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Table of Content - Volume 20 Issue 2 - November 2021


Histopathology of lung carcinoma in smokers and non-smokers

 

Mridula Kamath1*, Taqiya Nuzhath2, Aysha Femy3, Greeshma Ann George4

 

1,2,3,4Department of Pathology, Kanachur Institute of Medical Sciences, INDIA.

Email: mridulakamath24@gmail.com

 

Abstract              Background: Lung cancer is one of the most common cancer worldwide. Smoking is said to be one of the main causative factor. Small cell carcinoma, squamous cell carcinoma and large cell carcinoma are closely associated with smoking while adenocarcinoma is seen mainly in non-smokers. Materials And Methods: Prospective type of study was done in a tertiary hospital for one year. Patients with lung lesions presenting to the department of pulmonology were identified. Biopsies were sent to the department of pathology. Statistical analysis was done using SPSS 21. Results: 88 patients were identified out of which 36 were smokers and 52 were non-smokers. Among the smokers, the most common malignancy was SCC (54.6%) while among the non-smokers adenocarcinoma (51.5%) was the most common Conclusion: Smoking is one of the significant factors in the development of lung malignancy. Squamous cell carcinoma remains the most common histologic type in our study

 

INTRODUCTION

Lung cancer is one of the most commonly diagnosed cancer as well as lethal cancer worldwide1. The main causative agent for development of lung cancer is tobacco use. However, higher rates are also found in non-smoking women1. Histologically there are 2 main subtypes of lung cancer – small cell and non-small cell lung carcinoma2. More common among these are the non-small cell lung carcinoma (NSCLC) which accounts for 85% of the cases.1 Small cell carcinomas (SCLC) are seen in close association to smoking, followed by squamous cell carcinoma (SCC), and large cell carcinoma (LCC) whereas adenocarcinoma is less associated with smoking.2 Various risk factors like genetics, environmental, dietary, occupational factors etc are involved in the development of lung carcinoma among non-smokers1.The aim of this study is to study the type of lung carcinoma among smokers and non-smokers.

 

MATERIALS AND METHODS

A prospective type of study was conducted at a tertiary care center for a period of one year. All patients with suspected lung lesions presenting to the department of pulmonology were studied. Biopsies taken were sent to the department of pathology in 10% formalin. The tissue was then processed and stained with hematoxylin and eosin. Statistical analysis was done using SPSS.

 

RESULTS

88 patients with lung lesions were studied out of which 36 were smokers and 52 were non-smokers. Among the smokers, 3 (15.0%) had benign lesions while 33 (48.5%) patients had malignant lesions. Out of the 52 non-smokers, 35 (51.5%) had malignant lesions (Table 1) Chi square test showed a p value of 0.007 which suggests that presence of smoking is a significant parameter in malignant lesions. In this study, 33 smokers and 35 non-smokers had malignant lesions in the lung. Among the smokers, the most common malignancy was SCC (54.6%) followed by adenocarcinoma and SCLC (21.2% each). The most common malignancy seen among the non-smokers was adenocarcinoma (51.5%) followed by SCC (31.4%) (Table 2)


Table 1: Distribution of lung lesions among smokers and non-smokers

 

Benign

Malignant

Total

Smokers

3(15.0%)

33(48.5%)

36(40.9%)

Non –smokers

17(85.0%)

35(51.5%)

52(59.1%)

Total

20

68

88

 

Table 2: Subtype of lung carcinomas among smokers and non-smokers

Subtype of lung carcinoma

Smokers

Non-smokers

SCC

18(54.6%)

11(31.4%)

Adenocarcinoma

7(21.2%)

18(51.5%)

SCLC (including combined carcinoma)

7(21.2%)

2(5.7%)

Adenosquamous carcinoma

1(3.0%)

2(5.7%)

Metastasis

-

2(5.7%)

Total

33

35

 

Table 3: Sex distribution in comparison to other studies

Sl. No

Authors

Males %

Females %

1.

Hanna Naqvi et al. (2013)8

63.8

36.2

2.

Jens Eckardt et al. (2009)7

56

44

3.

Pierre Loubeyre et al. (2005)9

61.3

38.7

5.

