ISSN: 0975766X CODEN: IJPTFI Available Online through Research Article www.ijptonline.com STUDYING THE AGE DISTRIBUTION AND FREQUENCY OF NEOPLASMS AND HISTOPATHOLOGICAL EVALUATION OF LUNG IN HOSPITALS OF AHVAZ UNIVERSITY OF MEDICAL SCIENCES IN 2003 2007 YEARS Nepton Emadmostofi *1, Arman Azmun 2 1 Department of Pathology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 2 School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Received on 10072016 Accepted on 26082016 Abstract Lung cancer is one the most common cause of cancer death in both sexes and due to the increased smoking prevalence in communities in recent years. The prevalence of lung cancer is almost 2 to 1 in men than women, but the ratio is gradually being reduced. Additionally, more than 50% of patients had distant metastases at diagnosis time, and more than 90% were over 40 years old. Clinical signs in order of frequency include: cough, weight loss, pain, confusion, homotization, fatigue, fever and symptoms associated with neoplastic syndrome. In this research that was descriptive epidemiologic type, 97 cases of biopsy confirmed lung cancer were examined, and then they were analyzed, so that the most common histopathologic lung cancers were squamous cell and next small cell cancer. The prevalence of lung cancer had ratio of 2 to 1 among male compared to female and the most common age group involved in the study was 7061 years. Keyword: Lung cancer, Homotization, Neoplastic Syndrom. Introduction Lung without any doubt is the most common cause of cancer death in both sexes as is responsible for almost onethird of cancer deaths in men's and recently and is the main cause of cancer death in women as well. According to the America Cancer Society in 2006, about 172000 people were diagnosed with lung cancer that 163000 deaths were reported (1). Lung cancer has become more common over the last 50 years. The increase is observed in both sexes and includes all main types of microscopy. Speed of increase is lower among men, but among women continues is increasing rapidly after 1987, while every year more women die due to lung cancer compared to the breast cancer. The statistics undoubtedly are related to the causal relationship between smoking and bronchogenic IJPT Sep2016 Vol. 8 Issue No.3 1748517490 Page 17485
(2). The maximum incidence of lung cancer have been reported between the ages of 70 and 60 years old, at present, ratio is about 2: 1 in male to female. At the time of diagnosis, more than 50% of patients have distant metastasis and in a quarter of cases had the regional lymph nodes were involved. Lung cancer prognosis is very bad and depends on many factors such as age, sex, tumor location, tumor size, and so on. Survival rate of 5 years is 15%. Even patients with limited lung disease have 5year survival rate for about 45% (3). Smoking, exposure to polycyclic aromatic hydrocarbons, arsenic, nickel, BCME compounds, vinyl chloride, X (Radation) (particularly in patients with uranium and radon deal) and asbestos have been proposed as the main pathology of lung cancer (38). However, the role of smoking in creating lung cancer is more important than the effects of other factors where 90% of the patients with lung cancer are smokers or were current smokers (4). Long term prognosis of lung is poor and, unfortunately, in recent years its progress has been made in improving (4, 9). The standard treatment for lung, based on the type of and its stage can be entirely removal of thoracotomy, pneumonectomy, and lobectomy or rarely removal of segmented. Radiotherapy controls local progression of tumor effectively and sometimes it leads to long term survival; however, it has been unsuccessful for treatment of many of patients because in 50% of them distant metastasis is observed at the time of recognition or a short time after recognition. Multidrug chemotherapy is currently the treatment of choice for small cell. However, some studies have reported that for a specific group of patient, the surgery alone is the most efficient treatment approach. In a study by Chan ticklee in Seoul Medical University, it was found that the most common form of lung cancer was squamous cell (44.7%), and then adeno (%27.9), smallcell (%16.8), respectively. Bronchoalveolar (%2.2) and large cell (%5.1) were the most common. In a study by Jelena Astvysych and colleagues at the Medical University of Belgrade, it was concluded that squamous cell was the most common in terms of the incidence and prevalence of lung cancer in 1042 women with lung cancer in terms of histologically confirmed (%45.7) and then was adeno (28.2%) and smallcell (%22.2) respectively. In terms of age, the highest rate of lung cancer prevalence in women between was 7061 years old and then was women 6051yearold age group had the highest value (5). In a study conducted by Samira Elkide on the prevalence lung cacer in several countries of the Middle East and comparing it with the prevalence this cancer in the United States it was proved that be its prevalence in the Middle East was much lower than United States (6). The main objective of this study was to determine age and frequency of neoplasms and lung histopathology in hospitals of Ahvaz University of Medical Sciences in 2003 2077 years. IJPT Sep2016 Vol. 8 Issue No.3 1748517490 Page 17486
