OBJECTIVETo describe the incidence trends and pathological characteristics of lung cancer in urban Beijing, China.

METHODSA total of 32 845 medical records of the residents diagnosed as lung cancer in urban Beijing from 1998 to 2007 were retrieved through the cancer registry system of Beijing Cancer Registry. Crude incidence rate, age-specific incidence rate, adjusted incidence rate by world standardized population, annual percentage change (APC) and histological categorized incidence rate by world standardized population were calculated in order to compare the differences of the incidence trends in different time periods, or among different gender and age groups.

RESULTSA total of 32 845 newly diagnosed lung cancer patients between 1998 and 2007 were included in our study. The crude incidence rate was 47.81/100 000 (32 845/68 704 429), increasing by 38.80% from 39.30/100 000 in 1998 to 54.55/100 000 in 2007 with APC at 3.35% in urban Beijing (Z = 9.984, P < 0.001). While it changed to 28.95/100 000 with an APC at 0.27% (Z = 0.846, P = 0.422) when adjusted by world standardized population. For male, the crude incidence rate was 58.28/100 000 (20 342/34 906 580, adjusted rate at 37.03/100 000, APC at 0.38%, Z = 1.008, P = 0.343); while for female, the crude incidence rate was 36.99/100 000 (12 503/33 797 849, adjusted rate at 21.48/100 000, APC at 0.14%, Z = 0.431, P = 0.678). 17 920 lung cancer patients being diagnosed according to histological evidence, accounted for 54.56%. The respective proportion of the patients with histological diagnosis was 43.14% (1095/2538) in 1998 and 65.55% (2641/4029) in 2007, with a 51.95% increase (χ(2) = 859.152, P < 0.001) in decade. In terms of subtypes of lung cancer, the proportion of squamous cell carcinoma decreased annually, from 30.41% (333/1095) in 1998 to 24.16% (638/2641) in 2007; while the proportion of adenocarcinoma increased from 42.83% (469/1095) to 46.80% (1236/2641). As a result, the squamous cell carcinoma to adenocarcinoma ratio declined from 0.71 (333/469) to 0.52 (638/1236) (χ(2) = 50.214, P < 0.001). For women, the ratio declined more significantly and the proportion of the squamous cell carcinoma and adenocarcinoma were 14.77% (925/6262) and 60.83% (3809/6262), respectively in the period between 1998 and 2007.

CONCLUSIONNo significant change was found in the incidence trend of lung cancer after the incidence rate adjusted by world standard population, but the proportion of the subtypes of lung cancer categorized by histological evaluation changed apparently.

Adenocarcinoma ; epidemiology ; pathology ; Adult ; Aged ; China ; epidemiology ; Female ; Humans ; Incidence ; Lung Neoplasms ; epidemiology ; pathology ; Male ; Middle Aged

OBJECTIVETo investigate and analyze the variation trends in the pathological composition of thyroid cancer patients treated in Tianjin Cancer Hospital from 1954 to 2009.

METHODSTo retrospectively analyze the incidence and clinical features of different pathological types of thyroid cancers in 4342 patients between different time periods from 1954 to 2009.

RESULTSIn the four main pathological types of thyroid cancers, the component ratio of papillary thyroid cancer in every period was 68.1%, 78.3%, 81.3%, 82.1%, 85.8%, respectively, while the morbidity of patients with papillary thyroid carcinoma concurrent with Hashimoto's thyroiditis was increased, so was the proportion of tumors in diameter < or = 2 cm. The proportion of follicular thyroid carcinoma and anaplastic thyroid carcinoma was decreasing accordingly; however, the proportion of medullary thyroid carcinoma did not change significantly.

CONCLUSIONSThe pathological classification of the thyroid carcinoma patients has significant changes in the 4342 cases treated in our Hospital from 1954 to 2009. The proportion of papillary carcinoma is increased, while that of follicular carcinoma and anaplastic carcinoma is decreased. The reasons might attribute to the improved level of consultations and iodized diet or other factors.

