Changing trends in histologic types of lung cancer during the last decade (1981–1990) in Korea: a hospital-based study

doi:10.1016/0169-5002(94)90658-0

Lung Cancer

Volume 10, Issues 5–6, March 1994, Pages 287-296

https://doi.org/10.1016/0169-5002(94)90658-0 Get rights and content

Abstract

A review of the histopathology and past history of 2229 patients with primary lung cancer diagnosed at the Yonsei University Medical Center from 1981 to 1990 was performed to investigate the changes in histologic types and the relationship to smoking history. The most frequent histologic type of lung cancer was squamous cell carcinoma (956 patients, 54.0%) followed by adenocarcinoma (311 patients, 17.6%) in males (1772 patients), and adenocarcinoma (206 patients, 45.1%) followed by squamous cell carcinoma (126 patients, 27.6%) in females (457 patients). In both sexes, the predominant type was adenocarcinoma under the age of 40, whereas squamous cell carcinoma was the most frequent type above the age of 40. While squamous cell carcinoma decreased over 10 years (54.3% in 1981, 44.3% in 1990), adenocarcinoma showed a gradually increased incidence (17.0% in 1981, 28.3% in 1990) in both sexes, and the proportion of small cell carcinoma and large cell carcinoma remained unchanged. These changes in histologic type were more prominent in non-smokers. In conclusion, the increasing incidence of adenocarcinoma in both sexes, especially in non-smokers, suggests the possible presence of etiologic factors other than smoking, such as environmental pollution.

References (32)

JH Pemberton et al.
Bronchogenic carcinoma in patients younger than 40 years
Ann Thorac Surg
(1983)
HH McDuffie et al.
Characteristics of patients with primary lung cancer diagnosed at age 50 years or younger
Chest
(1989)
JG Antkowiak et al.
Bronchogenic carcinoma in patients under age 40
Ann Thorc Surg
(1989)
O Auerbach et al.
Histologic type of lung cancer in relation to smoking habits, year of diagnosis and sites of metastases
Chest
(1975)
P Correa et al.
Passive smoking and lung cancer
Lancet
(1983)
American Cancer Society
Cancer statistics 1988, CA
(1988)
IS Kim et al.
Incidence and survival of cancer in Kangwha County (1983–1987)
Yonsei Med J
(1989)
ER Greenberg et al.
Incidence of lung cancer by cell type: a population-based study in New Hampshire and Vermont
J Natl Cancer Inst
(1984)
L Dodds et al.
A population-based study of lung cancer incidence trends by histologic type, 1974–81
J Natl Cancer Inst
(1986)
AH Wu et al.
Secular trends in histologic types of lung cancer
J Natl Cancer Inst
(1986)

CM Beard et al.

Fifty-year trend in incidence rates of bronchogenic carcinoma by cell type in Olmsted County, Minnesota

J Natl Cancer Inst

(1988)

RG Vincent et al.

The changing histopathology of lung cancer: a review of 1682 cases

Cancer

(1977)

J Valaitis et al.

Increasing incidence of adenocarcinoma of the lung

Cancer

(1981)

CV Reyes et al.

Changing incidence of adenocarcinoma of the lung: a brief review

J Surg Oncol

(1987)

M El-Torky et al.

Significant changes in the distribution of histologic types of lung cancer: a review of 4928 cases

Cancer

(1990)

World Health Organization

The World Health Organization histological typing of lung tumors

Am J Clin Pathol

(1982)

Cited by (32)

