Perng D W, Perng R P, Kuo B I, Chiang S C
Chest Department, Veterans General Hospital-Taipei, Taiwan, ROC.
Jpn J Clin Oncol. 1996 Aug;26(4):229-33. doi: 10.1093/oxfordjournals.jjco.a023219.
The rise in the incidence of lung cancer has been associated with shifts in histologic distribution. A study was conducted to investigate changes in the cell type distribution in lung cancer in relation to age, sex, and smoking history, based on a retrospective analysis of 10,910 proven cases of lung cancer at the Veterans General Hospital-Taipei during the period from 1970 to 1993. The diagnosis in each case was substantiated by histologic samples from the original tumor site in the lung. Detailed smoking histories were obtained by personal interview at the time of the first admission. Adenocarcinoma (38.3%) was the most common type of lung cancer, followed by squamous cell carcinoma (37.1%) and small cell carcinoma (12.2%). Over the study period, the incidence of squamous cell carcinoma decreased from 46.4% to 36.2% in men (P < 0.005), adenocarcinoma increased from 30% to 36% in men (P = 0.001) and 50.7% to 64.8% in women (P = 0.008), and small cell carcinoma increased from 7% to 14% in men but showed no significant change in women. Adenocarcinoma exhibited a marked increase in both men and women, and surpassed squamous cell carcinoma as the most frequent type of lung cancer. Lung cancer among younger men, and among non-smoking older men and women, was more often adenocarcinoma. Small cell carcinoma showed a significant increase among males, differing from the trend for squamous cell carcinoma in men, though both are strongly associated with smoking. These findings suggest factors other then cigarette smoking could influence the development and distribution of lung cancer.
肺癌发病率的上升与组织学分布的变化有关。基于对台北荣民总医院1970年至1993年期间10910例经证实的肺癌病例进行回顾性分析，开展了一项研究，以调查肺癌细胞类型分布与年龄、性别和吸烟史之间的关系。每例病例的诊断均通过取自肺部原发肿瘤部位的组织学样本得以证实。详细的吸烟史是在首次入院时通过个人访谈获得的。腺癌（38.3%）是最常见的肺癌类型，其次是鳞状细胞癌（37.1%）和小细胞癌（12.2%）。在研究期间，男性鳞状细胞癌的发病率从46.4%降至36.2%（P<0.005），男性腺癌从30%增至36%（P = 0.001），女性从50.7%增至64.8%（P = 0.008），男性小细胞癌从7%增至14%，但女性无显著变化。腺癌在男性和女性中均显著增加，并超过鳞状细胞癌成为最常见的肺癌类型。年轻男性以及不吸烟的老年男性和女性患肺癌时，腺癌更为常见。小细胞癌在男性中显著增加，这与男性鳞状细胞癌的趋势不同，尽管两者都与吸烟密切相关。这些发现表明，除吸烟外的其他因素可能会影响肺癌的发生和分布。
