Hello,
everyone. I am Dr. Huang Fei from the Department of Respiratory Medicine of the First People’s Hospital of Jiujiang City. Today, I will give you a popular science about lung adenocarcinoma. Lung adenocarcinoma is one of the most common types of lung cancer, which belongs to non-small cell lung cancer. It originates from bronchial mucosal epithelium and alveolar epithelium. Under the microscope, it can be seen that cancer cells are acinar, papillary, bronchioloalveolar or accompanied by mucus production. In recent years, the incidence of lung adenocarcinoma has been on the rise, with a relatively high incidence in women and non-smokers. Mutations or genetic predisposition to certain genes may make individuals more susceptible to lung adenocarcinoma. For example, mutations of EGFR, ALK, ROS1 and other genes may play an important role in the development of lung adenocarcinoma. People with a family history of lung cancer have an increased risk of lung adenocarcinoma. Air pollution, especially long-term exposure to carcinogens such as benzopyrene and polycyclic aromatic hydrocarbons, can increase the risk of morbidity of lung adenocarcinoma. In addition, indoor radon pollution is also a risk factor, radon can enter the lungs through the respiratory tract, causing damage to lung tissue. Although lung adenocarcinoma is also common in non-smokers, smoking is still one of the important risk factors. Secondhand smoke exposure is also harmful to health. Long-term mental stress and bad eating habits may affect the body’s immune system and indirectly increase the risk of cancer. Cough is the most common symptom, mostly dry cough without sputum or less sputum, which may last for a long time and is not easy to relieve. Hemoptysis may also occur with blood in the sputum or a small amount of hemoptysis. When the tumor blocks the airway, the patient will have expiratory dyspnoea symptoms such as shortness of breath and wheezing, which may be more obvious after activity. It may be dull, dull, or tingling, and the location and extent of pain may vary depending on the location and extent of the tumor. If the tumor invades the pleura or chest wall, the pain may increase. Including weight loss, fatigue, low fever, etc. This is because the tumor consumes the body’s energy and may trigger an inflammatory response. Some patients may also have hoarseness because the tumor invades or compresses the recurrent laryngeal nerve. Chest CT is an important means to detect lung adenocarcinoma, which can clearly show the size, shape, location of lung nodules or masses and their relationship with surrounding tissues. For some small nodules suspected of early lung adenocarcinoma, high-resolution CT is helpful to further observe their characteristics. PET-CT can be used to determine the metabolic activity of the tumor, which is helpful for the staging of the tumor and the judgment of metastasis. Pathological diagnosis was made by bronchoscopy to obtain endobronchial lesions or CT-guided percutaneous lung biopsy to obtain lung mass tissues. Percutaneous lung biopsy is widely used for peripheral lung adenocarcinoma. In addition, pathological examination of surgically resected specimens is the most accurate method to confirm the diagnosis and determine the pathological type and stage. Genetic testing is very important for patients diagnosed with lung adenocarcinoma. Detection of mutations in EGFR, ALK, ROS1 and other genes can guide the subsequent targeted therapy and select appropriate targeted drugs. Surgical removal of the tumor is the mainstay of treatment for early lung adenocarcinoma. Lobectomy, wedge resection and other surgical methods can be selected according to the location and size of the tumor. The goal of the operation is to completely remove the tumor while preserving normal lung tissue as much as possible to ensure the patient’s respiratory function. It can be used to reduce the tumor volume before operation, so that inoperable patients have the chance of operation, and it can also be used to eliminate residual cancer cells after operation. Radiotherapy can relieve local symptoms such as hemoptysis and expiratory dyspnoea in patients who are inoperable in the middle and late stages. Chemotherapy drugs can kill cancer cells or inhibit their growth. Commonly used chemotherapy regimens are effective for lung adenocarcinoma, but chemotherapy may bring some adverse reactions, such as nausea, vomiting, alopecia, bone marrow suppression and so on. Targeted therapy has significant advantages for lung adenocarcinoma patients with specific gene mutations. For example, EGFR-TKI drugs are used in patients with EGFR mutations, and ALK inhibitors are used in ALK-positive patients. These targeted drugs can act on cancer cells more accurately, with good efficacy and relatively small side effects. By activating the body’s own immune system against cancer cells, drugs such as immune checkpoint inhibitors also play an important role in the treatment of lung adenocarcinoma, which can prolong the survival time of some patients, but may cause immune-related adverse reactions. The prognosis of lung adenocarcinoma depends on the stage of the tumor, the treatment method and the patient’s physical condition. Early diagnosis and treatment can significantly improve the survival rate and quality of life of patients, while the prognosis of advanced patients is poor. Therefore, to improve the understanding of lung adenocarcinoma, early detection and intervention are essential to improve the prognosis of patients. At the same time, with the continuous development of medical research, new treatment methods and drugs are constantly emerging, bringing more hope for patients with lung adenocarcinoma.
