Limsila T, Mitacek E J, Caplan L S, Brunnemann K D
Department of Surgery, Siriraj Hospital, Mahidol University School of Medicine, Bangkok, Thailand.
Prev Med. 1994 Mar;23(2):249-52. doi: 10.1006/pmed.1994.1034.
Lung cancer is now a major public health problem in Thailand. This descriptive study looked at the issue of whether tumor histology varied with smoking status among lung cancer patients in Bangkok, Thailand.
A retrospective descriptive study was made of the 1,600 Thai patients with histologically proven lung cancer admitted to University of Siriraj Hospital between 1967 and 1991. Cigarette smoking histories were obtained, and histologies were classified and related to tobacco consumption.
Overall, 78% were smokers, 72% being heavy smokers. The male to female ratio was 13:1 for smokers and 0.4:1 for nonsmokers. There were 29% squamous cell, 29% adenocarcinoma, 24% large cell, and 13% small cell carcinomas. Squamous cell carcinoma was significantly more frequent among cases with a history of smoking Thai cigarettes, which are known (from other studies) to be high in tar and nicotine, than among nonsmoking cases. Among the 350 nonsmokers, 252 of whom were female, adenocarcinoma was the most common (58%).
The results suggest that Thai smokers can reduce their risk for lung cancer by quitting smoking, or by substituting lower tar brands. Antismoking programs should therefore be a public health priority. Given the prevalence of adenocarcinoma among nonsmokers, further work should be done to identify environmental causes.
肺癌如今是泰国的一个主要公共卫生问题。这项描述性研究探讨了泰国曼谷肺癌患者的肿瘤组织学是否随吸烟状况而变化的问题。
对1967年至1991年间入住诗里拉吉医院且经组织学证实患有肺癌的1600名泰国患者进行了一项回顾性描述性研究。获取了他们的吸烟史，并对组织学进行分类并与烟草消费情况相关联。
总体而言，78%为吸烟者，其中72%为重度吸烟者。吸烟者的男女比例为13:1，不吸烟者为0.4:1。鳞状细胞癌占29%，腺癌占29%，大细胞癌占24%，小细胞癌占13%。有吸食泰国香烟史（从其他研究可知这种香烟焦油和尼古丁含量高）的病例中鳞状细胞癌的发生率显著高于不吸烟病例。在350名不吸烟者中，其中252名是女性，腺癌最为常见（58%）。
结果表明，泰国吸烟者可通过戒烟或改用焦油含量较低的品牌来降低患肺癌的风险。因此，反吸烟项目应成为公共卫生的优先事项。鉴于腺癌在不吸烟者中较为普遍，应进一步开展工作以确定环境病因。
