Pay attention to this word on the CT report! It is likely to be cancer, don't take it lightly!

Nowadays, everyone pays more attention to physical examinations, and as a result, the detection rate of lung nodules has increased. In the past, it seemed that few people had lung nodules, but now more and more people are finding lung nodules. One of the reasons is that more people are doing lung CT scans during physical examinations.

This is of course an over-examination, but it is not a bad thing if it is understood correctly. It is just that it will increase endless anxiety, and some people may even have their normal life and work affected. Since you have already done the examination and you happen to have lung nodules, what should you do? Could it be lung cancer? What kind of lung nodules should be paid special attention to?

Those larger than 3cm are generally not called nodules but masses. Lung nodules usually refer to those smaller than 3cm, while those smaller than 1cm are called small lung nodules , and those smaller than 5mm are called micro nodules . In terms of quantity, there are single and multiple lung nodules, and in terms of density, there are solid nodules, mixed ground glass nodules, and pure ground glass nodules.

Of course, what everyone is most concerned about is the nature of the nodules: most lung nodules are actually benign nodules (such as sensory or inflammatory lesions), and a few may also be malignant nodules. Malignant nodules are of course mainly lung cancer, but they may also be pulmonary lymphoma, or metastatic nodules formed by other cancers metastasizing to the lungs.

If the following types of nodules are found during physical examination, special attention should be paid and further examination and diagnosis should be sought promptly:

1

Nodule size

Generally, the larger the nodule, the greater the possibility of malignancy. Nodules smaller than 5mm have a low possibility of malignancy (less than 1%); nodules between 5 and 9mm have a possibility of malignancy of about 2% to 6%; nodules larger than 1cm but smaller than 2cm have a possibility of malignancy of nearly 20%; and nodules larger than 2cm have a probability of malignancy of more than 50%. Of course, size is only one aspect.

2

Nodule density

Generally, solid nodules have a lower possibility of malignancy, partially solid nodules (uneven density) have a higher possibility of malignancy, and pure ground glass nodules have an intermediate possibility of malignancy.
3

Periphery/Edge

Irregular shape, rough and uneven edges, lobulation, burrs and/or pleural indentation signs, and dilated or twisted blood vessels should alert people to the possibility of malignancy.
4

Follow-up trend

The changing trend of nodules is of great reference value. If during the follow-up examination, the nodule grows rapidly or progressively, such as a nodule that grows significantly within six months or a year, a nodule that more than doubles in size, or a subsolid nodule that has solid components or an increase in the original solid components, you should be particularly alert to the possibility of malignancy.

Of course, the above is just a reference. Doctors need to make a comprehensive analysis and judgment based on age, gender, smoking history, family history of cancer, as well as the size, texture density, edge morphology and change trend of the nodule.

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A brief introduction to lung cancer

Lung cancer includes small cell lung cancer and non-small cell lung cancer, the latter of which includes adenocarcinoma, squamous cell carcinoma, adenosquamous carcinoma, large cell carcinoma and carcinoid. The incidence and mortality of lung cancer have always ranked first among malignant tumors in the world, making it the veritable "number one killer" of health.

1

Lung cancer risk factors:

Smoking (including second-hand smoke and even third-hand smoke), air pollution, occupational exposure, genetic factors, etc. People over 40 years old who have at least one of the following risk factors are at high risk of lung cancer: smoking more than 400 cigarettes per year (including those who have quit smoking for less than 15 years); passive smoking; occupational or environmental exposure to various carcinogenic factors (asbestos, uranium, radon, etc.); a history of malignant tumors or a family history of lung cancer; a history of chronic obstructive pulmonary disease, diffuse pulmonary fibrosis, tuberculosis, etc.

2

Lung cancer prevention tips:

1. Quit smoking and stay away from secondhand smoke; 2. When air pollution is serious, try to avoid going out and exercising; 3. Avoid indoor air pollution (passive smoking, indoor smoke pollution, contact with oil smoke, etc.); 4. Those at risk of occupational exposure should take protective measures; 5. Chronic respiratory diseases should be treated promptly.

3

Lung cancer early screening recommendations:

Early detection, early diagnosis and early treatment are the key to reducing lung cancer mortality and increasing survival time.

People at high risk of lung cancer should take the initiative to undergo screening. It is recommended that a low-dose spiral CT scan of the lungs be performed once a year. If any abnormal symptoms occur, seek medical attention promptly.

Lung cancer is not an "incurable disease": in the early stages, comprehensive treatment with surgery as the main approach can achieve clinical cure. Even in the late stages with distant metastasis, through comprehensive treatments such as chemotherapy, targeted therapy, and immunotherapy, many patients can survive with the tumor for a longer period of time, especially as more targeted and immunotherapy are coming on the market.

Different lung cancers require different treatment strategies. Lung cancer diagnosis and treatment cannot rely on a single discipline, so the diagnosis and treatment of lung cancer should focus on the role of a multidisciplinary team (MDT).

In general, the treatment of lung cancer should be based on a variety of information such as the patient's age, physical condition, pathological type, stage, prognostic risk assessment factors, etc., and based on existing evidence-based medicine, a standardized and individualized diagnosis and treatment plan should be formulated to strive for the best results.

Planning and production

Source: Oncologist

Author: Pan Zhanhe, deputy chief physician of the Department of Oncology, Zhongshan Hospital, Xiamen University

Editor: Wang Mengru