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Association between cigarette smoking and FHIT gene alterations in Chinese lung cancer
Epidemiology
235
2. there is no significant difference between the 2 populations in terms of age, sex or smoking history. These results suggest that screening chest radiography should no longer be reserved for male smokers over 50 years of age.
Cohort: RR
•
Conclusions: The impact of gender sex as prognostic factor in earlier SCLC series may reflect social rather than biologic factors. Current changes in smoking habits may therefore change prognostic features of SCLC.
analysis patients in 0Turkey,retrospective -a country • where T smoking hof lungeis cancer highly prevalent
- 1919 0.71
1920-29 0.78
1930+ 0.90 (NS)
T. Lung. Pleural Malignancies Study Group, Turkey Lung cancer is the most common cancer in the world. We planned a multi-center and retrospective study to analyze the clinical data of lung cancer patients from January 1994 to December 1998. Sixteen centers entered the study and analyzed 11849 lung cancer patients. In this group of patients, 90.4% was male and 9.6% female. Most of these patients were smoker (77.2%) or ex-smoker (10.8%). The age distribution of the patients was 0.3% below 25 years, 11.4% 26-45 years, 56.7% 46-65 years, 31.6% above 66. Out of 11849 patients 39.2% was diagnosed as squamous cell cancer, 17.8% small cell, 17.5% adenocancer, 1.7% large cell, 7.8% unknown subgroup of non-small cell lung cancer, 1% combined small and non-small cell cancer, 0.6% adenosquamous, 8.8% unknown histological type (malignant cytology), 0.9% indiferent carcinoma, 0.9% carcinoid, and 3.8% radiological lung cancer. The stages of non-small cell lung cancer patients were stage I (5.6%), stage II (7.7%), stage IliA (14.1%), stage IIIB (32.1%), stage IV (40.4%). SCLC patients were staged as limited disease (37.9%) and extensive disease (62.7%). The results of the largest data so far collected in Turkey show that lung cancer is still more common in male patients, squamous cell is the most common histological type, and only a few patients can be diagnosed at early stages.
I - ~ - ] Will changing smoking habits influence the clinical prognosis in small cell lung cancer (SCLC)? K. •sterlind, U. Lassen, H.H. Hansen. The Copenhagen Lung Cancer
Group; Herlev University Hospital, Finsen Center, Denmark Smoking in Danish men peaked in 1950, when 78% were smokers, and 20 years later in women, when 47% smoked. Today 32% of males and 30% of females are daily smokers. In the same 40 years the proportions of heavy smokers (>15 cig./d) have increased from 7%-22% in men and 1%-16% in women. The changes are related to socioeconomic characteristics: More males in the upper social classes quit the tobaco, while smoking is more prevalent in women in jobs outside home. We have to wait 2-3 decades yet to see if these changes influence clinical characteristics of SCLC. As for the period before 1950, however, current data might reflect the differences in smoking habits between males and females. Therefore, we investigated relationships between sex, birth cohort and survival in 2131 SCLC patients (age < 71 yrs) treated with chemotherapy in trials between 1973 and 1998: Cohort - 1 9 1 4 Females 23%
1915-19 1920-24 1925-29 1930-34 1935-39 1940+ 31% 33% 39% 38% 33% 44%
Cox analysis was carried out, including serum LDH, performance status (PS), stage of disease (EX), and age. As etoposide + cisplatin were introduced in regimes after 1981 we added a dummy variable 'era': 1973-81 vs. 1982-98. LDH, PS, stage, and 'era' had significant influence on survival (p < .05). Survival in males was unrelated to both cohort and to age of the pt. In females, age < 65 years had significant positive impact, as had birth in the period 1900-19 or 1920-29:
Factor RR
LOH 1.49
PS 1.31
Stage 1.41
Era 0.88
18--•
Association between cigarette smoking and FHIT gene alterations in Chinese lung cancer
J. Zhang, D. Chen 1, Q . M Shen, D.L. Tian, Y.H. Jiang, H.N. Yin, H.W. Li. Department of Thoracic Surgery, The First Clinical College;
1Department of Nurosurgery, The Second Clinical College; China Medical University, Shenyang, PR China To identify the association between cigarette smoking and FHIT (fragile histidine triad) gene alterations in lung cancer, FHIT gene in matched normal and cancerous tissues from 21 cases of squamous call carcinoma and 10 cases of adenocarcinoma were detected by RT-PCR and DNA sequence analysis. Association between losses of FHIT gene and cigarette smoking was examined using x 2 test with a two sided Fisher's exact test. Aberrant mRNA transcripts of FHIT gene were detected in 15 of 31 (48.4%) cases of primary lung cancers. The frequency of losses of FHIT gene in smokers is 66.7% (12/18), which is significantly higher than 23.1% (3/13) in non-smokers (P = 0.02). In 21 cases of squamous cell carcinoma, the comparison of frequency of losses of FHIT gene between smokers and non-smokers was significantly different (73.3% versus 16.7%, P = 0.0294) whereas not significant in 10 cases of adenicarcinoma (33.3 versus 28.6%, P = 0.708). The rate of smoking in squamous cell carcinoma group is higher than that in adenocarcinoma group (71.4 versus 33.3%, P = 0.0363). Higher frequency of losses of FHIT gene in squamous cell carcinoma is related to cigarette smoking, suggesting that the FHIT gene should be a specific molecular target of carcinogens in tobacco smoke.
