The low doses spiral CT-earlier period lung cancer the valid means of the examination

The lung cancer has become the most familiar malignant tumor of current international community, though have various new treatment method to continuously appear, always say that come, the prepare of lung cancer is behind badly.Currently, the lung cancer is confirm above 80% has already belonged to a medium later period, 5 years and the existence rate is only 14% and only the sufferer canned get a surgical operation treatment in early days and reach to cure.Therefore inquiried into lung cancer to diagnose a method in early days, for valid control the lung cancer was very important.Several near in the last yearses, learn along with the image, inside the development of the mirror technique and the molecular biology, the earlier period that is in the lung cancer diagnosed aspect to make some progresses.The image learns a checkThe development that the image learn provided emollient tool into the earlier period diagnosis of the lung cancer and provided a premise for the death rate which lowers lung cancer.Currently, CT already extensively applied periodically sieve at the lung department paroxysm or head the normal regulations check for diagnose means.BE a particularly spiral CT, high resolution CT doubly are valued with low emanation quantity CT(TSLDSCT).1.spiral CT and low doses CTThe sensitivity of the chest X line check is about the diameter one Li rice above knot stanza sexually transmitted disease to change, CT to surroundings type the lung paroxysm diagnose more common X line to check or the normal regulations whole lungses of break a layer to shoot to be like check more for the sensitive, the spiral CT can discover lung department 1~5 millimeter sub-footing stanzas, high diagnosis surroundings of the resolution CT type the sensitivity of the lung cancer more central type lung cancer Gao, can clearly show the lump internal bronchus weather, empty, liquefy bad dead, small calcify and edge change(if the hair stab, cent leaf) etc..But, high resolution CT mainly to lung inside dissect structure and blood vessel to show, to bronchus paroxysm the diagnosis relatively has advantage and mainly used for a quality pneumonia, lung fiber to turn, the bronchus extend and other diseases(like the system erythema lupus) cause of lung department change.The low doses spiral CT means when adopting spiral CT scan, the enactment electric voltage is 140,000 Fus, electric current 40 milli- Anne, the pitch is 10 millimeters, breathe out end 15~20 reconstructions and only provide a lung window.(window breadth 1500, window 650)Because the electric current reduce, radiate quantity to lower, the emanation amount of is only a normal regulations CT of 1/6.Compared with the normal regulations CT, to the sub-footing in the lung stanza of check a rate to have higher sensitivity, the low doses CT sieving can help have no symptom crowd the check of lung cancer was a rate in early days and all had meaning of show the Zhao to Gao Di Wei2's crowd.Certainly, the low doses spiral CT also exists the price higher etc. problem.2.PET-CTWhen 18 F － took off the PET positive electron of the oxygen glucose(FDG) blast-off to break a layer to develop its principle to be a tumor cell metabolism activity to increase its glucose metabolism increment, but normal organization and the cell metabolism and the glucose in the positive pathological changes took a rate opposite and lower.When inside the radio FDG infusion body after, tumor cell as to it's take a rate to obviously increase and the FDG is in the tumor cell of thick gather degree and the glucose metabolism level in the cell to present just related.Therefore, before the organization organ of pathological changes inside the body appear structure variety, PET can from the member level examination with identify the metabolism change take place.The PET helps chest slice or CT check to discover of settle sex diagnosis, and lung cancer treatment in front and back of curative effect judgment.Therefore, the CT discover of property inside the lung don't clear sub-footing stanza pathological changes, can go a PET check to further and definitely diagnose, with avoid only with from CT diagnosis is positive but press the way of doing that the positive pathological changes handle.The FDG-PET can show a focus of high metabolism information, but contrast rate and resolution of portrait be lower, can't to abnormality thick gather a focus to carry on a precision to dissect a fixed position;The CT can provide a high resolution, high contrast of break 1 F picture, but can't evaluate its function and metabolism information.The PET-CT installs CT and PET at same check bed with same machine, same processing work station and provide to the CT of the high resolution dissect the bio-chemical information that information and PET provide to carry on accurate match fusion, can not only show a focus and around organize a structural relation, and to FDG abnormality thick gather part to carry on an accurate fixed position, biggest raised to the accuracy of pathological changes property and pathological changes part diagnosis.The PET makes use of malignant tumor cell to excessively store FDG principle to provide the information of the physiology and metabolism of the part organization, because of some burning the disease cell can also in great quantities absorb FDG, for lung inside pimping knot stanza sexually transmitted disease cooking stove compare LDSCT bad.As a result the PET absorbs FDG to path inside the lung opposite smaller focus bad, diagnose opposite more difficult.3.inside the mirror super voiceThe technique which is about 20 in the last yearses development of mirror inside the windpipe super voice, discover the earlier period that the chamber outside grows to descend the tumor of the growth with mucosa is importance, someone useds for an outside week recently and lung cancer and windpipe outside share the diagnosis of.Cytology and pathology check1.phlegm cytologyThe phlegm cytology extensively useds for the diagnosis of lung cancer currently, it have simple easily go, the safety have no pain, re-usable for many times check also can system dynamic state the ground observe the last skin cell typical model to never increase to living to expect to be not before the cancer until develop for gradually and cancerously gradually change in a row process, can check other methods don't easily discover of the recessiveness lung cancer is one of the main meanses that the lung cancer diagnoses in early days.That method is adapt in a center type the diagnosis of the lung cancer, check the scale cancer and the cellule lung cancer a rate Gao, about 50%, to surroundings type the lung cancer be lower.The sensitivity of the earlier period lung cancer of the phlegm cytology's only ising 20% ～s is 30%s, the dependable sex margin is more big, is 13% ～s is 82%s.The phlegm cytology is in checking lung cancer of the biggest advantage lay in and create, is checked to be easy to accept, its