martes, 29 de julio de 2008

Cáncer de Pulmón

Es la neoplasia más frecuente a nivel mundial, 12% del total de cánceres nuevos, 17% de las muertes por cáncer.. Causa más muertes en países desarrollados que en vías de desarrollo (22% vs. 14%). La mayoría son Carcinomas (otras histologías 1%).

FfACTORES DE RIESGO:
Consumo de Tabaco
Nº de CigarrillosTiempo de la ExposiciónEdad de Inicio de la Exposición
Exposición Ambiental y Ocupacional
Medio AmbienteCarcinógenos Conocidos(Arsénico, Asbesto, Bysether, Cromo, Níquel)Carcinógenos Probables(Berilio, Cadmio,Formaldehído, Acetaldehído, Sílice, otros)
Infecciones Virales

Enfermedades Pulmonares
EPOCFibrosis Pulmonares
Factores Dietarios
Ácidos Grasos SaturadosBaja Ingesta de Antioxidantes
Factores Genéticos
HeredadosMutaciones


Características clínicas
•Alteraciones de la respiración
•Tos
•Pecho oprimido
•Pérdida de la voz
•Hemoptisis
•Neumonia
•Metástasis (CCP)
•Sd de la vena cava
•Pérdida de peso
•Sd paraneoplásico (ACTH, DM, Cushing)


Procedimientos diagnósticos
•Radiografía de tórax
•TAC de tórax
•Fibrobroncoscopía (carcinoma escamoso)
•Biopsia de metástasis
–Hueso, hígado, ganglio, piel, SSRR
•Marcadores séricos
•Función pulmonar


Etapificación
•Sistema TNM para carcinomas
•Importante para determinar pronóstico y planificar el tratamiento
•En el caso de CCP el sistema TNM no es de mucha utilidad se utiliza el consenso de la “International Association for the Study of Lung Cancer”


Procedimientos de Etapificación
•Permiten determinar pacientes candidatos para cirugía
•Si la resección quirúrgica es posible y no hay metástasis se deben estudiar los ganglios regionales

TIPOS HISTOLÓGICOS MÁS FRECUENTES


•Carcinoma escamoso
•Carcinoma de células pequeñas
•Adenocarcinoma
•Carcinoma de células grandes
•Carcinoma adenoescamoso

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