Kaur H, Sehgal I S, Bal A, Gupta N, Behera D, Das A, Singh N
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Cancer. 2017 Jan-Mar;54(1):285-290. doi: 10.4103/ijc.IJC_597_16.
Adenocarcinoma is the most prevalent histological type of lung cancer (LC) in developed countries while squamous cell carcinoma (SqCC) has so far been the most common type at our center. Herein, we report our continued assessment of the epidemiological trend of LC aimed at determining any change in the histological distribution.
Retrospective analysis involving all consecutive newly diagnosed LC patients over a 4-year period (March 2011-February 2015). Demographic characteristics, histology, and staging data for current data set were compared with our previously published data (2008-2011). As before, smoking index (SI) was used to group patients as never (SI = 0), light (SI = 1-100), moderate (SI = 101-300), and heavy (SI ≥301) smokers.
Majority of 1301 patients had advanced disease (Stages IIIB = 30.1%; IV = 53.3%), were males (82.3%) and current/ex-smokers (76.9%). Adenocarcinoma and SqCC (36.4% each) were equally prevalent. As compared to our previous study, adenocarcinoma increased (36.4% vs. 27.5%) and nonsmall cell lung cancer-not otherwise specified (NSCLC-NOS) decreased (5.1% vs. 10.9%) significantly (P < 0.001). The current study had more heavy smokers (68.3% vs. 61.1%; P = 0.013) and median SI was also higher (500 vs. 400; P = 0.001). Among SI-based groups, significant differences were observed for age, gender, body mass index, histology, TNM stage, and metastatic disease distribution.
Reduction in NSCLC-NOS has led to adenocarcinoma and SqCC being equally prevalent at our center in North India despite an increase in heavy smokers. Accurate histological NSCLC subtyping is necessary for optimal epidemiological assessment.
在发达国家，腺癌是肺癌（LC）最常见的组织学类型，而在我们中心，鳞状细胞癌（SqCC）是迄今为止最常见的类型。在此，我们报告对肺癌流行病学趋势的持续评估，旨在确定组织学分布的任何变化。
回顾性分析涉及4年期间（2011年3月至2015年2月）所有连续新诊断的肺癌患者。将当前数据集的人口统计学特征、组织学和分期数据与我们之前发表的数据（2008 - 2011年）进行比较。和以前一样，吸烟指数（SI）用于将患者分为从不吸烟（SI = 0）、轻度吸烟（SI = 1 - 100）、中度吸烟（SI = 101 - 300）和重度吸烟（SI≥301）者。
1301例患者中大多数患有晚期疾病（IIIB期 = 30.1%；IV期 = 53.3%），为男性（82.3%）且为现吸烟者/既往吸烟者（76.9%）。腺癌和SqCC（各占36.4%）同样常见。与我们之前的研究相比，腺癌增加（36.4%对27.5%），非小细胞肺癌-未另行特指（NSCLC-NOS）显著减少（5.1%对10.9%）（P < 0.001）。当前研究中有更多重度吸烟者（68.3%对61.1%；P = 0.013），且吸烟指数中位数也更高（500对400；P = 0.001）。在基于吸烟指数的分组中，观察到年龄、性别、体重指数、组织学、TNM分期和转移疾病分布存在显著差异。
尽管重度吸烟者增加，但NSCLC-NOS的减少导致在印度北部我们中心腺癌和SqCC同样常见。准确的非小细胞肺癌组织学亚型分类对于最佳的流行病学评估是必要的。
