Srpski arhiv za celokupno lekarstvo 2010 Volume 138, Issue 9-10, Pages: 595-599
https://doi.org/10.2298/SARH1010595V
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Importance of early detection of lung cancers with initial paraneoplastic manifestations
Vukić Vera
Škodrić-Trifunović Vesna
Gvozdenović Branislav S.
Jovanović Dragana
Žunić Miodrag
Đurić Dušan
Introduction. Lung cancers are mostly detected in the developed clinical
stages, with clearly manifested pulmonary, extrapulmonary or metastatic
manifestations. In the early disease stages, radiographic and clinical
manifestations may be absent or mimicked. Objective. The aim of this study
was the timely detection of early pulmonary, extrapulmonary and
paraneoplastic manifestations of lung cancers in order to apply the most
appropriate treatment protocols. Methods. We examined 230 patients with lung
cancer, among them 125 of the working study group with minimal pulmonary
and/or initial paraneoplastic symptoms, and 105 patients in the control group
with clear tumour manifestations. Results. The symptom analysis revealed a
statistically significantly lesser presence of the respiratory symptoms in
the working study group (68%) in comparison with the control group of
patients (97%) (c2=29.996; p<0.001). The analysis of radiographic
presentations of lung cancer showed that there were significantly more
patients with normal findings in the working group (6.4%) than in the control
group - 1.9% (p>0.05), and a positive bronchoscopic finding of the centrally
localized tumour (mainly right upper lobe) was confirmed in patients of both
groups with normal radiographic findings. The number of diagnosed patients in
earlier clinical disease stages (I, II, IIIa) with better prognosis in
non-small cell lung cancer was significantly higher (c2=19.149; p<0.001) in
the working group (71.1%) in comparison with the control group (38.1%). Small
cell lung cancer was more frequently diagnosed in the stage of limited
disease in the working (80%) than in the control group (38.1%) (c2=10.039;
p<0.05). With regard to treatment administration, there is a statistically
significant difference (c2=4.013; p=0.0452) in the frequency between the use
of chemotherapy and highly significant difference (c2=22.044; p<0.001) in the
frequency of use of surgical treatment in the working group in comparison
with the control group - both chemotherapy and surgery treatment were more
frequent in the patients of the working group. Conclusion. Recognizing the
initial pulmonary, extrapulmonary or paraneoplastic manifestations as well as
performing diagnostic procedures in due time represent the most important
guidelines in early detection and the most efficacious therapeutic choice in
lung cancer.
Keywords: lung cancer, radiography, clinical stage, paraneoplastic syndromes
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