act on specific targets on cancer cells, such as epidermal growth factor receptor (EGFR), so as to kill cancer cells more accurately and reduce damage to normal cells. However, targeted therapies for lung squamous cell carcinoma are relatively limited at present, and genetic testing is needed to screen suitable patients. Immunotherapy attacks cancer cells by activating the patient’s own immune system. Immune checkpoint inhibitors such as Paborizumab have shown good efficacy in the treatment of lung squamous cell carcinoma. It can help the immune system recognize and attack cancer cells, but it may also cause immune-related adverse reactions, such as immune pneumonia, immune hepatitis and so on. The prognosis of lung squamous cell carcinoma is related to many factors, including the stage of the tumor, treatment methods, and the physical condition of patients. The 5-year survival rate of patients with early lung squamous cell carcinoma is relatively high if they can receive surgical treatment in time. However, most of the patients are in the middle and late stages when they are diagnosed, and the prognosis is poor. The main goal of the treatment of advanced patients is to alleviate symptoms and prolong survival time. Comprehensive treatment can improve the quality of life and survival time of patients to a certain extent. Knowledge of lung squamous cell carcinoma is essential for early detection, diagnosis and treatment. For high-risk groups, such as long-term smokers and occupational groups exposed to carcinogens, regular physical examination should be carried out in order to detect lung lesions as soon as possible. At the same time, with the deepening of medical research, the treatment of lung squamous cell carcinoma is constantly improving and perfecting, which brings more hope to patients.
