Auerbach O, Garfinkel L
Veterans Administration Hospital, East Orange, NJ 07019.
Cancer. 1991 Nov 1;68(9):1973-7. doi: 10.1002/1097-0142(19911101)68:9<1973::aid-cncr2820680921>3.0.co;2-z.
In a study of 505 cases of lung carcinoma from a period in which there was a significant change in tobacco-smoking habits, a dramatic shift in the histologic type and location of the lung tumors was observed. Peripheral tumors, found in 30.7% of the carcinomas occurring before 1978, were found in 42% of the carcinomas from 1986 to 1989. The corresponding decrease in the centrally originating bronchial carcinoma was from 69.3% to 57.3%. The greatest change in histologic cancer type was that the incidence of bronchioloalveolar carcinoma more than doubled from 9.3% in the earlier period to 20.3% percent in the 1986-to-1989 period. Corresponding to the decreasing incidence of lung carcinoma, there is a decrease in cancers related to cigarette smoking. A study of cases of lung carcinoma among nonsmokers and former smokers showed a decreased incidence of the bronchogenic cancers and an increase of cancer occurring in the peripheral lung parenchyma. This finding should be validated in other population-based studies, and if confirmed, new studies should be undertaken in an attempt to discover the factors that play a role in the development of such cancers. As an example, viral oncogenes may be a possibility. Viruses were suggested in the past as being related to the development of some of these tumor types.
在一项对505例肺癌病例的研究中，该时期吸烟习惯发生了显著变化，观察到肺肿瘤的组织学类型和位置出现了戏剧性的转变。1978年以前发生的癌中，30.7%为周围型肿瘤，而在1986年至1989年的癌中，这一比例为42%。中心型支气管癌的相应比例则从69.3%降至57.3%。组织学癌症类型的最大变化是细支气管肺泡癌的发病率从早期的9.3%增加了一倍多，在1986年至1989年期间达到20.3%。与肺癌发病率下降相对应的是，与吸烟相关的癌症也在减少。一项对非吸烟者和既往吸烟者肺癌病例的研究表明，支气管源性癌症的发病率下降，而周围肺实质发生的癌症有所增加。这一发现应在其他基于人群的研究中得到验证，如果得到证实，应开展新的研究以试图发现在此类癌症发生过程中起作用的因素。例如，病毒癌基因可能是一个原因。过去曾有人提出病毒与其中一些肿瘤类型的发生有关。
