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Vol.43 No.3 contents | Japanese/English |
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- Original Article -
Incidence, Content and Primary Sites of Multiple Lung Cancers, Especially Cases of Three or More Cancers, in the Annual of Pathological Autopsy Cases in Japan, From 1958 to 1997
Toyohiko Morita11Department of Pathology, International Medical Center Of Japan, Japan
Objective. The author studied multiple lung cancers, especially double cancers, in the Annual of Pathological Autopsy Cases in Japan (the Autopsy Annual) for 35 years, from 1958 to 1992, and reported the findings in JJLC 1997; 37: 283-294. The present report studies cases of three or more lung cancers during the 40-year period of 1958 to 1997, comparing them with lung cancer and double cancer cases in the same period, and in an attempt to clarify the background and factors related to the occurrence of multiple cancers in the lungs. Subjects and Methods. There were 41 cases of three or more lung cancers in males and 9 cases of triple lung cancers in females in the above period. These cases were studied on the basis of year, gender, age, histological type and primary site (right or left lungs and lobes). The cases were grouped into four 10-year periods, I to IV. Each lung cancer of the multiple lung cancer cases was categorized as fatal or non-fatal. The distribution and combination of histological types were examined. Results. Relative incidence of lung cancer cases has gradually been increasing in men. Cases with three or more in lung cancers in men gradually decreased from 6% to 4%, from periods II to IV. In men with three or more lung cancers in period III and IV, the peak age increased to the 70's and was significantly older than the total single and fatal lung cancer cases. Small cell carcinoma and large cell carcinoma were significantly frequent among fatal cases and squamous cell carcinoma and adenocarcinoma were more significantly frequent among non-fatal lung cancers. Ninety percent of men with three or more lung cancers and 67% of female triple lung cancer cases occurred in both lungs and all the other cases in these groups occurred in the right lung. This 90% figure for men was significantly more frequent than the 67% for double lung cancers in men. Almost all cases with three or more lung cancers occurred in two or three lobes of the lung. Conclusion. Cases with three or more lung cancers were relatively less frequent than double lung cancer cases. From the histological distribution of fatal and non-fatal lung cancers, small cell carcinoma and large cell carcinoma were suggested to be more malignant than squamous cell carcinoma and adenocarcinoma. It was suggested that the stimuli causing lung cancer act diffusely, not at any single point, but to all lobes of the lung.
key words: Three or more lung cancer, Gender and age, Fatal and non-fatal lung cancers, Histological type, Laterality (right and left) and lung lobes
Received: September 3, 2002
Accepted: February 27, 2003
JJLC 43 (3): 237-246, 2003