Present study

77

23

 

Table 4: Distribution of lung lesions among smokers and non-smokers in comparison to other studies

Authors

Smokers

Non-smokers

Total

Noronha et al. (2012)85

234

255

489

Toh et al. (2006)86

597

286

883

Present study

33

35

68

 

Table 5: Distribution of types of lung carcinoma with relation to smoking in comparison with other studies

 

Noronha et al. (2012)85

Toh et al. (2006)86

Present study

 

Smokers

Non-smokers

Smokers

Non-smokers

Smokers

Non-smokers

SCC

31.8

17

33.83

5.9

54.6

31.4

Adenocarcinoma

35.5

44.8

41.7

69.9

21.2

51.5

SCLC

10.5

5.8

-

-

21.2

5.7

LCC

1.4

2.5

-

-

-

-

NSCLC, NOS

15.9

19.9

-

-

-

-

Others

5

9.9

24.45

24.1

3

11.4

 


DISCUSSION

As one of the leading causes of cancer worldwide still remains lung cancer, the key for better prognosis is early detection2. A strong gender bias is seen where men are more commonly affected by lung cancers compared to females3. In our study a male: female ratio of 3.3:1 was observed which is concurrent with other studies like like Hanna Naqvi et al. (2013)4, Jens Eckardt et al. (2009)5, Pierre Loubeyre et al. (2005)6 (Table 3). Incidence in males was more commonly seen in our study as they form a major population of smokers in our region. However the present global trends have shown increased prevalence of lung malignancies in females. This can be attributed to the increase in smoking among women3. In our study out of the 88 patients, 68 patients had malignancy. 33 patients were smokers while non-smokers were 35. This is similar to the study done by Noronha et al. (2012)7 but in contrast to Toh et al. (2006)8 study who had majority of patients with history of smoking (Table 4). In the present study, among the smokers the most common malignancy was SCC while in non-smokers it was adenocarcinoma. Among the females the most common malignancy was adenocarcinoma and all of them were non-smokers. This was concurrent with other studies like Noronha et al. (2012)7 and Toh et al. (2006)8 (Table 5). However, among the non-smokers, majority were females in these studies. In our study, males formed a majority among both smokers and non-smokers. Out of the 8 SCLC cases in our study, 6 were smokers.

 

CONCLUSION

In conclusion, this study shows that smoking can be one of the significant factors in the development of lung malignancy. Squamous cell carcinoma still remains the most common histologic type in our study. This study reveals the importance of education and awareness among the population on smoking cessation programmes. Also importance should be given to population based screening for early detection of cancer.

 

REFERENCES

  1. Muhas C, Kumar PRAV, Seenivasan P and Raja D: Relationship between smoking and histology of lung cancer in Malappuram district of Kerala, South India. Int J Pharm Sci and Res 2018; 9(12): 5490-95. doi: 10.13040/IJPSR.0975-8232.9(12).5490-95
  2. Veni KS, Balachandran J. Histology of lung cancer: experience from a tertiary care centre in South India. Int J Res Med Sci 2019;7:1196-9.
  3. ALQudah MA, ALFaqih MA, Hamouri S, Ala'a F, Haddad HK, Al-Quran WY, ALebbini MM, Al-Smadi HI, Alzoubi KH. Epidemiology and histopathological classification of lung cancer: A study from Jordan, retrospective observational study. Annals of Medicine and Surgery. 2021 May 1;65:102330.
  4. Naqvi H, Edhi M, Aslam M, Faridi N. Spectrum of intra-thoracic lesion detected by computed tomography guided fine needle aspiration biopsy. International Archives of Medicine. 2013; 6(4): 1-5
  5. Eckardt J, Petersen HO, Hakami-Kermani A, Olsen KE, Jorgensen OD, Licht PB. Endobronchial ultrasound-guided transbronchial needle aspiration of undiagnosed intrathoracic lesions. Interact Cardiovasc Thorac Surg. 2009 Aug 1;9(2):232–5.
  6. Loubeyre P, Copercini M, Dietrich P-Y. Percutaneous CT-Guided Multisampling Core Needle Biopsy of Thoracic Lesions. Am J Roentgenol. 2005 Nov;185(5):1294–8.
  7. Noronha V, Dikshit R, Raut N, Joshi A, Pramesh C S, George K et al. Epidemiology of lung cancer in India: Focus on the differences between non-smokers and smokers: A single centre experience. Indian J Cancer. 2012;49: 74-81
  8. Toh C-K, Gao F, Lim W-T, Leong S-S, Fong K-W, Yap S-P, et al. Never-Smokers With Lung Cancer: Epidemiologic Evidence of a Distinct Disease Entity. J Clin Oncol. 2006 Apr 24;24(15):2245–51.

 











































 








 




 








 

 









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