Lung Squamous Cell Carcinoma

　　1. More than 90% of lung squamous cell carcinomas occur in smokers who smoke cigarettes.

　　2. Arsenic is also closely related to the occurrence of squamous cell carcinoma.

　　3. In heavily polluted industrial cities, the amount of benzopyrene in the air inhaled by residents each day can exceed that of 20 cigarettes. For every 1μg/L increase in the content of 3,4-benzopyrene in the atmosphere, the mortality rate of lung cancer increases by 1% to 15%.

　　4. Studies have shown that eating less vegetables and fruits rich in beta-carotene can increase the risk of lung cancer.

　　5. The influence of tumor genetic genes in the family will also affect the occurrence of lung squamous cell carcinoma.

　　1. Respiratory Complications:such as sputum retention, atelectasis, pneumonia, and respiratory insufficiency. Especially in elderly and weak patients, those with pre-existing chronic bronchitis and emphysema have a higher incidence. Due to postoperative wound pain, patients cannot cough effectively, leading to airway obstruction, atelectasis, and respiratory insufficiency. Prevention lies in ensuring that patients fully understand and cooperate, actively preparing for surgery before it, and encouraging and supervising them to perform deep breathing and forceful coughing to effectively expel sputum. If necessary, nasal catheter aspiration or bronchoscope aspiration can be performed. For patients with concurrent pneumonia, active anti-inflammatory treatment should be given. When respiratory failure occurs, mechanical ventilation assistance is often required.

　　2. Postoperative Hemothorax, Empyema, and Bronchopleural Fistula:The incidence is very low. Postoperative hemothorax is a serious complication that requires emergency treatment, and it may be necessary to perform a chest tube thoracotomy to stop bleeding in a timely manner. During pulmonary surgery, bronchial or pulmonary secretions may contaminate the pleural cavity, leading to empyema. At this time, in addition to choosing effective antibiotic treatment, timely and thorough pleural puncture and aspiration of pus are extremely important. For those with poor results, chest tube thoracostomy can be considered. After pulmonary resection, the presence of residual bronchial cancer, hypoproteinemia, and improper surgical procedures can lead to poor healing of the bronchial stump after surgery or the formation of fistulas. In recent years, the incidence of such complications has decreased significantly.

　　3. Cardiovascular System Complications:Old age and weakness, traction and stimulation of the mediastinum and pulmonary hilum during surgery, hypokalemia, hypoxia, and massive hemorrhage often become the triggering factors. Common cardiovascular complications include postoperative hypotension, arrhythmia, pericardial tamponade, and heart failure. For elderly patients with pre-existing heart disease and low cardiac function, the indication for surgery should be strictly controlled. The surgeon should pay attention to gentle operation. After surgery, maintain a clear airway and provide sufficient oxygen, closely monitor blood pressure and pulse changes, and timely replenish blood volume. The rate of intravenous infusion after surgery should be slow and balanced to prevent rapid and excessive infusion that may trigger pulmonary edema. At the same time, perform electrocardiographic monitoring, and once abnormalities are found, handle them in a timely manner according to the condition. Elderly patients often have latent coronary heart disease, and various stimulations from surgical trauma can trigger an acute attack. However, under the strict monitoring and timely treatment of the clinical staff, it is possible to turn a dangerous situation into a safe one.

　　The appearance of the tumor is usually white or gray depending on the degree of fibrosis, with a harder texture, accompanied by local carbon-like pigmentation, and呈星状倒行至四周 in the center of the lesion. Tumors can be large and accompanied by cavitation. Central tumors can form intraluminal polypoid masses and/or infiltrate surrounding tissues through the bronchial wall, or they can block the bronchial lumen, leading to bronchial secretion retention, atelectasis, bronchiectasis, obstructive lipoid pneumonia, and infectious bronchopneumonia. A few cases may originate from peripheral small airways. However, research results have changed because a recent study reported that 53% of squamous cell carcinomas can occur in the peripheral lungs.

　　Tumor spread and staging

　　Central squamous cell carcinoma is characterized by two main modes of spread: intracellular spread (in situ) with or without subcutaneous invasion and polypoid growth within the bronchus. Extensive intracellular spread is common in the main bronchi. The bronchial glandular or ductal epithelium is often involved. Two growth patterns of early invasive squamous cell carcinoma have been described: one is the growth along one side of the bronchial mucosal membrane to replace the superficial epithelium, accompanied by submucosal microinvasion and adenoid duct invasion (spreading type); the other is manifested as small polypoid mucosal lesions, accompanied by deep infiltration. Direct invasion of mediastinal lymph nodes by the hilum can be seen in advanced cases.

