Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Metabolic Epidemiology Branch, National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA.
Thorac Cancer. 2019 Aug;10(8):1717-1724. doi: 10.1111/1759-7714.13141. Epub 2019 Jul 10.
Lung cancer is the leading cause of cancer mortality among women in China, and incidence and mortality continue to rise despite the fact that smoking prevalence is very low among Chinese women.
This study investigated tobacco smoking and trends in histological subtypes of female lung cancer in a central cancer hospital in China.
Demographic, smoking history and histological information on female lung cancer patients diagnosed or treated from 2000 to 2012 was collected from the Cancer Hospital, Chinese Academy of Medical Science (CHCAMS). The classification of histological subtypes and clinical stages were conducted using the ICD-O-3 and Eighth AJCC Cancer Staging Manuals. Time-trends of histological subtypes were analyzed based on annual percentage change (APC).
Overall, 5870 female cases of lung cancer were included in the analysis. The number of female lung cancer patients increased from 509 (2000-2002) to 1744 (2011-2012). The most common histological type of lung cancer was adenocarcinoma (ADC) (72.93%), followed by small cell lung cancer (SCLC) (11.06%), squamous cell carcinoma (SCC) (8.38%) and other (7.63%). Among smokers, the proportion of SCC decreased from 40.5% to 23.7% (P = 0.005), while ADC increased from 35.7% to 50.7% (P = 0.009). In non-smokers, ADC increased from 63.1% to 80.6% (P = 0.006) and SCC decreased from 13.6% to 4.5% (P = 0.016). Among SCC cases, smokers made up a larger proportion of early stage (I/II: 47.1%) compared with late stages (III, 34.3%; IV, 18.6%).
The number of female lung cancer patients has increased in CHCAMS. In both smoking and non-smoking cases, the proportion of adenocarcinoma increased. Squamous cell carcinomas were more likely to be diagnosed in early stages among smokers.
在中国，肺癌是女性癌症死亡的主要原因，尽管中国女性的吸烟率非常低，但肺癌的发病率和死亡率仍在持续上升。
本研究旨在探讨中国某肿瘤医院女性肺癌患者的吸烟状况及组织学亚型变化趋势。
收集中国医学科学院肿瘤医院（CHCAMS） 2000 年至 2012 年间诊断和治疗的女性肺癌患者的人口统计学、吸烟史和组织学信息。采用 ICD-O-3 和第八版 AJCC 癌症分期手册对组织学亚型和临床分期进行分类。根据年度百分比变化（APC）分析组织学亚型的时间趋势。
共有 5870 例女性肺癌患者纳入分析。女性肺癌患者人数从 509 例（2000-2002 年）增加到 1744 例（2011-2012 年）。最常见的肺癌组织学类型是腺癌（ADC）（72.93%），其次是小细胞肺癌（SCLC）（11.06%）、鳞状细胞癌（SCC）（8.38%）和其他（7.63%）。在吸烟者中，SCC 的比例从 40.5%下降到 23.7%（P=0.005），而 ADC 的比例从 35.7%上升到 50.7%（P=0.009）。在非吸烟者中，ADC 的比例从 63.1%上升到 80.6%（P=0.006），SCC 的比例从 13.6%下降到 4.5%（P=0.016）。在 SCC 病例中，吸烟者中早期（I/II 期：47.1%）的比例高于晚期（III 期：34.3%；IV 期：18.6%）。
CHCAMS 女性肺癌患者数量有所增加。在吸烟和非吸烟患者中，腺癌的比例均有所增加。在吸烟者中，SCC 更有可能在早期被诊断。
