小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 咳嗽
- 呼吸困难
- 咯血
- 胸痛
- 体重减轻
其他诊断因素
- 年龄 65-70 岁
- 男性
- 乏力
- 肺部检查异常
- 声嘶
- 意识模糊
- 人格改变
- 恶心和呕吐
- 头痛
- 吞咽困难
- 骨痛和/或骨折
- 惊厥
- 颈部或锁骨上淋巴结肿大
- 面部肿胀
- 颈部或胸部/腹壁静脉曲张
- 杵状指
- 肥大性骨关节病
危险因素
- 吸烟
- 暴露于烟草环境
- 氡气暴露
- 石棉暴露
诊断性检查
首要检查
- 胸部 X 线检查
- 胸部、肝脏、肾上腺 CT
需考虑的检查
- 支气管镜检查
- 活检
- 胸腔穿刺术
- 胸腔镜
- 脑部 MRI 或 CT
- 骨扫描
- 纵隔镜检查
- 正电子发射断层成像 (positron emission tomography, PET)
- 骨髓穿刺和活检
- 全血细胞计数（FBC）
- 肝功能检查 (LFT)
- 血清钠
- 肾功能
- 肺功能检查
治疗流程
初始就诊时：局限性疾病
初始就诊时：广泛性疾病
6 个月内复发
6 个月后复发
撰稿人
作者
Rebecca Suk Heist, MD, MPH
Associate Professor of Medicine
Harvard Medical School
Thoracic Oncology
Massachusetts General Hospital
Boston
MA
利益声明
RSH has received honoraria for consulting from Novartis, Abbvie, Daichii Sankyo, and EMD Serono. RSH's institution (not RSH) has received research funding from Agios, Abbvie, Exelixis, Daichii Sankyo, Novartis, Lilly, Mirati, Corvus, Incyte, and Genentech Roche.
Catherine B. Meador, MD, PhD
Clinical Fellow in Thoracic Oncology
Massachusetts General Hospital
Boston
MA
利益声明
CBM declares that she has no competing interests.
鸣谢
Dr Rebecca Suk Heist and Dr Catherine B. Meador would like to gratefully acknowledge Dr Leena Gandhi, Dr Alvin R. Cabrera, Dr Christopher R. Kelsey, and Dr Lawrence B. Marks, previous contributors to this topic.
利益声明
LG, ARC, CRK, and LBM declare that they have no competing interests.
同行评议者
Alan Neville, MD
Professor
Assistant Dean
Undergraduate Program
McMaster University
Hamilton
Ontario
Canada
利益声明
AN declares that he has no competing interests.
鉴别诊断
- 非小细胞肺癌
- 肺炎/支气管炎
- 类癌
更多 鉴别诊断指南
- 肺癌：诊断和治疗
- 指南和建议：肺癌
更多 指南患者教育信息
肺癌：询问医生
支气管镜检查
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