The association between atypical adenomatous hyperplasia and primary lung cancer.
Atypical adenomatous hyperplasia (AAH) has been suggested as the adenoma in an adenoma-carcinoma sequence in the lung periphery. From 1989-1998, we undertook a systematic, prospective search for AAH in lungs resected for cancer. AAH was found in 67 of 554 patients (12. 1%) with primary lung carcinoma (9.2% in male patients and 19.0% in females). AAH was found in lungs bearing adenocarcinoma (23.2%) more frequently than with large cell undifferentiated carcinoma (12.5%) or squamous carcinoma (3.3%). A greater percentage of females with adenocarcinoma had AAH (30.2%) than did males with adenocarcinoma (18.8%). Numbers of AAH ranged from 1-42 per patient and more patients had small numbers of AAH, although 12 patients had 6 or more AAH foci. Larger numbers of AAH tended to be found in adenocarcinoma-bearing lungs. Ten of the 67 patients with AAH and primary lung carcinoma (15%) had multiple primary cancers (range 2-6), all of which were adenocarcinoma. Synchronous cancers were rare in lung tumour-bearing resections without AAH. Patients with AAH show no difference in post-operative survival to those without, for all stages of carcinoma and for Stage I disease alone. This study provides evidence for a strong association between atypical adenomatous hyperplasia and primary lung adenocarcinoma and lends weight to the AAH/adenoma-carcinoma hypothesis.
Chapman
A D
AD
Department of Pathology, Aberdeen Royal Infirmary and Aberdeen University Medical School, Foresterhill, Aberdeen, AB25 2ZD, UK.
Kerr
K M
KM
D000230:Adenocarcinoma / Q000150:complications / Q000401:mortality / Q000473:pathology; D018255:Adenomatosis, Pulmonary / Q000150:complications / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018287:Carcinoma, Large Cell / Q000150:complications / Q000401:mortality / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000401:mortality / Q000473:pathology*; D008175:Lung Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000401:mortality / Q000473:pathology*; D011446:Prospective Studies