I•-•
Lung cancer in Poland - analysis o f 21242 cases registered between 1995 to 1998 E. Radzikowska, K. Roszkowski, P. Glaz. National Tuberculosis and
Lung Diseases Research Institute, Warsaw, Poland Lung cancer is the most prevalent cancer in Poland. Stabilisation of the incidence was noticed in last decade, but it is still one of the highest in the world. 21242 lung cancer cases were registered in National Tuberculosis and Lung Diseases Research Institute during years 1995 to 1998. There were 3033 (14.3%) women and 18209 (85.7%) men. Women developed lung cancer earlier (mean age 59.9 vs 62.7 p. < 0.001). Similar results were obtained for patients with adenocarcinoma (mean age 56,9 vs 60.2 years, p. < 0.001), small cell (57,4 vs 59.6 years, p < 0.01) and squamous lung cancer (60.3 vs 61.8 years, p. < 0.02). Adenocarcinoma and small cell lung cancer were diagnosed in younger age than patients with squamous cancer (mean age 59.1 and 59.2 vs 61.7 years p. < 0.001). Extremely young patients was observed among those with carcinoid (mean age of women was 50.1 and 55 years for men p. < 0.001). More than 14% of patients were bellow 50 years old. Squamous cancer was the predominant type of lung cancer (41.7%). Small cell lung cancer was noticed in 16.6% and adenocarcinoma in 8.9% of patients. 2.5% of patients were nonsmokers. Significantly more nonsmokers were noticed among those with adenocarcinoma (10.57% vs 2.8%, p. < 0.001), particularly women (30.8%). Family history of cancer was positive among 19.6% of lung cancer patients.
235
2. there is no significant difference between the 2 populations in terms of age, sex or smoking history. These results suggest that screening chest radiography should no longer be reserved for male smokers over 50 years of age.
Cohort: RR
•
Conclusions: The impact of gender sex as prognostic factor in earlier SCLC series may reflect social rather than biologic factors. Current changes in smoking habits may therefore change prognostic features of SCLC.
analysis patients in 0Turkey,retrospective -a country • where T smoking hof lungeis cancer highly prevalent
- 1919 0.71
1920-29 0.78
1930+ 0.90 (NS)
T. Lung. Pleural Malignancies Study Group, Turkey Lung cancer is the most common cancer in the world. We planned a multi-center and retrospective study to analyze the clinical data of lung cancer patients from January 1994 to December 1998. Sixteen centers entered the study and analyzed 11849 lung cancer patients. In this group of patients, 90.4% was male and 9.6% female. Most of these patients were smoker (77.2%) or ex-smoker (10.8%). The age distribution of the patients was 0.3% below 25 years, 11.4% 26-45 years, 56.7% 46-65 years, 31.6% above 66. Out of 11849 patients 39.2% was diagnosed as squamous cell cancer, 17.8% small cell, 17.5% adenocancer, 1.7% large cell, 7.8% unknown subgroup of non-small cell lung cancer, 1% combined small and non-small cell cancer, 0.6% adenosquamous, 8.8% unknown histological type (malignant cytology), 0.9% indiferent carcinoma, 0.9% carcinoid, and 3.8% radiological lung cancer. The stages of non-small cell lung cancer patients were stage I (5.6%), stage II (7.7%), stage IliA (14.1%), stage IIIB (32.1%), stage IV (40.4%). SCLC patients were staged as limited disease (37.9%) and extensive disease (62.7%). The results of the largest data so far collected in Turkey show that lung cancer is still more common in male patients, squamous cell is the most common histological type, and only a few patients can be diagnosed at early stages.
