National Office of Cancer Prevention and Control, Cancer Institute/Hospital, Chinese Academy of Medical Sciences Beijing, China.
Department of Pathology, National Cancer Center, Cancer Institute/Hospital, Chinese Academy of Medical Sciences Beijing, China.
Thorac Cancer. 2014 Sep;5(5):447-54. doi: 10.1111/1759-7714.12121. Epub 2014 Aug 25.
The aim of the study was to characterize the histological and epidemiological features of lung cancer in Chinese women.
Demographic and histological information on female lung cancer cases identified during 1 January 2000 through 31 December 2012 from the Cancer Hospital of the Chinese Academy of Medical Sciences were collected. The International Classification of Diseases for Oncology system was used to classify the histological subtypes. Relative frequencies (RF) were estimated for major histological subtypes and compared by the years of diagnosis and birth, and among residential areas. Statistical differences were tested for RFs in the time periods with a trend test and with Pearson Chi square tests for distribution.
Of 7070 female Chinese lung cancer cases, the major histological subtypes were adenocarcinoma (ADC) 65.79%; squamous cell carcinoma (SCC) 10.21%; small cell cancer 8.12%; large cell carcinoma, 2.79%; and adeno-squamous carcinoma (ASC), 2.19%. ADC increased, with RFs from 46.72% in the cases identified in 2000-2002 to 76.49% in 2011-2012 (Z = 16.998, P < 0.0001); SCC decreased from 15.69% to 5.97% (Z = -8.750, P < 0.0001). Compared to the cases identified in 2000-2006, the age-adjusted RFs of ADC in 2007-2012 consistently increased in all study areas.
The significant increase of ADC of the lung in Chinese women suggests that a persistently strong exposure to potential carcinogens in the Chinese population should be further and fully investigated.
本研究旨在描述中国女性肺癌的组织学和流行病学特征。
收集中国医学科学院肿瘤医院 2000 年 1 月 1 日至 2012 年 12 月 31 日期间确诊的女性肺癌病例的人口统计学和组织学信息。采用国际肿瘤疾病分类系统对组织学分型进行分类。采用相对频率(RF)估计主要组织学亚型,并按诊断和出生年份以及居住地区进行比较。采用趋势检验和 Pearson Chi 平方检验对各时间段 RF 的差异进行统计学检验。
在 7070 例中国女性肺癌病例中,主要组织学亚型为腺癌(ADC)65.79%;鳞状细胞癌(SCC)10.21%;小细胞癌 8.12%;大细胞癌 2.79%;腺鳞癌(ASC)2.19%。ADC 呈上升趋势,2000-2002 年确诊病例的 RF 为 46.72%,2011-2012 年增至 76.49%(Z=16.998,P<0.0001);SCC 则从 15.69%降至 5.97%(Z=-8.750,P<0.0001)。与 2000-2006 年确诊的病例相比,2007-2012 年所有研究地区的 ADC 年龄调整 RF 均持续升高。
中国女性肺癌中 ADC 的显著增加表明,中国人群中持续存在强烈的潜在致癌物质暴露,应进一步进行全面调查。