title: [Importance of early detection of lung cancers with initial paraneoplastic manifestations].
abstract: BACKGROUND
  Lung cancers are mostly detected in the developed clinical stages, with clearly manifested pulmonary, extrapulmonary or metastatic manifestations. In the early disease stages, radiographic and clinical manifestations may be absent or mimicked.
  
  
  OBJECTIVE
  The aim of this study was the timely detection of early pulmonary, extrapulmonary and paraneoplastic manifestations of lung cancers in order to apply the most appropriate treatment protocols.
  
  
  METHODS
  We examined 230 patients with lung cancer, among them 125 of the working study group with minimal pulmonary and/or initial paraneoplastic symptoms, and 105 patients in the control group with clear tumour manifestations.
  
  
  RESULTS
  The symptom analysis revealed a statistically significantly lesser presence of the respiratory symptoms in the working study group (68%) in comparison with the control group of patients (97%) (chi2 = 29.996; p < 0.001). The analysis of radiographic presentations of lung cancer showed that there were significantly more patients with normal findings in the working group (6.4%) than in the control group--1.9% (p > 0.05), and a positive bronchoscopic finding of the centrally localized tumour (mainly right upper lobe) was confirmed in patients of both groups with normal radiographic findings. The number of diagnosed patients in earlier clinical disease stages (I, II, IIIa) with better prognosis in non-small cell lung cancer was significantly higher (chi2 = 19.149; p < 0.001) in the working group (71.1%) in comparison with the control group (38.1%). Small cell lung cancer was more frequently diagnosed in the stage of limited disease in the working (80%) than in the control group (38.1%) (chi2 = 10.039; p < 0.05). With regard to treatment administration, there is a statistically significant difference (chi2 = 4.013; p = 0.0452) in the frequency between the use of chemotherapy and highly significant difference (chi2 = 22.044; p < 0.001) in the frequency of use of surgical treatment in the working group in comparison with the control group--both chemotherapy and surgery treatment were more frequent in the patients of the working group.
  
  
  CONCLUSIONS
  Recognizing the initial pulmonary, extrapulmonary or paraneoplastic manifestations as well as performing diagnostic procedures in due time represent the most important guidelines in early detection and the most efficacious therapeutic choice in lung cancer.
authors.affiliation: Pulmonary Department, Clinic for Internal Medicine, Clinical Hospital Centre "Bezanijska kosa", Belgrade, Serbia.
authors.forename: Vera
authors.initials: V
authors.lastname: Vukić
authors.forename: Vesna
authors.initials: V
authors.lastname: Skodrić-Trifunović
authors.forename: Branislav S
authors.initials: BS
authors.lastname: Gvozdenović
authors.forename: Dragana
authors.initials: D
authors.lastname: Jovanović
authors.forename: Miodrag
authors.initials: M
authors.lastname: Zunić
authors.forename: Dusan
authors.initials: D
authors.lastname: Djurić
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008297:Male; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy