| Clinical Study on Primary Carcinoma of the Lung (2) -Comparison with Previous Period(1960-1977)- |
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Dong Il Ahn, Sung Kwang Kim, Sung Jin Kim, Hee Jin Kim, Kuan Sig Jang, Nam Soo Rhu, Dong Il Cho, Jae Won Kim |
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Department of Chest Medicine, National Medical Center, Seoul, Korea |
| 원발성 폐암의 조직학적 분류 및 임상적 관찰(2) |
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안동일, 김성광, 김성진, 김희진, 장관식, 유남수, 조동일, 김재원 |
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| Abstract |
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A clinical evaluation was done on 132 patients with primary bronchogeic carcinoma, who came to the department of chest medicine National Medical Center, during the period of 8 years from Jan.
1978 to Dec. 1985.
Stress has been placed on the change of the incidence according to the histological t types, and on the change of diagnostic dependence with the development of cytologic study.
1) The ratio of male to female incidence was 2.9: 1 and it showed no change in comparison with the 3.0: 1 ratio of the previous period (1960-1977), but the total incidence was increased about 3 times.
2) Patients with the duration of symptoms before the first admission, which was less than 3 months,
represented 68.9% of the total patients at this study, while 31.3% at the previous period. Which showed that the number of early diagnosed patients has been increàsed.
3) 80.6% of the patients were smokers. Smoking history and histological cell type were correlated, especially in epidermoid carcinoma, small cell carcinoma and alveolar cell carcinoma.
4) The histological results were: epidermoid carcinoma 47.7%, adenocarcinoma 31.1 %, and small cell carcinoma 10.6%, etc. ln comparison with the previous period, incidence of adenocarcinoma was markedly increased.
5) The positive ratio of the diagnostic methods was as follows: sputum cytology 70.0%, bronchoscopic biopsy 66.7%, bronchial washing cytology 61.0%, cervical lymph node biopsy 90.3%, and percutaneous needle aspiration biopsy of lung 61.5%.
6) ln adenocarcinoma, only 6% of the patients in the previous period was positive in sputum cytology study, but in this period 56%. This means that almost cases are confirmed as adenocarcinoma by biopsy at the metastatic site in the previous period but in this period the improvement of accuracy of cytology made it possible to diagnose lung cancer by sputum cytology. We considered that this is one of the important causes of increased incidence of adenocarcinoma compared to previous period.
7) The number of patients who has not been suspicious of lung cancer at first admission was 16.7 % and most of them (14.4%) were impressed as pulmonary tuberculosis.
8) Thoracotomy was undertaken in 11 cases. ln 9 (6.8%) of these 11 cases, resection of the lesion was possible. |
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