I - ~ - ] Will changing smoking habits influence the clinical prognosis in small cell lung cancer (SCLC)? K. •sterlind, U. Lassen, H.H. Hansen. The Copenhagen Lung Cancer
Group; Herlev University Hospital, Finsen Center, Denmark Smoking in Danish men peaked in 1950, when 78% were smokers, and 20 years later in women, when 47% smoked. Today 32% of males and 30% of females are daily smokers. In the same 40 years the proportions of heavy smokers (>15 cig./d) have increased from 7%-22% in men and 1%-16% in women. The changes are related to socioeconomic characteristics: More males in the upper social classes quit the tobaco, while smoking is more prevalent in women in jobs outside home. We have to wait 2-3 decades yet to see if these changes influence clinical characteristics of SCLC. As for the period before 1950, however, current data might reflect the differences in smoking habits between males and females. Therefore, we investigated relationships between sex, birth cohort and survival in 2131 SCLC patients (age < 71 yrs) treated with chemotherapy in trials between 1973 and 1998: Cohort - 1 9 1 4 Females 23%
1915-19 1920-24 1925-29 1930-34 1935-39 1940+ 31% 33% 39% 38% 33% 44%
Cox analysis was carried out, including serum LDH, performance status (PS), stage of disease (EX), and age. As etoposide + cisplatin were introduced in regimes after 1981 we added a dummy variable 'era': 1973-81 vs. 1982-98. LDH, PS, stage, and 'era' had significant influence on survival (p < .05). Survival in males was unrelated to both cohort and to age of the pt. In females, age < 65 years had significant positive impact, as had birth in the period 1900-19 or 1920-29:
Factor RR
LOH 1.49
PS 1.31
Stage 1.41
Era 0.88
18--•
Association between cigarette smoking and FHIT gene alterations in Chinese lung cancer
J. Zhang, D. Chen 1, Q . M Shen, D.L. Tian, Y.H. Jiang, H.N. Yin, H.W. Li. Department of Thoracic Surgery, The First Clinical College;
1Department of Nurosurgery, The Second Clinical College; China Medical University, Shenyang, PR China To identify the association between cigarette smoking and FHIT (fragile histidine triad) gene alterations in lung cancer, FHIT gene in matched normal and cancerous tissues from 21 cases of squamous call carcinoma and 10 cases of adenocarcinoma were detected by RT-PCR and DNA sequence analysis. Association between losses of FHIT gene and cigarette smoking was examined using x 2 test with a two sided Fisher's exact test. Aberrant mRNA transcripts of FHIT gene were detected in 15 of 31 (48.4%) cases of primary lung cancers. The frequency of losses of FHIT gene in smokers is 66.7% (12/18), which is significantly higher than 23.1% (3/13) in non-smokers (P = 0.02). In 21 cases of squamous cell carcinoma, the comparison of frequency of losses of FHIT gene between smokers and non-smokers was significantly different (73.3% versus 16.7%, P = 0.0294) whereas not significant in 10 cases of adenicarcinoma (33.3 versus 28.6%, P = 0.708). The rate of smoking in squamous cell carcinoma group is higher than that in adenocarcinoma group (71.4 versus 33.3%, P = 0.0363). Higher frequency of losses of FHIT gene in squamous cell carcinoma is related to cigarette smoking, suggesting that the FHIT gene should be a specific molecular target of carcinogens in tobacco smoke.
I•-•
Lung cancer in Poland - analysis o f 21242 cases registered between 1995 to 1998 E. Radzikowska, K. Roszkowski, P. Glaz. National Tuberculosis and
Lung Diseases Research Institute, Warsaw, Poland Lung cancer is the most prevalent cancer in Poland. Stabilisation of the incidence was noticed in last decade, but it is still one of the highest in the world. 21242 lung cancer cases were registered in National Tuberculosis and Lung Diseases Research Institute during years 1995 to 1998. There were 3033 (14.3%) women and 18209 (85.7%) men. Women developed lung cancer earlier (mean age 59.9 vs 62.7 p. < 0.001). Similar results were obtained for patients with adenocarcinoma (mean age 56,9 vs 60.2 years, p. < 0.001), small cell (57,4 vs 59.6 years, p < 0.01) and squamous lung cancer (60.3 vs 61.8 years, p. < 0.02). Adenocarcinoma and small cell lung cancer were diagnosed in younger age than patients with squamous cancer (mean age 59.1 and 59.2 vs 61.7 years p. < 0.001). Extremely young patients was observed among those with carcinoid (mean age of women was 50.1 and 55 years for men p. < 0.001). More than 14% of patients were bellow 50 years old. Squamous cancer was the predominant type of lung cancer (41.7%). Small cell lung cancer was noticed in 16.6% and adenocarcinoma in 8.9% of patients. 2.5% of patients were nonsmokers. Significantly more nonsmokers were noticed among those with adenocarcinoma (10.57% vs 2.8%, p. < 0.001), particularly women (30.8%). Family history of cancer was positive among 19.6% of lung cancer patients.