<原著>原発性肺癌の入院時臨床像と組織型

Abstract

Various clinical and laboratory findings at the time of first admission were analysed in a series of 728 patients (578 males and 150 females) with histologically and/or cytologically confirmed lung cancer who were admitted to the Chest Disease Research Institute Hospital of Kyoto University during a 10 year period from 1966 to 1977. Results were summarized as follows. 1. Among the 578 male cases, 290 (50.2%) were diagnosed as epidermoid carcinoma, 146 (25.3%) as adenocarcinoma, 137 (23.7%) as undifferenciated cell carcinoma which included both small-cell and large-cell carcinoma, and 5 (0.9%) as alveolar cell carcinoma. The 150 female cases contained 39 (26.0%) epidermoid carcinoma, 76 (50.7%) adenocarcinoma, 27 (18%) undifferenciated cell carcinoma, and 8 (5.8%) alveolar cell carcinoma. 2. About 60% of the epidermoid carcinoma and 68% of the undifferenciated cell carcinoma localized in the central area of the lung. In contrast, about 82% of the adenocarcinoma localized in the peripheral area. 3. Prevalences of positive cytology in epidermoid carcinoma, adenocarcinoma, and undifferenciated cell carcinoma were 77%, 55.9%, 72.5% respectively. 4. Among the cancer of all cell types localized in central area, 52.1% showed atelectasis and/or obstructive pneumonia. In almost all cases, cavities in tumor shadows indicated epidermoid carcinoma, and pleurisy indicated adenocarcinoma. 5. In the cases of adenocarcinoma, the periods between the discovery of the illness and the admission tend to be longer than those carcinoma of the other cell types. 6. Among the cases which were able to be examined for tuberculin reaction, negative conversions were observed in about 30% of cases. 7. Although 60.5% of all our cases showed an elevated blood sedimentation rate (≧26mm), it seemed to be caused by an inflamatory reaction rather than by the tumor itself. 8. The relation between cigarette smoking and cancer incidence was confirmed in epidermoid and undifferenciated cell carcinoma.