A. Kargi, D. Gurel, and B. Tuna, “The diagnostic value of...

来自 : www.oalib.com/references/13801 发布时间：2021-03-25

ABSTRACT: Purpose. The aim of this study was to assess the impact of immunohistochemical- (IHC-) studies on incidence and survival of lung cancer histotypes. Patients and Methods. Lung cancers occurred in southern Switzerland between 1996 and 2010 were selected by the Ticino Cancer Registry and categorised into adenocarcinoma (AC), squamous-cell-carcinoma (SqCC), small-cell-carcinoma (SmCC), and large-cell carcinoma/non-small-cell lung cancer (LCC/NSCLC). Incidence rates, annual-percentage-change (APC), and two-year overall survival (OS) (follow-up: 31.12.2010) were performed. Results. 2467 cases were selected: 997 (40.4%) AC; 522 (21.2%) LCC/NSCLC, 378 (15.3%) SmCC, and 570 (23.1%) SqCC. Trend-analysis showed significant increase in AC (APC: 4.6; 95% CI: 3.1; 6.0) and decrease of LCC/NSCLC, with significant joinpoint in 2003 (APC: ？14.7; 95% CI: ？21.6; ？7.1). Improved OS and decreased OS were detected in SqCC and LCC/NSCLC, respectively. Conclusions. This study highlights that diagnosis with ancillary immunohistochemical studies will change incidence and survival of precisely defined lung cancer subtypes. It calls attention to the need for cautious interpretation of studies and clinical trials, where the diagnosis was based on histology unaccompanied by IHC studies, and to the need of standardised diagnostic procedures. 1. Introduction Lung cancer is one of most common cancers in the world, representing 17.1% of all cancers in men, 6.7% in women, and 12.2% in both sexes [1]. Of the histological types, adenocarcinoma (AC) has remained the most prevalent among women over the past three decades, with incidence rates increasing slowly over time in many countries. In contrast, squamous cell carcinoma (SqCC) has historically been the predominant tumour type in men, but the incidence has declined and converged with the corresponding incidence in women, which has remained fairly stable [2]. Traditionally, lung carcinoma was classified into histological types using standard histological techniques. The most critical step in histopathological diagnosis was to distinguish small cell carcinoma (SmCC) from the other lung carcinomas, which were collectively called the non-small cell lung carcinomas (NSCLCs); patients with the former were referred to chemotherapy, whereas patients with the latter were potentially eligible for surgery or different chemotherapies. Over the past few years, the emergence of targeted or combination treatment strategies has created new demands on histopathological diagnostics, as it is now recognised that the efficacy and toxicity of some new drugs