　　Peripheric squamous cell carcinoma is characterized by the formation of solid nodules, often accompanied by nodular growth within the bronchus, intracellular spread, or both. In advanced cases, peripheric squamous cell carcinoma can directly penetrate the pleura to invade the chest wall or diaphragm.

　　Staging is usually based on the TNM method. Generally, squamous cell carcinoma tends to manifest as direct invasion of local adjacent tissues. Compared to adenocarcinoma or other primary lung cancer tissue types, squamous cell carcinoma is less likely to metastasize to distant organs. Diameter

　　According to staging, the survival rate of squamous cell carcinoma is significantly higher than that of adenocarcinoma. Approximately 80% of patients with stage I (T1N0M0) squamous cell carcinoma who undergo surgery are still alive 5 years after diagnosis, while about 70% of patients with the same stage of adenocarcinoma survive. There is the same difference in survival rates between stage II squamous cell carcinoma and adenocarcinoma patients. Important histological factors that can guide prognosis are difficult to determine, but tumors with extensive necrosis are considered to be associated with poor prognosis compared to those without necrosis.

　　1, Clinical criteria

　　Although clinical staging is usually determined by the extent of the lesion, cTNM staging is a major prognostic factor. There is a significant difference in survival between surgical patients and the rest of the patients (70%). Weight loss, poor behavior, and symptoms related to metastasis in non-surgical cases suggest a poor prognosis. In patients who have had the tumor resected, age is one of the reasons for the increase in postoperative mortality. Female gender is a favorable factor for overall survival rate in lung cancer, but its clinical significance is more obvious in adenocarcinoma patients than in squamous cell carcinoma patients. When social-economic factors affecting prognosis are excluded, race is not a prognostic-related factor. Many biological detection indicators have been published, such as lactate dehydrogenase (LDH) or serum tumor markers, but they and/or weight loss are not independent factors of cTNM staging in most cases.

　　2, Histopathological criteria

　　Currently, the disease stage and behavior at the time of diagnosis are still the strongest prognostic indicators for primary squamous cell carcinoma. However, histological typing can provide independent information for predicting prognosis. For example, well-differentiated squamous cell carcinoma tends to spread locally in the chest and directly invade adjacent mediastinal tissue; while poorly differentiated squamous cell carcinoma tends to metastasize early and remotely. The prognosis of peripheral squamous cell carcinoma with alveolar space filling is better.

　　3, Genetic predictive factors

　　The biological prognostic indicators of non-small cell lung cancer (NSCLC) have been confirmed, but they cannot be fully guaranteed, including the down-regulation of cyclin-dependent kinase inhibitors such as P16INK4A, P21WAF1, and P27K1P1; overexpression of cyclins such as cyclin E; members of growth factor signal transduction pathways such as HER2 and insulin-like growth factor binding protein 3, as well as inactivation of tumor suppressor genes such as RB, FHIT, and P53. The inactivation of P53 has no prognostic guidance significance in squamous cell carcinoma. Embryological mechanisms such as P16INK4A DNA methylation transcriptional silencing and P53 genetic mutations are different molecular mechanisms related to inactivation. P53 and FHIT mutations and P16INK4A embryonic stage transcriptional silencing are more common in squamous cell carcinoma and smokers than in adenocarcinoma and non-smokers. Because most studies only detect a relatively small number of NSCLC, this limits the statistical significance of comparing squamous cell carcinoma with other types of lung cancer. Another method is to perform a meta-analysis of multiple studies. For example, a meta-analysis of 43 research papers showed that P53 mutation and/or clonal expansion suggest a poorer prognosis in adenocarcinoma patients, but not in squamous cell carcinoma patients. RB deletion suggests poor survival prognosis in patients with squamous cell carcinoma or adenocarcinoma, while nuclear localization of the transcription factor YB-1 is only a prognostic factor for squamous cell carcinoma patients.

　　1, Bronchoscopy examination:It is an important measure for diagnosing lung cancer. Through bronchoscopy, the pathological changes of the bronchial mucosa and lumen can be directly observed.

　　2, X-ray examination:It is the most commonly used and important method for diagnosing lung cancer. X-ray examination can help understand the location and size of lung cancer.

　　3. Radioisotope examination:Radionuclides such as 67Ga-citrate have affinity for lung cancer and its metastatic lesions, can concentrate in the tumor after intravenous injection, and can be used for lung cancer localization, showing the range of the disease, with a positive rate of about 90%.

