肺癌如何治疗? 肺癌的治疗方法繁多,具体采取哪一种取决于肺癌的类型和分期。非小细胞肺癌患者可以接受手术,化疗,放疗,靶向治疗,中医中药或这些治疗的组合,小细胞肺癌患者通常接受放疗和化疗,近年学术界
肺癌早期有相当一部分表现为结节,但是结节也可能是良性病变,恶性结节占30%-40%。临床中一般认为肺部结节小于0.8厘米,边缘清楚光滑的,良性的可能性比较大,但仍然需要定期观察,如果结节在短时间内快速增大,则不能排除是恶性的(如果是恶性结节,病变增大一倍的时间约为300~400天;如果结节倍增时间大于600天,那么说明其恶性概率很低。)大多数结节在两年内未观察到生长,一般可视为良性。如果肺部结节大小超过0.8厘米,特别是边缘不规则,看上去有又短又细的毛刺,则认为恶性的可能性比较高。 *发现肺部小结节如何处理?如何复查? 有五类人在体检时发现肺部小阴影或小结节时,千万不要掉以轻心! 包括1长期吸烟,烟龄超过20年,每天抽烟超过20支以上者,或有被动吸烟的人群; 2年龄在40岁以上者; 3伴随有胸痛、咳嗽、不明原因的痰中带血丝、消瘦、体重下降等症状; 4有家族性的肿瘤史,特别是肺癌遗传史者; 5结节位于上叶,大小在1厘米以上,伴有毛刺样、分叶状或毛玻璃样改变的。 这些人属于有肺癌危险因素,应积极咨询专业胸外科医师,并接受正规的进一步检查和及时治疗。单个实性结节直径小于等于8mm且无肺癌危险因素者,恶性结节的风险相对较低,结节直径小于等于6mm者建议每12个月随访一次;结节直径在6mm至8mm之间的患者应半年复查胸部CT,如结节未发生变化,之后可每年定期复查。对于存在一项或更多肺癌危险因素直径小于等于8mm的单个实性结节者,随访频率须相对频繁:1)结节直径小于等于4mm者应每12个月随访;2)结节直径在4mm至6mm之间的患者应每隔6个月随访,如果两次随访结节没有变化,则每年定期随访;3)结节直径在6mm至8mm之间的患者应在最初的3至6个月之间随访,随后在9至12个月随访,如果没有变化,则每年定期随访。 而对于多个小的实性结节,随访的频率和持续时间应依照最大的结节进行。大于8mm的实性结节,恶性肿瘤的可能性相对增大。患者就诊时应特别注意携带既往影像学资料(如CT或PET-CT等),供医师比较评估恶性肿瘤的可能性。专科医师会根据结节的影像学特征、随访期间大小形态变化等特性,判断恶性结节的可能性,必要时会建议患者手术干预或行CT下经皮肺穿刺、气管镜检查等进一步鉴别。世界上有追踪研究显示,一个小结节经过大概10-20年也可发生恶变,肿瘤是分很多种性质的,有些是“活跃肿瘤”,可以很快长大,侵蚀和转移,杀伤人体,还有一种是“惰性肿瘤”,长得很慢,有些过了20年以上才转变成肺癌。
坚持英语学习不动摇,学习科普治病两不误 研究表明,女性高瘦=高寿 | Tall, slim women have best chance to live to 90 From CD君 CHINADAILY Today A woman's height and weight appear to play a greater part in her chance of enjoying a long life than a man's, according to a study investigating a person's likelihood of reaching the age of 90. Women who are taller than average, standing at 5 feet 9 inches (175cm) or above, were 31 percent more likely to enter their ninth decade compared with those standing at 5 feet 3 inches (160cm) or less, the study published in the Journal of Epidemiology & Community Health suggested. The same result wasn't found in men. The researchers at Maastricht University wanted to answer why the spike in life expectancies in Western countries has plateaued in recent decades. In the US, that figure currently stands at 78.6. Existing work indicates the obesity epidemic could be one culprit, as well as low levels of exercise. Most past studies into longevity featured only men, or a combination of men and women. This work, therefore, offers a new perspective by looking into how BMI (an individual's weight divided by height squared) and exercise levels might affect the lifespan of men and women separately. Women tend to live longer than men due to factors including differing lifestyles on average, as well as genetics and hormones, the authors wrote. To investigate, the team used data from the Netherlands Cohort Study, which was started in 1986, and collected information on over 120,000 men and women aged between 55 to 69 years old living in 204 Dutch municipalities. From this pool, the researchers assessed data from 3,646 men and 4,161 women born between 1916 and 1917. At the start of the study, the respondents answered questions about their lives (like how much they smoked, drank alcohol and spent walking per day), and detailed variables such as their weight, height, and their weight when they were 20 years old. Participants were categorized into three groups: those who exercised for less than 30 minutes; between 30 to 60 minutes; and for 1.5 hours or more. In women aged between 68 to 70, their height, current BMI and their weight gain since the age of 20 were associated with reaching the age of 90. And while exercising was found to boost the lifespan, working out for one hour a day was best suited to women before the effects plateaued. In men, there was no such cap. Men who worked out for more than 90 minutes per day were 39 percent more likely to see their 90th birthday than those who exercised for 30 minutes or less. In women, those who engaged in physical activity for 30 to 60 minutes were a fifth more likely to hit the age of 90, compared with those who engaged in half an hour of physical activity. Study author Lloyd Brandts, of the Maastricht University Department of Epidemiology, told Newsweek: "Chances of reaching old age did not increase further at higher physical activity levels." "In men it seems the more time they spend physically active every day, the better it is for their chances of reaching 90 years. We think the novelty of this research lies in the differences in associations we observed between both sexes." However, in men who had never smoked (10 percent of the cohort) a high BMI appeared to lower the chance of reaching 90 years of age, "but the number of never-smoking individuals was too small to conclude anything about this", said Brandts. "These finding indicate that both body size and physical activity are related to lifespan, but these associations seem to differ between men and women. We advise the readers to adapt a healthy weight (BMI between 18.5-25 kg/m2) and at least 60 minutes of physical activity a day," he said. But, Brandts highlighted, as the study is observational, it can't establish cause between height, weight, exercise levels and a person's lifespan. "For instance, a low level of physical activity might also be an indicator of deteriorating health, which in turn might also have led to an earlier death," he explained. "Furthermore, information on body size and physical activity was self-reported rather than objectively measured, which might have affected the results." And as the participants were already what the researchers considered elderly when the study started, the results might not be replicated in younger people, he said. The study is the latest to attempt to investigate human life expectancy. Last year, scientists published a paper in bioRxiv claiming they had devised a blood test that could predict when a person might die.