Abstract
Primary carcinoma of the bronchus is a major cause of death in males and females. Several studies report an increase in the incidence of adenocarcinoma and have suggested that this reflects changes in smoking habits or, alternatively, that it is a spurious rise due to changes in diagnostic criteria. To examine the latter suggestion we reviewed three cohorts of bronchial carcinoma from 1970, 1980 and 1990, using immunocytochemical techniques to refine diagnosis. We found that squamous cell carcinoma had been consistently overdiagnosed and adenocarcinoma and adenosquamous carcinoma consistently underdiagnosed in all groups. Also, many tumours showed evidence of divergent differentiation with both squamous and glandular components present. There was a small, but real temporal increase in the proportion of adenocarcinoma over the 10 years between 1970 and 1980, but this was not sustained between 1980 and 1990.
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Ando K, Kikuchi M, Eimto T, Shirakusa T (1991) Involucrin in well-differentiated adenocarcinoma of the lung. Comparison with adenocarcinomas of different organs. Pathol Res Pract 187:50–54
Auerbach O, Frasca JM, Parks VR, Carter HW (1982) A comparison of World Health Organisation (WHO) classification of lung tumours by light and electron microscopy. Cancer 50:2079–2088
Campobasso O, Andrion A, Riborta M, Ronco G (1993) The value of the 1981 WHO histological classification in inter-observer reproducibility and changing pattern of lung cancer. Int J Cancer 53:205–208
Corson JM, Pinkus GS (1982) Mesothelioma: profile of keratin proteins and carcinoembryonic antigen. An immunoperoxidase study of 20 cases and comparison with pulmonary adenocarcinoma. Am J Pathol 108:80–87
Cox JD, Yesner RA (1979) Adenocarcinoma of the lung: recent results from the Veterans Administration Lung Group. Am Rev Respir Dis 120:1025–1029
Dunnill MS, Gatter KC (1986) Cellular heterogeneity in lung cancer. Histopathology 10:461–475
El-Torky M, El-Zeky F, Hall JC (1990) Significant changes in the distribution of histologic types of lung cancer. A review of 4928 cases. Cancer 65:2361–2367
Fitzgibbons PL, Kern WH (1985) Adenosquamous carcinoma of the lung; a clinical and pathologic study of 7 cases. Hum Pathol 16:463–466
Her Majesty's Stationery Office (1994) 1989 Cancer statistics: registrations. HMSO, London
Ishida T, Kaneko S, Tateishi M, Oka T, Mitsudomi T, Sugimachi K, Hara N, Ohta M (1990) Large cell carcinoma of the lung. Prognostic implications of histopathologic and immunocytochemical subtyping. Am J Clin Pathol 93:176–182
Ishida T, Kaneko S, Yokoyama H, Inoue T, Sugio K, Sugimachi K (1992) Adenosquamous carcinoma of the lung. Clinicopathologic and immunohistochemical features. Am J Clin Pathol 97:678–685
Keehn R, Auerbach O, Nambu J, Carter D, Shimosato Y, Greenberg D, Tateishi, R, Sacomanna G, Tokuoka S, Lord C (1994) Reproducibility of major diagnoses in a binational study of lung cancer in uranium miners and atomic bomb survivors. Am J Clin Pathol 101:478–482
Khiyami A, Tomashefski JF, Kleinerman J (1988) Patterns of primary lung carcinoma from 1950–1987. Am J Clin Pathol 89:431
Mayall FG, Goddard H, Gibbs AR (1992) An assessment of involucrin as a diagnostically useful immunohistochemical marker in lung tumours. Histopathology 20:53–55
Morabia A, Wynder EL (1991) Cigarette smoking and lung cancer cell types. Cancer 68:2074–2078
Naunheim KS, Taylor SR, Skosey C, Hoffman PC, Ferguson MK, Golomb HM, Little AG (1987) Adenosquamous carcinoma: clinical characteristics, treatment and prognosis. Ann Thorac Surg 44:462–466
Rennert G, Rennert HS, Epstein L (1990) Lung cancer histology and smoking — relationship and time trends among Jewish males in Israel. Cancer Detect Prevent 15:99–101
Rice RH, Green H (1977) The cornified envelope of terminally differentiated human epidermal keratinocytes consists of cross-linked protein. Cell 11:417–422
Roggli VL, Vollmer RT, Greenberg SD, McGavran MH, Spjut HS, Yesner R (1985) Lung cancer heterogeneity: a blinded and randomised study of 100 consecutive cases. Hum Pathol 10:569–579
Said JW, Nash G, Sassoon AF, Shintaku IP, Banks-Schlegel S (1983) Involucrin in lung tumours. A specific marker for squamous differentiation. Lab Invest 49:563–568
Said JW, Nash G, Tepper G, Banks-Schlegel S (1983) Keratin proteins and carcinoembryonic antigen in lung carcinoma. An immunoperoxidase study of fifty-four cases with ultrastructural correlations. Hum Pathol 14:70–76
Sridhar KS, Raub W, Duncan RC, Hilsenbeck S, Richman SP (1990) Lung carcinoma in 1136 patients. Am J Clin Oncol 14:496–508
Suo Z, Holm R, Nesland JM (1993) Squamous cell carcinoma. An immunohistochemical study of cytokeratins and involucrin in primary and metastatic tumours. Histopathology 23:45–54
Valaitis J, Warren S, Gamble D (1981) Increasing incidence of adenocarcinoma of the lung. Cancer 47:1042–1046
Vincent RG, Pickren JW, Lane WW, Bross I, Takita H, Houten L, Gutierrez AC, Rzepka T (1977) The changing histopathology of lung cancer. A review of 1682 cases. Cancer 39:1647–1655
World Health Organisation (1982) The World Health Organisation histological typing of lung tumours. Am J Clin Pathol 77:123–126
Wynder EL, Goodman MT (1983) Smoking and lung cancer: some unresolved issues. Epidemiol Rev 5:177–207
Yang CP, Gallagher RP, Weiss NS, Band PR, Thomas DB, Russell DA (1989) Differences in incidence rates of cancer of the respiratory tract by anatomic subsite and histologic type; an etiologic implication. J Natl Cancer Inst 81:1828–1831
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Caldwell, C.J., Berry, C.L. Is the incidence of primary adenocarcinoma of the lung increasing?. Vichows Archiv A Pathol Anat 429, 359–363 (1996). https://doi.org/10.1007/BF00198440
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DOI: https://doi.org/10.1007/BF00198440