Statistical analysis of biopsy samples confirmed as lung cancer helped to determine the status of epidemiological lung cancer of age and sex, as well as its histologic type. Materials and Methods This is a retrospective descriptive epidemiologic study that is conducted based on hospital data. In this study, the data collected while observing ethical integrity, based on information available at the offices of the Department of Pathology, University Hospitals of Ahvaz. At first, the offices of the Department of Pathology were visited in order to and determining patients with pathologically confirmed diagnosis of lung cancer. After that information including age, gender, histological type of lesion, location, and anatomic lesions were collected and were adjust in extract tables. All the pathological reports of lung cancer in the years of 2003 2077 in Ahvaz Jondishapour University hospitals were studied. The results of the study were analyzed using SPSS system. Results In the present study, we evaluated the records of 97 patients, including 67 men (69%) and 30 women (31%). The most frequent histopathologic lung cancer obligated to squamous cell, small cell, adeno, large cell, broncho alveolar and metastatic type (Figure 1). 60 55/67% 50 40 30 25/77% 20 10 7/21% 4/12% 1/03% 6/8% 0 Squamous cell Small Cell Carcinoma Adenocarci noma Figure1: The prevalence of neoplastic lesions of the lung histopathology. Prevalence of neoplastic lesions based on sex is presented in Table 1. Table1: Prevalence of neoplastic lesions according to sex. Larg Cell Carcinoma bronchiole alveolar metastatic Series 1 54 25 7 4 1 6 squamous cell metaltatic broncho alveolar large cell adeno small cell squamous cell 33.3% 0 25% 42.86% 40% 25.93% women 66.6% 100 75% 57.14% 60% 74.07% Men IJPT Sep2016 Vol. 8 Issue No.3 1748517490 Page 17487
The age distribution of neoplastic lung lesions is presented in Table 2. As it can be seen most frequently between the ages of 61 to 70 years and the lowest has been in age ranges less than 50 years. Table2: Age distribution of neoplastic lesions of the lung. <50 5060 6170 >71 Age 8 20 39 30 Number 8.24% 20.61% 40.2% 30.92% Percentage Table3: The overall distribution of anatomic lesions of the lung biopsy showed that of the three anatomical regions of the bronchial, bronchus and pleura originate. squamous cell small cell Adeno large cell broncho alveolar Metaltatic lesions Bronchial 16 29.62% 15 60% 5 71.42% 4 100% 1 100% 2 33.3% Bronchos 70.37% 10 40% 1 14.28% 4 66.6% pleura 1 14.28% Discussion and Conclusion In this study that was conducted as epidemiologic descriptive and retrospective over a period of 6 years from 2003 to 2007, the biopsy confirmed 97 cases of lung cancer were extracted and examined. Based on the classification of age in the four age groups, the highest incidence of cancer of the lung was in the age group of 6170 years (39 cases), that accounted for 40.2% while the age group above 71 years included 30 cases which accounted for 30.92%. There were 20 patients in the age group 6050 years as% 20.61 and were age less than 50 years ultimately included 8 cases with 8.24% as the lowest. In addition, in this study the mean age of patients was 66 years, according to a study at the Medical University in Seoul and colleagues; mean age of patients was 62 years and the largest age group was 6069 years involved with 39.3% and after that was also 26% of patients over 70 years old that had the highest prevalence (5). Also in this study, 9.97% of patients at diagnosis than 40 years, according to reference books more than 90% of the cases diagnosed are over age 40. IJPT Sep2016 Vol. 8 Issue No.3 1748517490 Page 17488
