最近审阅: 24 十月 2020
最近更新: 26 六月 2018

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
  • 胸痛和/或肩痛
  • 体重减轻

其他诊断因素

  • 男性
  • 疲劳
  • 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
  • 无力、C8/T1 分布区感觉异常和/或疼痛
  • 癫痫发作
  • 颈部或锁骨上淋巴结肿大
  • Horner 综合征
  • 面部肿胀
  • 颈部或胸部/腹壁静脉曲张
  • 杵状指
  • 肥大性肺性骨关节病

危险因素

  • 吸烟
  • 暴露于烟草环境
  • 慢性阻塞性肺疾病
  • 家族史
  • 氡气暴露
  • 石棉暴露
  • 老年

诊断性检查

首要检查

  • 胸部 X 线检查
  • 颈部下段、胸部和上腹部的对比增强 CT 检查
更多 首要检查

需考虑的检查

  • 痰液细胞学检查
  • 支气管镜检查
  • 活检
  • 具有诊断意义的胸腔穿刺术和/或胸膜活检
  • 纵隔淋巴结取样:纵隔镜和支气管内超声
  • 电视辅助胸腔镜手术 (VATS)
  • 胸腔镜
  • 脑部 MRI 或 CT
  • 胸廓入口 MRI
  • 正电子发射断层显像 (PET-CT)
  • 骨扫描
  • 肝脏和肾上腺对比增强 CT
  • 肺功能试验 (PFT)
  • 全血细胞计数 (FBC)
  • 肝功能检查 (LFT)
  • 血清钙
  • 电解质和肾功能
  • 心电图和超声心动图
  • 表皮生长因子受体 (EGFR) 突变检测
  • 间变性淋巴瘤激酶 (ALK) 检测
  • ROS1 检测
更多 需考虑的检查

新兴检查

  • 程序性死亡-配体 1 (PD-L1) 检测
  • BRAF 检测
更多 新兴检查

治疗流程

撰稿人

Consultant Respiratory Physician

Nottingham University Hospitals

Honorary Professor of Medicine

University of Nottingham

Respiratory Medicine Unit

David Evans Research Centre

City Hospital Campus

Nottingham

UK

利益声明

DRB has received a lecture fee from Pierre-Fabre and educational grants from Boehringer Ingelheim Ltd, Irwin Mitchell, Roche, and Siemans; DRB has received assistance for travel to an international meeting from OncImmune Ltd.

Consultant Medical Oncologist

Department of Medicine

Royal Marsden Hospital

London

UK

利益声明

SP has been paid as a consultant to Eli Lilly and has acted as consultant to AstraZeneca, Boehringer Ingelheim, Clovis Oncology, BMS, MSD, Pfizer, Novartis, and Ariad. SP has received research grants from Pierre Fabre, Otsuka, and Boehringer Ingelheim. SP has received assistance for travel from Boehringer Ingelheim, MSD, and Pfizer.

Professor David R. Baldwin and Dr Sanjay Popat would like to gratefully acknowledge Dr Mick Peake, Dr Chris Kelsey, and Dr Lawrence Marks, previous contributors to this topic. MP has received lecture fees: AstraZeneca Pharmaceuticals, Lilly Oncology Ltd, Pierre-Fabre, GSK Ltd, and Roche Pharmaceuticals Ltd. MP has also received educational grants to attend scientific conferences from Roche Pharmaceuticals Ltd and Boehringer Ingelheim Ltd. CK and LM declare that they have no competing interests.

同行评议者展开全部内容

Professor

Assistant Dean

Undergraduate Program

McMaster University

Hamilton

Ontario

Canada

利益声明

AN declares that he has no competing interests.

Assistant Attending Surgeon

Thoracic Service

Memorial Sloan Kettering Cancer Center

New York

NY

利益声明

JH declares that he has no competing interests.

Consultant Medical Oncologist

University College Hospital

London

UK

利益声明

SML declares that he has no competing interests.

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