Single-nucleotide polymorphisms and haplotypes of vascular endothelial growth factor
2017, Gene Reports
Citation Excerpt :
It is well established that correlation between single nucleotide polymorphisms (SNPs) decays with physical distance in the genome, due to recombination events between markers (Ardlie et al., 2002), linkage disequilibrium (LD) can be used to quantify this effect. Non-small cell lung cancer (NSCLC) constitutes the majority of all diagnosed lung cancers in Kashmir India and adenocarcinoma is the predominant histologic type in NSCLC (Choi et al., 1994; Park et al., 1995). Genome-wide association studies based on tagging polymorphisms across the entire genome along with a large sample size and multiple-stage replications, have sufficient power for detecting genetic effects in complex diseases, including lung cancer.
Vascular endothelial growth factor (VEGF) is one of the most predominant mediators of angiogenesis, plays a critical role in lung carcinogenesis. We performed a case–control study of 209 non-small cell lung cancer (NSCLC) patients and 189 sex, age and smoking matched healthy controls; genotyped 9 VEGF single-nucleotide polymorphisms (SNPs) in patients and controls selected from Kashmiri population and evaluated the NSCLC risk conferred by individual SNPs and haplotypes. In single-locus analysis, alleles of rs699947, rs833061, rs13207351, rs2010963 and rs3025021 showed association with NSCLC [P value = 6.00e −⁰⁴, 2.54e −¹¹, 6.38e −⁰⁹, 0.0082 and 0.0024]. However permutation test revealed association of only three markers (rs83306, rs13207351 and rs699947) with NSCLC [P value = 0.000e⁰, 0.000e⁰ and 0.0086], Haplotype analysis of case-control subjects identified one block of two SNPs (rs3025020 and rs3025021) having linkage disequilibrium [D′ = 0.26]; NSCLC subjects formed two blocks of four SNPs in promoter, 5′-un-translated and intronic region (rs2010963, rs833061, rs13207351 and rs1413711) and four polymorphisms downstream of the coding sequence, in intron and 3′ un-translated region (rs2146323, rs3025020, rs3025021 and rs3025039) with highest linkage disequilibrium [D′ = 0.89] between rs13207351 and rs3025020. There were no significant differences in the tested single-nucleotide polymorphisms (SNPs) and haplotypes in patients with non-small cell lung cancer.
Genomic alterations of chromosome region 11p as predictive marker by array comparative genomic hybridization in lung adenocarcinoma patients
2010, Cancer Genetics and Cytogenetics
Citation Excerpt :
In Korea, the incidence of AdCC is increasing more than squamous cell carcinoma. In contrast to squamous cell carcinoma, which started to decrease in frequency in 1987, the incidence of AdCC has increased and represented 37.5% of all lung cancers in 2007 [3,4]. AdCC is the most common subtype in younger patients, women, and nonsmokers [5] and is expected to constitute a high proportion of surgical cases.
Array comparative genomic hybridization (aCGH) provides a method to quantitatively measure the changes of DNA copy number with an extremely high resolution and to map them directly onto the complete linear genome sequences. In this study, we used aCGH to compare genomic alterations in fresh-frozen lung cancer tissues of 21 adenocarcinomas (AdCCs) (11 early relapse and 10 nonrelapse) and identified genomic alterations that showed significant by different frequency between early relapse and nonrelapse AdCCs. Twelve clones were identified by the false discovery rate (FDR) test, and Kaplan-Meier analyses were selected as predictive markers. The significant gain clones were found in 11p (11p15.4, 11p15.1, and 11p13). When the cutoff value was 2, study of the association between candidate clones and relapse prediction revealed that early relapse and nonrelapse groups were most effectively separated. To further validate the gain of chromosome 11p region that was identified by array CGH, fluorescence in situ hybridization (FISH) was performed. To further confirm the results of aCGH, copy number changes of cancer-related candidate genes in AdCC patients were compared by real-time quantitative polymerase chain reaction. Array CGH and real-time quantitative polymerase chain reaction data were found to correspond to delineated DNA copy number changes. Genomic alterations of chromosome 11p region in AdCC patients were observed with aCGH, and a relapsable marker was identified in the nonrelapse group. This marker could be useful in stratifying patient groups according to likelihood of relapse for adjuvant treatment after surgical resection.
Adenocarcinoma of the lung: Application of the 1999/2004 WHO classification for case studies at the Department of Pathology of the University Hospital in Coimbra
2006, Revista Portuguesa de Pneumologia
