Lung Carcinoma

Rak pluća zloćudni je epitelni tumor koji raste polagano i podmuklo, često bez simptoma, brzo se širi u druge organe, a rezultati liječenja su skromni. Incidencija raka pluća u svijetu i u nas neprestano raste. Incidencija raka pluća u Hrvatskoj u 1998. godini iznosila je 55,6/100.000, a mortalitet je iznosio 53,7/100.000 stanovnika. Pušenje cigareta navodi se kao glavni rizični čimbenik u nastanku raka pluća. SZO klasificirala je rak pluća prema histološkoj slici u četiri skupine: rak pločastih stanica, rak malih stanica, adenokarcinom, rak velikih stanica. Kliničke manifestacije raka pluća ovise o lokalizaciji i veličini primarnog tumora, njegovoj propagaciji na okolne strukture u toraksu, pojavi regionalnih i udaljenih metastaza, vrsti tumora, imunosnom stanju organizma, dosadašnjim i sadašnjim bolestima, profesionalnoj izloženosti etiološkim čimbenicima, životnim navikama (pušenju), spolu, dobi i komplikacijama samog tumora. U dijagnostici raka pluća rabe se različite metode: radiološke, endoskopske, citološke/histološke, scintigrafske itd. Nemikrocelularni karcinom pluća klasificira se po TNM klasifikaciji u četiri klinička stadija, a mikrocelularni rak u dva stadija: ograničena bolest i proširena bolest. U liječenju se rabe ove metode: kirurška, radioterapija, kemoterapija, međusobna kombinacija svih spomenutih i simptomatsko liječenje. Odabir pojedinog načina liječenja ovisi o kliničkom stadiju.Lung carcinoma is a malignant epithelial tumour with slow and perfidious growth, often without symptoms, quickly spreading in other organs, while the results of treatment are modest. Incidence of lung carcinoma in the world and in our country is constantly rising. In Croatia, in the year 1998, the incidence was 55.6/100,000, and mortality 53.7 on 100,000 inhabitants. Smoking is stated as the main risk factor in the occurrence of lung carcinoma. The WHO classified it according to histological features in 4 groups: the carcinoma of platelet cells, the carcinoma of small cells, adenocarcinoma, the carcinoma of large cells. Clinical manifestations of the lung carcinoma depend on: the site and size of the primary tumour, its propagation to neighboring structures in the thorax, emergence of regional and distal metastases, the type of the tumour, immunological status of the organism, prior and current diseases, life style (smoking), gender, age and complications of the tumour itself. In the diagnostics of the lung cancer various methods are applied: radiological, endoscopic, cytological/ histological, scintrigraphic, etc. Nonmicrocelluar lung carcinoma is classified according to the TNM classification into four clinical stages, and microcellular type into two stages: limited disease and spread disease. In treatment are used the following methods: surgery, radiotherapy, chemotherapy, combination of all the mentioned and symptomatic treatment. The choice of a particular way of treatment depends on clinical stage