中国晚期原发性肺癌诊治专家共识(2016年版)

2016-04-21 中国肺癌杂志2016年1月第19卷第1期

中国晚期原发性肺癌诊治专家共识(2016年版)

中文标题:

中国晚期原发性肺癌诊治专家共识(2016年版)

发布机构:

发布日期:

2016-04-21

简要介绍:

原发性肺癌(以下简称肺癌)是我国最常见的恶性肿瘤之一。国家癌症中心2015年发布的数据显示,2006年-2011年我国肺癌5年患病率是130.2(1/10万)。其中男性84.6(1/10万),居恶性肿瘤第2位。女性45.6(1/10万),居恶性肿瘤第4位。 国际肺癌研究协会(International Association for the Study of Lung Cancer, I ASLC)2015年制定了第八版肺癌肿瘤-淋巴结-转移(tumor-node-metastasis, TNM)分期。美国医疗保险监督、流行病学和最终结果(Sur veillance, Epidemiology, and End Results, SEER)数据库显示,在初诊时57%的肺癌患者已经发生了远处转移,所以晚期患者的治疗是肺癌治疗体系的重要组成部分,也是近年来进展最多的部分。 


病理诊断是肺癌诊断的金标准,与此同时,近年来肺癌的分子遗传学研究取得了显著进展,基于遗传特征的分子分型使晚期肺癌的治疗步入了个体化分子靶向治疗时代。正是在这样的背景下,2015年世界卫生组织(World Health Organization, WHO)发表了肺肿瘤组织学的新分类。

与2004年分类相比,其中一项最主要的变化就是在晚期肺癌患者的个体化治疗策略中强调了分子遗传学的作用。国家卫生和计划生育委员会医政医管局委托中国抗癌协会肿瘤临床化疗专业委员会制定了《中国原发性肺癌诊疗规范(2015年版)》,但是近些年晚期肺癌的治疗进展迅速,治疗选择显著增多,为进一步提高我国晚期肺癌的诊疗水平,改善晚期肺癌患者的预后,中国医师协会肿瘤医师分会和中国抗癌协会肿瘤临床化疗专业委员会组织全国专家,结合近年来肺癌病理、分子遗传学及诊断和治疗的最新研究成果,制定了《中国晚期原发性肺癌诊疗专家共识(2016年版)》。 

临床表现 

晚期肺癌患者可出现刺激性干咳、咯血、胸痛、发热、气促等症状。当肿瘤在胸内蔓延侵及周围组织时,可导致声音嘶哑、上腔静脉阻塞综合征(superior vena caval obstruction syndrome)、霍纳氏综合征(Horner syndrome)、胸腔积液及心包积液等。远处转移至脑、骨、肝、肾上腺及其他器官时,可引起相应器官转移的临床表现。另外,部分患者可出现副肿瘤综合征(paraneoplastic syndromes),包括库欣综合征(Cushing syndrome)、抗利尿激素分泌异常综合征(syndrome of inappropriate antidiuretic hormone, SIADH)、高钙血症、类癌综合征(carcinoid syndrome)及继发增殖性骨关节病等。

制定者:
中国医师协会肿瘤医师分会
中国抗癌协会肿瘤临床化疗专业委员会



相关资料下载:
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中国晚期原发性肺癌诊治专家共识(2016年版)
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  1. [GetPortalCommentsPageByObjectIdResponse(id=1052239, encodeId=866a1052239fb, content=文章不错 受教了 谢谢分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=989a5607928, createdName=H8888888, createdTime=Fri Sep 17 09:15:53 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198614, encodeId=9d5d198614f2, content=怎么打不开啊?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuEYA6ZJS2RZEJp0LgvdXH072EszfvD8xib0UGViaFO626UZIkB4ibvY1NicVJDFUSYoQjZvL6gnjziaYl/0, createdBy=48511932758, createdName=1e0d2fb7m34(暂无匿称), createdTime=Tue May 16 06:04:27 CST 2017, time=2017-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=150106, encodeId=7fef15010641, content=好东西!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160525/IMG5745C196909489510.jpg, createdBy=7f051724297, createdName=1ded263cm87(暂无匿称), createdTime=Fri Oct 21 14:09:09 CST 2016, time=2016-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148844, encodeId=e1ea14884401, content=值得学习!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/96A4B35900FD02B08C46DE33C3A06890/100, createdBy=f4011956702, createdName=扬州国信商标, createdTime=Sun Oct 16 18:10:20 CST 2016, time=2016-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111466, encodeId=9d361114667a, content=这么好的东西,可以下载吗?有原文最好了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7fe51947033, createdName=1e105634m93(暂无匿称), createdTime=Mon Sep 05 13:09:00 CST 2016, time=2016-09-05, status=1, ipAttribution=)]
    2021-09-17 H8888888