biggestly limitting sex to lie in can'ted position for the lung cancer in earlier period exist, then can't cure of problem.And, the masculine gender rate of phlegm cytology needs to be raise.Traditional check masculine gender of the phlegm cytology rate not an important reason of Gao be a film producer error margin.But thin layer the liquid Ji cytology technique be directly to pass a technique processing, throw away Tu2 Pian4 up miscellaneous quality, make into an observation a clear thin layer Tu2 Pian4, make Tu2 Pian4 easier observation, raised accuracy.This technique not only improved the collections rate of specimen, but also canned make the cell evenly single layer distribute on the glass slice and consumedly raised a rate and accuracy of the check of cancer cell.2.the bronchus mirror of the fluorescence fiberThe fiber bronchus mirror(the bronchoscopy of the white-light, WLB) check mainly useds for a center type lung cancer Shai to check to diagnose with earlier period, can acquire the specimen of histology and cytology.Checking a rate to center type the bronchus mirror of the lung cancer fiber can reach to above 95%, but the surroundings type only 50%ly checks a rate.To the hard detection of the bronchus mirror of the lung cancer fiber in earlier period, it particularly is pathological changes and home position cancer before the cancer.The fluorescence bronchus mirror(lung ima, the endoscopy of the going fluorescence, LIFE) ability developped on common fiber bronchus mirror foundation can't observe to the WLB of the suspicious part carry on a fixed position to live check tie a department a processing, can raise lung cancer thus for earlier period of the masculine gender rate of diagnosis.Adopt fluorescence fiberscope to not the typical model increase to living and check of home position cancer a rate raise 50%.Molecular biology technique1.the protein set learn a techniqueProtein set(proteome) mean to have a gene set express of all proteins, protein set's learn(proteomics) is science which passes a biochemistry method to carry on a large-scale research to the protein.The growth dependence of the tumor is various protein members, like various growth factor and Mao, but the occurrence of these protein members and tumor development near concern, as a result may become latent tumor marking a thing, but traditional examination method usually a can examine a kind of tumor marking thing, but make use of single tumor marking a thing diagnosis tumor, its particularity and sensitivities all not enough ideal, the protein set learn a technique can high flux of sieving tumor dissimilarity development stage gene expression of various protein, particularly is organization and body fluid in imply of and the tumor related low and plentiful degree egg white, develop thus to in great quantities have diagnosis a worth marking thing, the sieving which unites various marking things to carry on tumor will include particularity and sensitivity of hope the exaltation sieving.Study aspect in the tumor, variety and tumor which learn a technique and can announce to public the expression level of the tumor egg white of the protein set have a relation of develop different stage, is diagnosis and treatment of tumor to provide new means.The tumor disease is from the angle for learn of the protein set again can be think to be a kind of protein blemish disease, there is various protein in its occurrence process occurrence abnormality variety, this kind of variety not only include protein expression the increment of the quantity or decrease, also include an egg white translation behind process the last change, cause thus the tumor organization express of the protein compose of change, make use of a protein set to learn a method examination protein a table of the variety diagnoses tumor more accurately.2.gene chip techniqueThe occurrence development of lung cancer is many genes participate, many stage, many step of complicated living creature process, lung cancer gene expression table of the research has already examine much more outstanding and the lung cancer related gene, have already known expression abnormality but speech of gene, mainly involve cell to propagate, anti- cell Diao Wu, signal conduct, DNA hurt repair, the immunity escape, divide gradually and transfer the excrescent expression of related gene, and lung cancer and embryo lung gene expression table likeness.Gene chip(genechip) means to be probes many particular few pit Mao sour fragments or gene fragment, there is one alignment fixed in support thing up, then with treat to measure of the gene of marking sample press the alkali Ji to form couples principle to carry on miscellaneous hand over, again pass laser to totally focuse a fluorescence examination system etc. carry on scan to the chip, and go together with to make a comparison and examine to the fluorescence signal of probe by calculator system, thus quick get the information want by.Gene expression chip gram Long go to of thousands probe with particular gene or its cDNA fragment fixedly on the chip, to the different individual(normal person and sufferer), organization, the cell period, growth divide under the conditions, such as stage, pathological changes and incitement(include the treatment means of the dissimilarity inducement, dissimilarity)...etc. of mRNA inside the cell carry on an examination, carry on comprehensive analysis and judgment thus and quickly get up a certain or a few genes and disease contact.The gene chip technique can transfer to the occurrence from the gene level etc. the biology behavior carry on a research, will develop new path with treatment for the diagnosis(especially diagnosed in early days) of the lung cancer.Make progress along with the research of lung cancer gene in these aspect, have already displayed good foreground.The technical main advantage of the gene chip is an information to have great capacity, current of a gene chip once can logarithms thousand is ten thousand highest Ba gene parts which differently have already know or didn't know its meaning to carry on analysis, pass to contrast two kinds of different samples of miscellaneous hand over signal, can acquire several ten even several 100 genes of difference expressions, can obtain several 100,000 traditional Northerns in an experiment miscellaneous hand over in the acquisition get of gene expression information;Secondly is an accuracy Gao, the chip technique is according to the alkali Ji to with each other repair principle and synthesize particularity strong.The picture connected with each other with calculator is analytical to systematically make research as a result more objective and accurate;Check speed quick, automate degree Gao.Weakness' ising an equipments is expensive currently, check expenses Gao, the technique treat further perfect, such as when the home position of chip synthesize, unavoidably have false pit Mao sour fragment to add and sneak into miscellaneous quality, influence result analysis, calculator processing software disunity etc..