| Background:Lung cancer has become the most commonly diagnosed cancer and the leading cause of cancer death in China.There are an estimated 733,300 new cases and 610,200 deaths of lung cancer in China in 2015.Regrettably,since the incomplete registration of case information,the clinical profiles of lung cancer patients in the mainland of China,such as histologic composition,staging proportion,smoking prevalence and gene mutation profiles,are rarely reported and largely unknown.On the other hand,in China,the estimated mortality of lung cancer is significantly higher than the world average,which is related to the neglect of early finding and diagnosis.It is reported that approximately two-thirds of patients are diagnosed at the advanced stage.During the past five years,a rising Chinese population,especially people in East China,is covered by medical insurance and routine physical examinations.Thus,more patients with early-stage lung cancer can be found.Objective:In this study,we analyzed the characteristics and variation trends of newly diagnosed lung cancer cases during the past five years in an academic tertiary care hospital of East China,and aimed to demonstrate some clinical profiles of Chinese lung cancer.Methods:The data came from an academic tertiary care hospital of East China.Patients who were newly diagnosed as lung cancer from 2011 to 2015 were enrolled.All new cases got pathological supports by lung biopsy or surge ry.Tumor staging was performed according to the seventh edition of the Tumor Node Metastasis(TNM)classification of malignant tumors.The patients' disease information was collected from the database of the hospital information system.Results:From 2011 to 2015,aggregately 5779 patients,including 3719 males and 2060 females,were diagnosed as lung cancer.The major histologic subtypes of lung cancer were adenocarcinoma(ADC,60.0%),squamous cell carcinoma(SCC,25.6%),small cell lung cancer(SCLC,8.5%),large cell carcinoma(0.6%),adenosquamous carcinoma(1%),other non-small cell carcinoma(1.6%)and unclassified or rare carcinoma(2.8%).ADC proportion of female was much higher than that of male.During the past five years,the proportion of patients who diagnosed by routine chest examination of asymptomatic lung cancers rose gradually from 21.6%to 27.5%.The proportion of ADC increased gradually from 54.1%to 62.5%,whereas SCC decreased from 31.8%to 23.4%.A higher proportion of advanced stage(Stage ?B&?)of lung cancer existed in patients who were admitted to hospital due to respiratory or cancer related symptoms(RCRS)than those without RCRS.Smoking rate in male patients reached 80.2%,while it was only 2.7%in females.EGFR mutation existed in 66%of female and 37%of male patients with ADC.Exon21 L858R and Exon19 DEL were the most common mutation types,which consisted of 91%in female and 88%in male among all mutation types.Of all the 61 SCC patients who took gene detection,only one case was proved positive for EGFR mutation.6 patients were also found EGFR mutation among total 8 patients of adenosquamous carcinoma.Conclusions:This study demonstrates the clinicopathologic characteristics of lung cancer patients from East China,including histologic composition,staging proportion,smoking prevalence and gene mutation status.Our study showed several clinical profiles of Chinese lung cancer patients:(1)Adenocarcinoma was the most common histologic subtype which reached 86.9%in females.It may related to the low smoking rate in Chinese women.(2)During past five years,the proportion of patients who diagnosed by routine chest examination of asymptomatic lung cancers rose gradually.(3)During past five years,the proportion of ADC increased gradually,whereas SCC decreased.(4)A higher proportion of advanced stage(Stage ?B&?)of lung cancer existed in patients with RCRS than those without RCRS.Regular CT scan can find more patients in early stage.(5)EGFR mutation existed in 66%of female and 37%of male patients with ADC.Exon21 L858R and Exon19 DEL were the most common mutation types. |
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