    文章不错 受教了 谢谢分享

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1052239, encodeId=866a1052239fb, content=文章不错 受教了 谢谢分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=989a5607928, createdName=H8888888, createdTime=Fri Sep 17 09:15:53 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198614, encodeId=9d5d198614f2, content=怎么打不开啊?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuEYA6ZJS2RZEJp0LgvdXH072EszfvD8xib0UGViaFO626UZIkB4ibvY1NicVJDFUSYoQjZvL6gnjziaYl/0, createdBy=48511932758, createdName=1e0d2fb7m34(暂无匿称), createdTime=Tue May 16 06:04:27 CST 2017, time=2017-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=150106, encodeId=7fef15010641, content=好东西!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160525/IMG5745C196909489510.jpg, createdBy=7f051724297, createdName=1ded263cm87(暂无匿称), createdTime=Fri Oct 21 14:09:09 CST 2016, time=2016-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148844, encodeId=e1ea14884401, content=值得学习!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/96A4B35900FD02B08C46DE33C3A06890/100, createdBy=f4011956702, createdName=扬州国信商标, createdTime=Sun Oct 16 18:10:20 CST 2016, time=2016-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111466, encodeId=9d361114667a, content=这么好的东西,可以下载吗?有原文最好了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7fe51947033, createdName=1e105634m93(暂无匿称), createdTime=Mon Sep 05 13:09:00 CST 2016, time=2016-09-05, status=1, ipAttribution=)]
    2017-05-16 1e0d2fb7m34(暂无匿称)

    怎么打不开啊?

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1052239, encodeId=866a1052239fb, content=文章不错 受教了 谢谢分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=989a5607928, createdName=H8888888, createdTime=Fri Sep 17 09:15:53 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198614, encodeId=9d5d198614f2, content=怎么打不开啊?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuEYA6ZJS2RZEJp0LgvdXH072EszfvD8xib0UGViaFO626UZIkB4ibvY1NicVJDFUSYoQjZvL6gnjziaYl/0, createdBy=48511932758, createdName=1e0d2fb7m34(暂无匿称), createdTime=Tue May 16 06:04:27 CST 2017, time=2017-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=150106, encodeId=7fef15010641, content=好东西!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160525/IMG5745C196909489510.jpg, createdBy=7f051724297, createdName=1ded263cm87(暂无匿称), createdTime=Fri Oct 21 14:09:09 CST 2016, time=2016-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148844, encodeId=e1ea14884401, content=值得学习!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/96A4B35900FD02B08C46DE33C3A06890/100, createdBy=f4011956702, createdName=扬州国信商标, createdTime=Sun Oct 16 18:10:20 CST 2016, time=2016-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111466, encodeId=9d361114667a, content=这么好的东西,可以下载吗?有原文最好了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7fe51947033, createdName=1e105634m93(暂无匿称), createdTime=Mon Sep 05 13:09:00 CST 2016, time=2016-09-05, status=1, ipAttribution=)]
    2016-10-21 1ded263cm87(暂无匿称)

    好东西!

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1052239, encodeId=866a1052239fb, content=文章不错 受教了 谢谢分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=989a5607928, createdName=H8888888, createdTime=Fri Sep 17 09:15:53 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198614, encodeId=9d5d198614f2, content=怎么打不开啊?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuEYA6ZJS2RZEJp0LgvdXH072EszfvD8xib0UGViaFO626UZIkB4ibvY1NicVJDFUSYoQjZvL6gnjziaYl/0, createdBy=48511932758, createdName=1e0d2fb7m34(暂无匿称), createdTime=Tue May 16 06:04:27 CST 2017, time=2017-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=150106, encodeId=7fef15010641, content=好东西!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160525/IMG5745C196909489510.jpg, createdBy=7f051724297, createdName=1ded263cm87(暂无匿称), createdTime=Fri Oct 21 14:09:09 CST 2016, time=2016-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148844, encodeId=e1ea14884401, content=值得学习!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/96A4B35900FD02B08C46DE33C3A06890/100, createdBy=f4011956702, createdName=扬州国信商标, createdTime=Sun Oct 16 18:10:20 CST 2016, time=2016-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111466, encodeId=9d361114667a, content=这么好的东西,可以下载吗?有原文最好了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7fe51947033, createdName=1e105634m93(暂无匿称), createdTime=Mon Sep 05 13:09:00 CST 2016, time=2016-09-05, status=1, ipAttribution=)]
    2016-10-16 扬州国信商标

    值得学习!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1052239, encodeId=866a1052239fb, content=文章不错 受教了 谢谢分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=989a5607928, createdName=H8888888, createdTime=Fri Sep 17 09:15:53 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198614, encodeId=9d5d198614f2, content=怎么打不开啊?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuEYA6ZJS2RZEJp0LgvdXH072EszfvD8xib0UGViaFO626UZIkB4ibvY1NicVJDFUSYoQjZvL6gnjziaYl/0, createdBy=48511932758, createdName=1e0d2fb7m34(暂无匿称), createdTime=Tue May 16 06:04:27 CST 2017, time=2017-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=150106, encodeId=7fef15010641, content=好东西!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160525/IMG5745C196909489510.jpg, createdBy=7f051724297, createdName=1ded263cm87(暂无匿称), createdTime=Fri Oct 21 14:09:09 CST 2016, time=2016-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148844, encodeId=e1ea14884401, content=值得学习!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/96A4B35900FD02B08C46DE33C3A06890/100, createdBy=f4011956702, createdName=扬州国信商标, createdTime=Sun Oct 16 18:10:20 CST 2016, time=2016-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111466, encodeId=9d361114667a, content=这么好的东西,可以下载吗?有原文最好了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7fe51947033, createdName=1e105634m93(暂无匿称), createdTime=Mon Sep 05 13:09:00 CST 2016, time=2016-09-05, status=1, ipAttribution=)]
    2016-09-05 1e105634m93(暂无匿称)

    这么好的东西,可以下载吗?有原文最好了

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