【摘要】 近十多年来 很多学者对小细胞肺癌的临床表现和治疗特别关注,改变了认为外科治疗无效的传统观念,为探索本病的早期诊断和治疗,我们收集146例小细胞肺癌,提出初步意见。小细胞肺癌的发病年龄较早,病程短,症状明显,除咳嗽、血丝痰及胸痛外,常合并发热、胸水和声嘶以及锁骨上淋巴结转移。病人吸烟指数超过400以上者,占本组吸烟病例76.2％;左肺上叶占48.5％,右肺上叶占44.7％,这与肺结核的发生部位相似,需小心鉴别。X线表现以肺门团块影为特征的占54.8％,以肺门增宽者占15.1％,余为肺内孤立圆形块影,但有一点值得注意,X线平片上常可出现阻塞性肺不张和阻塞性肺炎。因此,提出我们对小细胞肺癌的诊断程序。@刘广森$近十多年来!很多学者对小细胞肺癌的临床表现和治疗特别关注,改变了认为外科治疗无效的传统观念,为探索本病的早期诊断和治疗,我们收集146例小细胞肺癌,提出初步意见。小细胞肺癌的发病年龄较早,病程短,症状明显,除咳嗽、血丝痰及胸痛外,常合并发热、胸水和声嘶以及锁骨上淋巴结转移。病人吸烟指数超过400以上者,占本组吸烟病例76.2％;左肺上叶占48.5％,右肺上叶占44.7％,这与肺结核的发生部位相似,需小心鉴别。X线表现以肺门团块影为特征的占54.8％,以肺门增宽者占15.1％,余为肺内孤立圆形块影,但更多还原

【Abstract】 In the recent 10 more years many specialists have paid attention to theclinical manifestation and treatment of the small cell lung carcinoma (SCLC). The traditional opinion that surgical treatment is not effective has been changed. In order to study the early dlaognosis and treatment, from 1981 to 1985 146 cases with SCLC were collected and analysed.In this data, the age of onset in patients with SCLC was earlier, the course was short-ter and the symptoms were clearer than those of other kinds of lung cancer. Besides coughing , bloody sputum and chest pain, patients usually had fever, pleural effusion, hoarseness and metastasis of supraclavicular lymph node. Patients with index of smoking over 400 consisted 7-6,2% among patients of smoker. The lesion usually located in the upper lobe of either lung, 48.5%, in the upper lobe of left lung and 44.7% in the upper lobe of right lung . The location was similar to that of tuberculosis. Therefore, differential diagnosis should be made carefully. In the X-ray film the shadow of mass in hilum accounted for 54.8%, wide shadow in hilum accounted for 15.1%, and the rest had the appearance of solitary round shadow in the lung. It was emphasized that atelectasis and obstructive pleumonitis appeared frequently. Therfore. it was suggested that the procedures of diagnoses should be carried out as fo-llow. cytology, fibroscopy, or percutaneous lung aspiration and then CT scan, bone marrow or lymph nodes biopsy.更多还原