![防癌生活:27位一线肿瘤专家的37条忠告](https://wfqqreader-1252317822.image.myqcloud.com/cover/924/52288924/b_52288924.jpg)
上QQ阅读APP看书,第一时间看更新
不到10块钱的体检,做了能早期筛查
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/043.jpg?sign=1739367396-jGVCZ7Rw3DV6mFRe4bwehbhOdGfkGloo-0-0feb36435cb6c6a6262f61b7dee1553d)
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/044.jpg?sign=1739367396-UDiLNWdyhi0VAClNOXYnBzreQTvgq68y-0-cbf0b9a4e9e6771ac4c775af4a3af903)
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=1739367396-Z5GppVJHYBAN5aRcswSRZxBLHuaTQuSY-0-dc95ae318c7ad28de209f175de2f753e)
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/046.jpg?sign=1739367396-GQLHx5Piiv9BiwYYqMEbat0Z4PBPIXGP-0-ca2c7a8255414f8a114174deaa71ca05)
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=1739367396-ZFmkqLjf8wSbv9aWgk8cNrEZhdoXERc3-0-d90cf49532a447714ad67080fb85c8d3)
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=1739367396-mFAxNsYwoym9LshlGlY5KS19vdn91VRI-0-69c3d6452fd9f0c3fa024ce20da9fdd3)
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/049.jpg?sign=1739367396-WYK8ckdhFRLT7FDJNfIZ1SCXR1WrpxOL-0-1394bf9daae57ddb21d28250906c29b6)
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=1739367396-CywFGkcWU1b8WufAkNY9AC685oIMAoIF-0-fc4138014acb73ffa2580166961790e9)
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/051.jpg?sign=1739367396-fJKlWfuaMI2kGjX3FBMNO09lrzILPvi7-0-5950ab6b8cd07d0968f538e334b9b181)
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=1739367396-SboQoskQFOZIk0R1wxVtS2qmp8UMiXTE-0-05e3834fa15f8e0bb79fa2a58afd04aa)
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=1739367396-t9rLBG3dhW4lp6RsawWLBheNn2iY1VvK-0-084561e35838a81c89ccf6a9e277f8fd)
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/054.jpg?sign=1739367396-qJJ3NGFmdtRXvi1xQQj9zjXyQ1mNPyrz-0-eb4301f4b1ee9e4f653d079f2e2b8ce4)
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=1739367396-gz1rywVJZYMvdZxQCJybS3AojJlJuqGx-0-e0f1f3f4bd22ed37ff9190fe10a0d44d)
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/056.jpg?sign=1739367396-OdFnu2mWxOGdhR1VfirLMjGFTmYGJdkQ-0-46b9a90b194ee0afa3c59ca19fe1495c)
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=1739367396-WzUEu59Tl9V3NHYxfgoC5EFGj1t348eI-0-4206ae33dffb7da779a2ee2252f8dd79)
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=1739367396-pjWRlD6M7d527msh3aoZnIAzHsfzto9E-0-cf73f28d56a8714f70e754f0ae6b667a)
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/059.jpg?sign=1739367396-vi1TCs75lZvtRD6taGkXQsfbWmVXBm8G-0-325a69cc57207a6d1997332e2f785310)
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=1739367396-ZC5BIx8EWCJvGHCLIL6cAyFfm3XVpEGc-0-c2256648da04eafb3ff5c5fdf42c546e)
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/061.jpg?sign=1739367396-B7fDywQsiDVdV6yLzBlzBGa0lv0JCqDm-0-6e6daac01ede66a0616819195a5241a7)
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=1739367396-RYlC9EgMbQ1cERz5ewQGFeR61ohfr9q3-0-e7fe441a0732493c25d7984f32637260)
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/063.jpg?sign=1739367396-yemVE91EtZ5tT7JrXU8KaCY1AYIv6ivt-0-6832b6e661b6f3b7419604127b936b75)
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。
![](https://epubservercos.yuewen.com/3445AE/30973956407048006/epubprivate/OEBPS/Images/064.jpg?sign=1739367396-QL9mlCjbDiKj8xqmNgMf5p8BYqaOCQ8c-0-89d7eb26717f24a550cc5c62a73eada0)