Scherrer M, Zeller Ch, Christen H, Bachofen H, Senn A, Zimmermann H
Schweiz Med Wochenschr. 1976 Aug 28;106(35):1167-73.
223 lung cancer patients were observed from June 1974 to April 1976. The diagnosis was by histology (after biopsy, operation or autopsy). There were 125 (56%) squamous cell carcinomas (sqcc), 42 (19%) small cell carcinomas (smcc), 27 (12%) large cell carcinomas (lacc) and 29 (13%) adenocarcinomas (adec). There were only 6 women (2.7%) in the series (3adec, 2 smcc and 1 lacc). Heavy and very heavy smokers were common in each group; smoking habits--even of patients with adec - differed markedly (p less than 0.0005) from those of an age and sex matched control group of 90 asthmatic patients with atopy. Sqcc patients were evenly distributed over the rural and urban zones of our region. But smcc, lacc and adec were more often seen coming from urban zones (p less than 0.0025). The whole lung cancer group was divided into a small group of 6 non-smokers (2.7%), into a 6.7% group of 15 pipe smokers, into a large group of 69 cigar smokers (30.9%) and into a final group of 133 (59.6%) cigarette smokers. The cigar smokers usually had sqcc (p less than 0.0005). The cancer of cigar smokers is more often a central lesion than a peripheral one (p less than 0.025). A history of repeated airway infections on the one hand, and severe airway infection at the beginning of lung cancer history on the other, are a more frequent association in cigar smokers than in cigarette smokers (p less than 0.01). Therefore, the lung cancer of cigar smokers is especially difficult to recognize. Cigar smoking appears to be just as important a link in the chain of causative factors leading to lung cancer as cigarette smoking.
1974年6月至1976年4月期间，对223例肺癌患者进行了观察。诊断依据组织学检查（活检、手术或尸检后）。其中有125例（56%）为鳞状细胞癌（sqcc），42例（19%）为小细胞癌（smcc），27例（12%）为大细胞癌（lacc），29例（13%）为腺癌（adec）。该系列中仅有6名女性（2.7%）（3例腺癌、2例小细胞癌和1例大细胞癌）。每组中重度和极重度吸烟者都很常见；吸烟习惯——即使是腺癌患者的吸烟习惯——与90名患有特应性的哮喘患者组成的年龄和性别匹配对照组相比也有显著差异（p<0.0005）。鳞状细胞癌患者在本地区农村和城市区域分布均匀。但小细胞癌、大细胞癌和腺癌患者更多来自城市区域（p<0.0025）。整个肺癌组分为一小组6名不吸烟者（2.7%）、一组15名烟斗吸烟者（6.7%）、一大组69名雪茄吸烟者（30.9%）和最后一组133名（59.6%）香烟吸烟者。雪茄吸烟者通常患有鳞状细胞癌（p<0.0005）。雪茄吸烟者的癌症更常为中央型病变而非周围型病变（p<0.025）。一方面，有反复气道感染史，另一方面，在肺癌病史开始时有严重气道感染，在雪茄吸烟者中比在香烟吸烟者中更常见（p<0.01）。因此，雪茄吸烟者的肺癌尤其难以识别。雪茄吸烟似乎与吸烟一样，是导致肺癌的致病因素链中的重要环节。