　　4. Thoracotomy exploration:Lung mass after examination by various methods and short-term exploratory treatment still could not determine the nature of the lesion, and the possibility of lung cancer could not be excluded. If the patient's overall condition permits, thoracotomy exploration should be performed.

　　5. Cytological examination:Most primary lung cancer patients can find shed cancer cells in their sputum and can determine the histological type of cancer cells. Therefore, sputum cytology is a simple and effective method for lung cancer screening and diagnosis.

　　1. Quit smoking, which is the most effective method to prevent lung cancer.

　　2. Reduce the intake of strong alcohol.

　　3. Do not eat moldy and deteriorated food and eat fewer preserved foods.

　　4. Chew food slowly while eating and do not eat overly hot food.

　　5. Do not consume too much fat, and control the intake to less than 30% of the total calorie intake, which is 50g to 80g of animal and plant fats per day; eat more fresh vegetables and fruits, and provide 10g of fiber and general levels of vitamins daily.

　　6. Eat fewer smoked foods.

　　7. Do not abuse drugs, especially do not abuse sex hormones and drugs with cytotoxicity to prevent the risk of drug-induced cancer.

　　10. Consume fruits, vegetables, and coarse grains daily.

　　The treatment methods for lung squamous cell carcinoma include surgical treatment, radiotherapy and chemotherapy, and drug treatment, etc. The therapeutic effect of lung squamous cell carcinoma is closely related to the choice of treatment method. Appropriate treatment methods should be adopted according to the different conditions of the patient, and different treatment methods should be adopted according to different symptoms.

　　1. Surgical treatment for lung squamous cell carcinoma

　　Due to the late metastasis of lung squamous cell carcinoma, the prognosis after resection is relatively good, so surgical treatment is the preferred treatment method. For all stage Ⅰ, Ⅱ, and selected stage ⅢA patients, surgical treatment should be performed. Efforts should be made to achieve radical resection of the tumor and clearance of regional lymph nodes. However, the following patients with lung squamous cell carcinoma cannot undergo surgical treatment:

　　4. Tumors have invaded the mediastinum and heart, large blood vessels, trachea, esophagus, vertebrae, and carina, or there are nodules within the same lobe, or there is malignant pleural effusion, cases of stage ⅢB and Ⅳ.

　　3. Patients with severe complications such as severe pulmonary infection, emphysema, decreased lung function, insufficient cardiac function, recent angina pectoris, myocardial infarction, and history of cerebrovascular accidents cannot tolerate surgery.

　　Second, radiotherapy and chemotherapy for lung squamous cell carcinoma

　　The first cycle of chemotherapy for lung squamous cell carcinoma is relatively sensitive, with a therapeutic effect of up to 25%, the second cycle reaches 15%, and the third cycle is 5%. After three cycles, the effect is basically zero, and lung squamous cell carcinoma is prone to recurrence and metastasis. However, the toxic and side effects of chemotherapy in the near and long term are extremely可怕. The short-term toxic and side effects include hair loss, decreased white blood cells, nausea, vomiting, decreased appetite, and decreased immune function; the long-term toxic and side effects include liver and kidney dysfunction, and inhibition of bone marrow hematopoietic function.

　　During radiotherapy and chemotherapy, it can be used in conjunction as a BRM (Biological Response Modifier) drug to effectively improve cell tolerance, enhance immunity, reduce the side effects of radiotherapy and chemotherapy, and improve efficacy.

　　The characteristics of the stereotactic radiosurgery (SRS) in radiotherapy are: the SRS uses a revolutionary stereotactic localization tracking method, even for brain surgery, it does not require the current craniotomy and metal head frame fixation. Therefore, during the 'surgery' process, patients do not need local anesthesia and there is no bleeding or pain. After the 'surgery' is completed, there is no need for recovery time after anesthesia. More importantly, without the obstruction of the metal head frame, the SRS has no blind spots during the surgery process.

　　Three. Traditional Chinese Medicine Treatment for Lung Squamous Cell Carcinoma

　　The treatment of lung squamous cell carcinoma with traditional Chinese medicine focuses on invigorating the body and eliminating pathogenic factors, treating both the symptoms and the root cause. It not only can cooperate with surgery and chemotherapy to achieve a synergistic effect, but also can have a good curative effect on lung squamous cell carcinoma patients with weak constitution in the middle and late stages, who cannot adapt to surgical treatment and radiotherapy and chemotherapy. Traditional Chinese medicine can also effectively extend the survival time of lung squamous cell carcinoma patients.

　　In addition to choosing the correct and appropriate treatment method for the treatment of lung squamous cell carcinoma, it is also necessary to detect and treat it in a timely manner, do a good job of dietary and psychological care, and encourage patients to be more positive in treatment. The specific treatment for lung squamous cell carcinoma still needs to be determined according to the specific situation of the patient, be individualized, and can truly control the spread of the virus.

　　Four. Reversal Lung Cancer Therapy Treatment

　　1. Therapy Principle

　　(1) A large number of scientific experiments have proven that each cell in the human body has a substance called CAMP (cyclic adenosine monophosphate) on its cell membrane, which is the main component controlling or adjusting cell metabolism (and does not disappear due to cancer). It also has a very significant ability, that is, to transform cancer cells into healthy cells.

　　(2) Lung cancer cells are transformed from normal cells through multiple mutations, but during the process of self-replication and reproduction of the transformed cancer cells, the nature of some substances has not changed, such as cyclic adenosine monophosphate (cAMP), which is a second messenger. Relevant research both domestically and internationally has confirmed that under certain conditions, these substances can have the ability to reverse cancer cells back into healthy cells.

　　(3) The substances with this ability have a significantly lower content in cancer cells than in normal cells, which is one of the reasons why cancer cells are unable to reverse into healthy cells. However, the 'reversal lung cancer therapy' can, after controlling the development of lung cancer, promote the body's environment to enter a stable state, and directly act on the surface of lung cancer cells with drug molecules, increase the level of second messenger content in cancer cells to become healthy cells, and play a direct role in 'recruiting' cancer cells, causing a large number of cancer cells to reverse into healthy cells.

　　2. Application Scope

　　Clinical Application: Suitable for various types of lung cancer; early, middle, and late stages of lung cancer; lung cancer metastasis.

　　3. Basic Function

　　(1) Special drugs in traditional Chinese medicine enter the interior of lung cancer cells in a molecular state, activate the reversal function of lung cancer cells, and reverse lung cancer cells into healthy cells.

　　(2) Control the development speed of lung cancer.

　　(3) Directly kill free floating cancer cells and control recurrence.

　　(4) Activate the body's immune function and kill free floating cancer cells.

　　(5) It can be carried out simultaneously with Western medicine chemotherapy, with a synergistic effect, reducing the side effects of Western medicine's radiotherapy and chemotherapy, allowing Western medicine treatment to proceed smoothly.

　　(6) Drug molecules enter the cancerous site directly from the inside and outside, fully penetrating into the interior of cancer cells.

　　Fifth, Gamma Knife Treatment

　　Gamma knife is actually a process where the radioactive element 'cobalt-60' naturally decays into 'gamma rays' and through the collimation system, they are concentrated at a focal point. This effect is similar to using a magnifying glass to concentrate sunlight, thus producing a high radiation dose area. By placing the tumor (what we call the 'target area') in this high-energy area, we can subject the tumor to a high-dose, lethal dose of radiation, causing the NDA double strand break of the tumor to achieve the effect of killing the tumor and stopping the replication of tumor DNA (cell reproduction), thus achieving the purpose of treating tumors.

　　Sixth, Comprehensive Treatment

　　For stage I lung squamous cell carcinoma, which is the early stage, it can be treated with surgery. The patient's survival time will exceed ten years, but early metastasis is not excluded in the early stage of lung squamous cell carcinoma. If there is early metastasis, refer to the comprehensive therapy mentioned later.

　　For middle-stage lung squamous cell carcinoma, surgery combined with biological immunotherapy for cancer elimination and radiotherapy combined with biological immunotherapy for cancer elimination can be adopted. After surgery and radiotherapy and chemotherapy, recurrence is easy, and the patient's own immunity is reduced. Moreover, surgery and radiotherapy and chemotherapy can also have a great impact on the patient's diet and spirit, and the tumor itself is a consumptive disease.

　　For advanced lung squamous cell carcinoma, most patients have already developed metastasis and spread. Surgery and radiotherapy and chemotherapy are no longer of great significance. For such patients, conservative Chinese medicine treatment can be adopted, using a treatment plan that coexists with the tumor. Perhaps coexistence with the tumor is unacceptable to most patients, but from the perspective of tumor treatment, most advanced cancer patients and elderly, weak patients who cannot undergo surgery choose conservative Chinese medicine treatment to coexist with the tumor, which is the best treatment plan.