| Popis |
Background: There are estimated in the National Czech Cancer Registry since 1976 to 2010 among 203, 858 cancers a total of 16 622 lung cancers (LCs) in males associated with other neoplasms, presented 10 % of 166 239 (81,5%) newly registered LCs in males. They were 4,395 (2.6 %) primary and 12,227 (7.4 %) subsequent LCs; A total of 5,322 LCs in females, presented 14.1 % of 37,619 (18,5%) newly registered LCs in females, of which were 1,022 (2.7 %) primary and 4,300 (11.4 %) subsequent LCs. Their representation at the early clinical stages decreased gradually from 53% to 22 %, at the advanced stages increased from 20 % to 64 %; One third of subsequent neoplasms in early stage and one fifth in advanced stage evaluated replenish 51,2% of unknown stage in men and 47,4% in women. High proportion of LCs at unknown stages limited detailed analysis. Dichotomous question of early diagnosis is inquired. Methods: Miscellaneous group of 548 individuals (260 females and 288 males) with high risk of lung cancer was formed predominantly from South Moravia region of the Czech Republic, EU. They were enrolled since 2001 to 2010. Approximately one third (n=185) from the group had undergone surgery due to cancer of head and neck, gastrointestinal, gynecological including breast, urological and skin location (n=86) and due to pulmonary malignancy (n=99) . The follow up scheme for this subgroup represents four time yearly careful clinical investigation with monitoring of appropriate TM levels during first three years, then three time in the year during fourth and fifth years, and two time yearly follow up investigation during sixth to tenth year in connection with yearly paraclinical set of CT of thorax and USG of abdominal spaces on even-numbered, and X-rays of thorax and CT of abdomen on odd-numbered years, two-year period bone scan, endoscopy, and yearly laboratory screening tests – serology, hematology, and basic urine investigation. Another parts of the risk group are represented by persons (n=203) with high risk of lung cancer (uranium miners with long term professional exposure to Rn222, heavy smokers minimally 20 yrs with 1 to 2 packs cigarettes per day (n=60), pts with hemoptysis (n=15) and persons with other kind of risk (n=85). These were screened one time yearly by clinical, laboratory, and bronchoscopy examination and imaging alternately yearly X rays / thoracic CT scan and abdominal USG. Classification of malignant tumours TNM-7 and Program Microsoft Excel® were used to data analysis. Results: Among 548 persons from the risk group followed during ten years period they were found in 29 individuals (5,3%) counting 11 females and 18 males a total of 40 lung cancers. They were 14 primaries and 26 subsequent LC with two cases of triplicity. The early diagnosis in the stage (I, II) was established 32-times (i.e. 4/5) versus 8-times diagnosed advanced stage (III, IV) of disease (i.e. 1/5). Appropriate treatment was organized and follow up continues to evaluate survival. Conclusion: Early diagnosis in patients with lung cancer multiplicity seems attainable despite of certain limitation.
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