- 防癌生活:27位一线肿瘤专家的37条忠告
- 付凤环张晓丹主编
- 721字
- 2024-11-28 18:30:56
不到10块钱的体检,做了能早期筛查
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我认为,一套完整的癌症筛查应该有四个部分。第一部分是病史采集,其中包括家族史、个人史、既往病史等。
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/045.jpg?sign=1738921427-DYtJYT0IcGb2v0UCLFLahOw0PD26AyAl-0-738872f20312739c932ded999d50621e)
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举个例子,乳腺癌就有明显的遗传性,如果某人家族有乳腺癌病史,外加其他不良因素,那她就一定要重点关注乳腺。
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/047.jpg?sign=1738921427-Tv1ZUGkqM3YEi8RakcMmD4l1SrIvTYPc-0-7b83841721ababff1360f164b5052233)
个人史中的生活习惯、工作环境,也会增加癌症发病概率。比如,长期大量吸烟的人,肺癌的发生风险就会较高,一定要用低剂量胸部螺旋CT筛查肺癌。
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/048.jpg?sign=1738921427-a9scWhPTZt6wHbnUMevH5GEbnKVBQigp-0-4764daac25ebcf691d09e17e65b37b56)
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患癌大多是日积月累的过程,既往病史也很重要。比如,一个人常年胃不舒服,幽门螺杆菌检测呈阳性,就一定要做胃镜,排除胃癌方面的问题。
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/050.jpg?sign=1738921427-8FqRq1MUQMk0wWvnORGHa2wWfgiKbGSj-0-a32ca35db335f6605c17bb0efa0b32a2)
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第二部分就是实验室检查,如血常规、尿常规、便常规、生化检查、肿瘤标志物检查。这些指标如有异常,也要引起注意。
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/052.jpg?sign=1738921427-22jOlzmhP9DlpdhWhKtr3viaS1SoJLyn-0-86d3142f7bf6ce7f6219d4574834ea8f)
举个简单的例子,我们现在大部分社区都开展老年人“便常规+潜血”的检验。而消化道癌的早期特点,就是便潜血阳性。
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/053.jpg?sign=1738921427-c60E6YzcbSw2CEuPCX6xw6k490ycWMvy-0-d8f5a9e30fbd508caf4199ebdf8820cc)
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第三部分就是影像学或者内镜检查,如螺旋CT、核磁、胃镜、肠镜等。这对一些平常不重视自己身体变化的人很重要。
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/055.jpg?sign=1738921427-eTaF4vrqJdxoIobfElDGWSMy2baUrR1S-0-df5a1894b93eae44fcaa211c4f47e743)
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至于PET-CT,更适合用于判断癌症转移与否,或者癌症患者的复查。换句话说,PET-CT用于正常人体检,那就是“高射炮打蚊子”,浪费不说,还不一定准确。
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/057.jpg?sign=1738921427-TDY5VUGU2WzvlBLOGkopammC2Qo5gtBy-0-f9f3664b9933e40193f38cfff6c1f4f1)
至于“一滴血测癌症”,这是未来的理想状态,因为到现在为止,根本没有一个血液标志物的检测结果能百分之百诊断肿瘤。
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/058.jpg?sign=1738921427-vT4daEzvIMsZNW2InjX7xxbsqAH619Wf-0-dd325a7168b730bb848ebcd3317e9257)
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就像上面提到的,不到10块钱的“便常规+潜血”检验,就是筛查结直肠癌最基本的有效手段,PET-CT都不一定比它更有意义。
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/060.jpg?sign=1738921427-uDzmdzTLm6dhPlAyJcm4AyaXvO7N4MOe-0-f480378df38edbddd464c64a1689b351)
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这是肯定的,因为癌症本身更容易发生在中老年人群。但是年轻人也不能掉以轻心,就像刚才说的小刘,忽视了正确的体检,这不就悲剧了?
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/062.jpg?sign=1738921427-NBahWdnCRcR861BwABkSp5Q70LbVSgFk-0-1d6816d03e0fdfc332010f1a18bc0e21)
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复查的间隔时间要根据上一次体检的结果判断。正常人一年查一次没问题,但要是合并慢性疾病或者异常情况的话,就要具体情况具体分析,听从医生的建议确定复查时间。
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