Chapman A D, Kerr K M
Department of Pathology, Aberdeen Royal Infirmary and Aberdeen University Medical School, Foresterhill, Aberdeen, AB25 2ZD, UK.
Br J Cancer. 2000 Sep;83(5):632-6. doi: 10.1054/bjoc.2000.1317.
Atypical adenomatous hyperplasia (AAH) has been suggested as the adenoma in an adenoma-carcinoma sequence in the lung periphery. From 1989-1998, we undertook a systematic, prospective search for AAH in lungs resected for cancer. AAH was found in 67 of 554 patients (12. 1%) with primary lung carcinoma (9.2% in male patients and 19.0% in females). AAH was found in lungs bearing adenocarcinoma (23.2%) more frequently than with large cell undifferentiated carcinoma (12.5%) or squamous carcinoma (3.3%). A greater percentage of females with adenocarcinoma had AAH (30.2%) than did males with adenocarcinoma (18.8%). Numbers of AAH ranged from 1-42 per patient and more patients had small numbers of AAH, although 12 patients had 6 or more AAH foci. Larger numbers of AAH tended to be found in adenocarcinoma-bearing lungs. Ten of the 67 patients with AAH and primary lung carcinoma (15%) had multiple primary cancers (range 2-6), all of which were adenocarcinoma. Synchronous cancers were rare in lung tumour-bearing resections without AAH. Patients with AAH show no difference in post-operative survival to those without, for all stages of carcinoma and for Stage I disease alone. This study provides evidence for a strong association between atypical adenomatous hyperplasia and primary lung adenocarcinoma and lends weight to the AAH/adenoma-carcinoma hypothesis.
非典型腺瘤样增生（AAH）被认为是肺外周腺癌-癌序列中的腺瘤。1989年至1998年，我们对因癌症切除的肺部进行了系统的前瞻性AAH搜索。在554例原发性肺癌患者中，67例（12.1%）发现了AAH（男性患者为9.2%，女性患者为19.0%）。在腺癌肺中发现AAH的频率（23.2%）高于大细胞未分化癌（12.5%）或鳞癌（3.3%）。腺癌女性患者中AAH的比例（30.2%）高于腺癌男性患者（18.8%）。每位患者的AAH数量为1至42个，更多患者的AAH数量较少，尽管有12例患者有6个或更多的AAH病灶。在腺癌肺中往往发现更多数量的AAH。67例有AAH的原发性肺癌患者中有10例（15%）患有多发性原发性癌症（范围为2至6个），均为腺癌。在无AAH的肺肿瘤切除术中，同步癌很少见。对于所有癌症阶段以及仅I期疾病，有AAH的患者与无AAH的患者术后生存率无差异。本研究为非典型腺瘤样增生与原发性肺腺癌之间的强关联提供了证据，并支持了AAH/腺癌-癌假说。