Num período de quinze anos, entre 1990 e 2004, foram diagnosticados 701 adenocarcinomas primários do pulmão no Serviço de Anatomia Patológica do Hospital da Universidade de Coimbra e 382 metástases de carcinomas, com predomínio do cólon (119) e mama (66). Os adenocarcinomas do pulmão tiveram um aumento relativo no sexo masculino, com crescimento de 16 casos em 1990 para 49 em 2004, e no sexo feminino verificou-se um aumento de 12 para 37 no mesmo período e, assim, a partir de 2001, a incidência foi equivalente em ambos os sexos.
Também nos últimos quatro anos, o grupo etário de incidência dos adenocarcinomas passou para os 70 anos, havendo casos diagnosticados em doentes com idade superior a 80 anos.
Acompanhando o estudo numérico dos adenocarcinomas, foi feita a respectiva reclassificação histológica para aplicação dos critérios de diagnóstico estabelecidos pela classificação da OMS 1999-2004 para os tumores do pulmão, pleura, timo e coração. A incidência dos carcinomas bronquíoloalveolares foi naturalmente maior no sexo feminino, enquanto no sexo masculino, se verificou um maior número de adenocarcinomas acinares. Estas conclusões foram retiradas dos diagnósticos obtidos nas peças cirúrgicas e quando em biópsias cirúrgicas se considerou a amostra representativa. O estadiamento cirúrgico predominou entre IIA e IIIB e, em 109 casos, o diagnóstico possível foi apenas de adenocarcinoma do pulmão, por falta de amostragem e com imuno-histoquímica concordante.
Rev Port Pneumol 2006; XII (3): 255-268
A study of 701 primary adenocarcinomas of the lung was made at the Department of Pathology of the Hospital da Universidade de Coimbra for a period of fifteen years, between 1990 and 2004. In the same period 382 metastases were diagnosed, mainly from colon (119) and breast (66). The incidence of primary adenocarcinomas varied from 16 cases in 1990 to 49 cases in men and from 12 to 37 cases in women in that period. From 2001 onwards, the incidence was almost coincident in both genders. In the last four years, since 2001, patients were in the seventies at the time of diagnosis and a considerable number of cases were diagnosed after 80 years of age.
The criteria defined by the WHO classification of Tumours of the Lung, Pleura, Thymus and Heart 2004 were applied to the primary adenocarcinomas of the lung and as was expected, bronchioloalveolar carcinomas had its incidence in women while acinar adenocarcinomas were diagnosed mainly in men. These conclusions were obtained via surgical specimens and when surgical biopsies were representative and those were mainly in stage IIB and IIIA. A number of 109 cases had the final diagnosis of adenocarcinoma of the lung based on morphology and immunohistochemistry criteria.
Rev Port Pneumol 2006; XII (3): 255-268
Lung cancer - What has changed in two decades
2005, Revista Portuguesa de Pneumologia
O cancro do pulmão (CP) é um problema major de saúde pública, sendo a neoplasia mais comum no sexo masculino e a que maior mortalidade determina em ambos os sexos. Há duas décadas observava-se um predomínio do carcinoma epidermóide; no entanto, actualmente, o adenocarcinoma é o tipo histológico mais frequente.
Foi objectivo deste trabalho retrospectivo a comparação dos dados demográficos e dos factores relacionados com a doença em doentes cujo diagnóstico de CP foi efectuado nos períodos compreendidos entre 1979-1982 e 1999-2002 no H. S. João.
Nos oito anos referentes ao estudo foi diagnosticado CP em 750 doentes. Dos 236 doentes cujo diagnóstico foi efectuado entre 1979-1982, 84,3% eram do sexo masculino, com uma idade média de 60,0 ± 10,0 anos. O tipo histológico predominante foi o carcinoma epidermóide (46,2%). No período entre 1999-2002 foi diagnosticado CP em 514 doentes (83,9% sexo masculino; idade média 64,7 ± 10,8 anos), com um predomínio do adenocarcinoma (47,1%). Ao longo dos 20 anos analisados verificaram-se diferenças estatisticamente significativas em relação aos hábitos tabágicos (aumento da percentagem de fumadores; 73,7% vs 82,4%), idade dos doentes (aumento da idade média), tipo histológico (aumento da percentagem de adenocarcinoma e diminuição do carcinoma epidermóide e carcinoma de pequenas células) e tratamento (diminuição da proporção de doentes submetidos apenas a terapêutica de suporte; 26% vs 19%).
Como conclusão, saliente-se a evolução dos tipos histológicos nos últimos 20 anos e um menor recurso ao tratamento sintomático como única opção terapêutica.
Rev Port Pneumol 2005; XI (2): 135-154
Lung cancer (LC) is a major public health problem and it is the most common form of cancer in men. It remains the most common cause of cancer death in men and women. In the initial decades of the smoking-caused epidemic, squamous cell carcinoma was the most frequent type. Recently there was a shift toward predominance of adenocarcinoma.
The aim of our retrospective study was to compare the demographic factors and factors connected with the disease in patients whose LC was diagnosed in two distinct periods in H.S.João (1979-1982 and 19992002).
