title: Is there a relationship between the presence of lung mucosa preinvasive lesions and lung cancer incidence? Influence of tobacco consumption.
abstract: Although studied for years, the nature of the relationships between tobacco consumption, bronchial preinvasive lesions and lung cancer are still not completely elucidated. Objectives were to determine the relationship between tobacco consumption and lung mucosa preinvasive and invasive lesions and to describe patients' evolution according to baseline characteristics.
  
  
  METHODS
  Bronchial biopsy specimens were taken at six predetermined sites in 156 males, current smokers, aged above 18 years. Relationships between smoking characteristics and preinvasive lesions indexes and between baseline characteristics and lung cancer occurrence during a prospective follow-up were examined.
  
  
  RESULTS
  Maximum grade was hyperplasia for 16.7% of patients, metaplasia 33.3%, dysplasia 25.0%, and carcinoma in situ 1.3%. For 23.7% of patients, all biopsies were considered normal. Preinvasive lesion indexes were related to smoking intensity (cigarettes/day). Lung cancer incidence during the follow-up was 19.9%. No association between severity of mucosa lesions at baseline and incidence of cancer during the follow-up period was observed.
  
  
  CONCLUSIONS
  The majority of smokers had mucosa lesions, but a relatively small number of them would have a cancer, and there was a poor correlation between severity of mucosalesions and incidence of cancer. Even if an evolution from preinvasive lesions to an invasive cancer is plausible and coherent with current concepts, this link does not appear strong enough to recommend the use of systematic classic endoscopy for targeting of a sub-group of higher risk smokers who would require a closer follow up.
authors.affiliation: Chest Department, University Hospital of Nancy, Nancy, France; Research Team EA7298, INGRES, Lorraine University, Medical School, Lorraine, France. Electronic address: christelle.clementduchene@gmail.com.
authors.forename: Christelle
authors.initials: C
authors.lastname: Clément-Duchêne
authors.affiliation: Epidemiology, University Hospital of Nancy, Nancy, France.
authors.forename: François
authors.initials: F
authors.lastname: Alla
authors.affiliation: Pathology Department, University Hospital of Nancy, Nancy, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Gauchotte
authors.affiliation: Pathology Department, University Hospital of Nancy, Nancy, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Marie
authors.affiliation: Chest Department, University Hospital of Nancy, Nancy, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Carnin
authors.affiliation: Chest Department, University Hospital of Nancy, Nancy, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Menard
authors.affiliation: Pathology Department, University Hospital of Nancy, Nancy, France; Centre de Ressources Biologiques, University Hospital of Nancy, Nancy, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Vignaud
authors.affiliation: Chest Department, University Hospital of Nancy, Nancy, France; Research Team EA7298, INGRES, Lorraine University, Medical School, Lorraine, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Martinet
mesh_terms: D000328:Adult; D004947:Esophagus / Q000473:pathology; D006801:Humans; D006965:Hyperplasia / Q000453:epidemiology / Q000209:etiology; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D020545:Respiratory Mucosa / Q000473:pathology*; D012907:Smoking / Q000009:adverse effects*
keywords: Bronchial pre-invasive lesions; Lung cancer; Tobacco smoking