Lung Adenocarcinoma

Lung adenocarcinoma is a type of lung cancer that accounts for 40% to 55% of all lung cancers and is the most common type of lung cancer. It mainly originates from the bronchial mucosal epithelium and mucous glands, and most patients' lesions occur in the periphery, with slow progression. The incidence age of lung adenocarcinoma is higher than that of lung squamous cell carcinoma and small cell lung cancer. The incidence rate of young women is relatively high, but the incidence of men is still higher than that of women in China. The mortality rate of this disease increases with the progression of the disease. Early stage lung adenocarcinoma may be asymptomatic, but as the condition progresses, the symptoms gradually become more diverse but lack specificity. Common symptoms include cough, bloody sputum, chest pain, local wheezing, fever, and shortness of breath. Late stage patients may experience symptoms such as weight loss, fatigue, decreased appetite, hoarseness, and esophageal compression. In addition, lung adenocarcinoma may also develop brain metastasis, bone metastasis, and other related symptoms. This disease is not contagious and will not be transmitted to others through any means.

Figure 1. Lung adenocarcinoma.

Overview

The treatment principle for lung adenocarcinoma is individualized treatment based on comprehensive multidisciplinary opinions. Surgery is the preferred treatment method and is suitable for patients with localized lung adenocarcinoma. For patients who have already undergone metastasis or are unable to undergo surgery, radiotherapy, chemotherapy, molecular targeted therapy, immunotherapy, and other methods can be used. The prognosis is related to tumor staging, pathological tissue type, selection of treatment plan, and patient physical condition score. In terms of prevention, efforts should be made to avoid exposure to carcinogenic factors such as smoking, air pollution, etc. At the same time, good lifestyle and dietary habits should be developed, and regular physical examinations should be conducted. In recent years, with the deepening of medical research, the treatment methods for lung adenocarcinoma have been continuously enriched, especially with the progress of molecular targeted therapy and immunotherapy, providing patients with new treatment options. However, the pathogenesis and prevention strategies of lung adenocarcinoma still need further exploration and research.

Classification of Lung Adenocarcinoma

Surgical Treatment

Surgery is the preferred treatment for lung adenocarcinoma, but often only 25% of patients are still suitable for surgical treatment when diagnosed.

1. Treatment of stage I lung cancer

The preferred treatment for stage I non-small cell lung cancer (NSCLC) is lobectomy combined with hilar mediastinal lymph node dissection. Partial lobectomy, including segmentectomy and wedge resection, may be considered for some patients, especially those with ground glass nodules on imaging.

2. Treatment of stage II lung cancer

For N1 stage II lung cancer patients, the preferred treatment is lobectomy combined with mediastinal lymph node dissection, and lobectomy, bilateral lobectomy, or total lobectomy can also be performed. Only for those with poor lung function who cannot tolerate lobectomy, smaller resection surgery is considered.

3. Stage III N2 locally advanced NSCLC

The current recommended treatment mode is neoadjuvant chemotherapy plus surgical treatment, and the standard surgical procedure is lobectomy plus systematic mediastinal lymph node dissection. When N2 is generally affected, the surgical prognosis is poor, but efforts should be made to completely remove mediastinal metastatic lymph nodes. In recent years, immunotherapy has been applied as a neoadjuvant therapy before surgical treatment, and some patients have achieved good therapeutic effects.

Antibodies