Based on the gender classification, among the studied 97 subjects, 67 were male and 30 were female, respectively, as 69.08%, and 30.92%, so that it can be said that the ratio of male to female was 4, and in reference books also the same prevalence rate of lung cancer has been reported in men than in women. The study of Rita at the University of Finland had showed that among 602 cases of cancer and pulmonary, 510 cases were men (84%) and 92 were women (16%) while in the study of Blake at the University of Kingstone among 1450 subjects with lung cancer 1145 were men (78.96%) and 305 were females (21.03%), respectively (7). Previous studies investigating the risk factors and prognostics of similar cancers have shown a close correlation between specific biomarkers and the diseases progression. The histopathological lesions categorization demonstrated in terms of the incidence of neoplastic lung following results were obtained respectively. Including 54 cases of squamous cell that% 55.67% of all cases constituted. Among these 54 cases, 40 cases were male (74.07%) and 14 were females (25.93 %). The mean age of patients in this group was 62 years. Carcinoma of small cells 25 to 25.77% of the total cases were total 25 cases, 15 cases were male (60%) and 10 were women (40%), respectively. The mean age of patients in this group was 7.69. There were 7 cases of adeno as 7.21% in the category. Four of 7 men (57.14) and two women (%42.86), respectively. In addition, this group mean age of patients was 76 years. Large cell, including 4% who were 12 quarters of the patients were included, of 3 men (75%) and 1 was woman (25 percent). The mean age of patients was 67 years in this category. Broncho alevolar s included one man who was only 1.03% of lung cancer category. In this study, 97 cases of Pyvspy confirmed six cases of metastatic lesions which %18.6 of the total cases were from the 6 with 4 male (66.66%) and two females (33.33%) and the Group the mean age of patients in 2.65 years. In this study, lung squamous cell was the most common neoplastic lesions that were matched with references. But then small cell was at the second place while on textbooks it placed after squamous cell and smallcell and adeno had the highest rate. The study of anatomical samples resulted in the followings: from 54 cases of squamous cell, 38 (70.37%) of Bronchos and 16 (29.61%) of bronchial biopsy were 25 cases of smallcell in 15 patients (60 %) of Bronchial and 10 (40%) of the bronchus were taken. Five of 7 cases of adeno patients (71.42%) of bronchial Affairs (14.28%) of Bronchos and 1 (14.28%) were from pleural biopsy. There were 4 cases of large cell, all cases (100%) of bronchial biopsies. Carcinoma of the bronchial biopsy was the only Broncho alveolar. Six cases of metastatic lesions in lung and 4 cases (66.6%) of bronchus and 2 cases (33.3%) of bronchial were taken. A total of 97 cases of biopsy, 53 patients (54.63%) of the bronchus, 43 (44.32%) of bronchial and 1 case (1.03%) had biopsy of the pleura. Based IJPT Sep2016 Vol. 8 Issue No.3 1748517490 Page 17489
on the of geographical distribution of the 97 patients, there were 52 people from Ahvaz and suburban (52.60%), 12 patients from Dezful (12.37%), 8 patients living in Masjed Soleyman (8.24%), seven residents of Abadan (7.21%), 7 residents and Baghmalek (7.29%), 5 patients from Shushtar (5.15%), four residents Rāmhormoz (4.21%) and 2 patients also lived in Behbahan (2.06), respectively. References 1. Richardson J, Jonson B. The biology of lung cancer. Semin Oncol 1993, 20: 105127. 1993. 2. Sikl H. The present status of knowledge about the Jachymov disease (Cancer of the lungs in the miners of the radium mines). Acta Un int Cancr. 1950;6:136675. 3. Krauss S, Macy S, Ichiki AT. A study of immunoreactive calcitonin (CT), adrenocorticotropic hormone (ACTH) and carcinoembryonic antigen (CEA) in lung cancer and other malignancies. Cancer. 1981;47(10):248592. 4. Fouci A, Braunwal E, Kasper D, Hausers, lonqo D, Jameson L, loscalzot. Harrison,s principles of Internal medicine. 17 th. Newyork:Mcc Hill; 2008. p 52530. 2008. 5. Lee CT. Epidemiology of lung cancer in Korea. Cancer Res Treat. 2002;34(1):37. 6. Samir Al Kayed, M.Bassam Qasem. Lung Cancer Middle East Cancer Consortium (MECC) cancer in cadence. 2005;63565. 2005. 7. Makitaro Ritta. Prevalence of lung cancer in Oculu. 2002;218230. 2002. 8. Ger L, Liou S, Shen C, Kao S, Chen K. [Risk factors of lung cancer]. Journal of the Formosan Medical Association= Taiwan yi zhi. 1992;91:S22231. 9. Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A, et al. Risk factors for lung cancer and for intervention effects in CARET, the BetaCarotene and Retinol Efficacy Trial. Journal of the National Cancer Institute. 1996;88(21):15509. Corresponding Author: Nepton Emadmostofi* Email: emadmostofin@ajums.ac.ir IJPT Sep2016 Vol. 8 Issue No.3 1748517490 Page 17490