A total of 750 LC were diagnosed. Between 19791982 a total of 236 patients were diagnosed LC (84.3% male; mean age 60.0 ± 10.0). The most common histological type was squamous cell (46.2%). A total of 514 LC were diagnosed during the period 1999-2002 (83.9% male; mean age 64.7 ± 10.8) and adenocarcinoma was the most frequent (47.1%). There were significant differences, between the two periods analysed concerning smoking (increase in the number of smokers; 73.7% vs 82.4%), age (increase in the mean age of patients) and histology (higher percentage of adenocarcinoma and reduction of squamous cell and small-cell lung cancer). The percentage of patients treated symptomatically decreased significantly in 20 years (26% vs 19%).
As a conclusion we can say that there was an evolution of histological types in the last two decades and a reduction in the number of patients submitted to symptomatic treatment alone.
Rev Port Pneumol 2005; XI (2): 135-154
Effects of the ADH3, CYP2E1, and GSTP1 genetic polymorphisms on their expressions in Caucasian lung tissue
2002, Lung Cancer
Individual differences in lung cancer susceptibility should be considered for effective lung cancer prevention. We investigated the CYP2E1, ADH3, and GSTP1 genetic polymorphisms that biotransform xenobiotic carcinogens, and variations of their enzyme activity in Caucasian lung tissues (N=28), and found a variant distribution in pulmonary ADH and CYP2E1 activity. The ADH3*1/*1 subjects (N=8) showed significantly higher ADH activity than ADH3*2/*2 (N=3) subjects (P<0.01). On the other hand, we found a 5-fold variation in the pulmonary CYP2E1 activity using a sensitive HLPC/EC based technique. A subject with the CYP2E1-c/t allele showed 2-fold higher CYP2E1 activity than subjects with the c/c allele (N=14). GSTP1 expression comprised 83% of the total pulmonary GSTs. However, neither the GSTP1 polymorphism, nor other lifestyle factors, such as age, gender, smoking status, were found to be associated with pulmonary GST expression. In conclusion, subjects with the ADH3*1 allele showed higher ADH activity and acetaldehyde–DNA adducts in lung than other subjects; thus, the ADH3*1 allele could be considered a risk factor for lung cancer.
A time trend of profile and surgical results in 1123 patients with non-small cell lung cancer
2002, Surgery
Background. A time trend for characteristics and prognoses of patients with non-small cell lung cancer (NSCLC) who underwent surgical resection was investigated. Methods. A series of 1123 consecutive patients with NSCLC who underwent surgical resection from 1975 to 1998 was reviewed with respect to changes in patient profile and surgical outcome among subgroups classified by clinicopathologic factors. Results. With time, the proportion of female, elderly (≥70 years), pathologic stage IA, nonsmoking, and adenocarcinoma patients increased significantly whereas pneumonectomy, incomplete resection, and pathologic stage IIIA patients decreased significantly. Overall survival showed an upward trend with 5-year survival rates of 30.0% in the 1970s, 41.6% in the 1980s, and 50.1% in the 1990s (P < .0001). This tendency was similar in every pathologic stage that was observed. The proportion of female patients with adenocarcinoma that exhibited the most favorable prognosis among subpopulations classified by gender and cell types was significantly higher in the 1990s (28.0%) than in the 1970s (14.0%). Multivariate analysis revealed that female gender, adenocarcinoma, complete resection, and early pathologic stage were independently favorable factors whereas advanced age was an unfavorable factor. Conclusions. The improved survival following surgical resection for NSCLC during the study period was associated with an increasing population of female patients with adenocarcinoma, more detection of early disease, and effective elimination of unresectable cases.(Surgery 2002;131:S242-8.)

View all citing articles on Scopus

View full text

Changing trends in histologic types of lung cancer during the last decade (1981–1990) in Korea: a hospital-based study

Abstract

Ann Thorac Surg

Chest

Ann Thorc Surg

Chest

Lancet

Cancer statistics 1988, CA

Incidence and survival of cancer in Kangwha County (1983–1987)

Yonsei Med J

Incidence of lung cancer by cell type: a population-based study in New Hampshire and Vermont

J Natl Cancer Inst

A population-based study of lung cancer incidence trends by histologic type, 1974–81

J Natl Cancer Inst

Secular trends in histologic types of lung cancer

J Natl Cancer Inst

Fifty-year trend in incidence rates of bronchogenic carcinoma by cell type in Olmsted County, Minnesota

J Natl Cancer Inst

The changing histopathology of lung cancer: a review of 1682 cases

Cancer

Increasing incidence of adenocarcinoma of the lung

Cancer

Changing incidence of adenocarcinoma of the lung: a brief review

J Surg Oncol

Significant changes in the distribution of histologic types of lung cancer: a review of 4928 cases

Cancer

The World Health Organization histological typing of lung tumors

Am J Clin Pathol