Adenocarcinoma, Follicular ; epidemiology ; pathology ; Carcinoma ; epidemiology ; pathology ; Carcinoma, Medullary ; epidemiology ; pathology ; Carcinoma, Papillary ; epidemiology ; pathology ; China ; epidemiology ; Female ; Hashimoto Disease ; complications ; epidemiology ; pathology ; Humans ; Incidence ; Male ; Retrospective Studies ; Thyroid Neoplasms ; complications ; epidemiology ; pathology ; Tumor Burden

The materials used in this study consist 744 gastric resections removed subtotally at the Yonsei University College of Medicine and Severance Hospital during the last 11 years from Jan. 1. 1959 to Dec. 31, 1969. Among these, 446 cases of gastric carcinoma were diagnosed at the Department of Pathology Yonsei University College of Medicine for this same duration. Histopathological studies as well as clinical study on all cases were performed. Summary: 1. Among 744 gastric resections examined during the last 11 years, gastric carcinoma was found in 446 cases, giving an incidence of 59.95% for subtotally removed stomachs. 2. Male to female ratio was 2.28 to 1. The peak age incidence is between 50 and 59 years and accounted for 172cases(35.77%). 3. There is no relation between blood group and incidence of gastric carcinoma. 4. Clinical symptoms in order of frequency were as follows: epigastric discomfort and pain(86%), indigestion(66.67%), weight loss(35.67%), nausea and vomiting(35.33%) and palpable epigastric mass(23.33%). The duration of the chief complaints was usually within six months(54.66%). 5. The gastric acidity disclosed that achlorhydria was found in 36.21%, hypochlorhydria in 32.26% and hyperchlorhydria in 2.15%. 6. The location of the tumor was as follows: 44.86% at the pyloric canal, and 26.53% at the antrum. The size of the tumor varied in diameter. The most frequent size was 3-5cm (43.43%) and 6-10cm(42.90%). 7. On the macroscopical examination, the classification based on Borrmann's gross types and their incidences were as follows: Type I(3.71%), type II(11.22%), type III(62.18%), and type IV(23.64%). 8. On the histological classification, 70% of the cases were adenocarcinomas. Serosal involvement was found in most cases(86.89%). 9. Metastasis to the regional lymphnodes was found in 68.84%, and direct extension of the omentum was 21.39%. 10. According to the relationship between regional lymphnode metastases and lymphatic permeation, and relationship between lymphatic permeation and histologic type, the degree of lymphatic permeation is more, the more metastases to regional lymphnode is found. And metastasis to regional lymphnode and lymphatic permeation is more common in adenocarcinoma than other types. 11. There is no relationship between intestinal metaplasia and histologic type. But each histologic type was accompanied by intestinal metaplasia frequently. In conclusion based on the above findings, it can be stated that gastric carcinoma among Koreans exhibited a far advanced stage, both clinically and morphologically.
Adenocarcinoma/pathology* ; Adenocarcinoma, Mucinous/pathology* ; Adult ; Aged ; Carcinoma/pathology* ; Female ; Human ; Korea ; Male ; Metaplasia/epidemiology ; Middle Age ; Neoplasm Metastasis ; Sex Factors ; Statistics ; Stomach Neoplasms/epidemiology ; Stomach Neoplasms/pathology*

Although there is a controversy, several reports have shown that gastric cardia cancer has tended upwards in recent years. The aim of this study was to investigate the changing trend of stomach cancer according to the location of cancer and histologic type in Korea, where is known to be one of the most prevalent areas for gastric cancer. All the patients newly diagnosed as gastric cancer from 1991 through 2000 were recruited in Hallym University Medical Center. The periods were divided into the first (1991 through 1995) and the second (1996 through 2000) period. We analyzed the characteristics of cancer in the aspects of age, sex, tumor locations (cardia and non-cardia), and tumor grade of differentiation (well, moderate, and poor differentiated type). The number of cases was 2,395 and that of cardia cancer was 158 (6.6%). There was no evidence about the changes in the incidence of cardia cancer and histologic differentiation between two periods. The development of cardia cancer was not associated with the factors of age and sex with having no difference in the point of tumor grade. We could not find an upward tendency of cardia cancer development in recent 10 yr in Korea.
Adenocarcinoma/epidemiology* ; Adenocarcinoma/pathology ; Cardia* ; Cell Differentiation ; Comparative Study ; Female ; Human ; Incidence ; Korea/epidemiology ; Male ; Morbidity/trends ; Retrospective Studies ; Stomach Neoplasms/epidemiology* ; Stomach Neoplasms/pathology

To determine the cytologic and histologic correlation of atypical glandular cells of undetermined significance (AGUS) in Papanicolaou smears, a cytology file from January 1998 to May 1999 was reviewed. Surgical pathology files were searched to determine which patients received subsequent biopsies. One hundred thirty-two patients with AGUS were identified. Corresponding biopsies were available for 82 of these cases. AGUS has been sub-classified into 3 subtypes: 1) AGUS, favor reactive; 2) AGUS, not otherwise specified; and 3) AGUS, favor neoplasia. The pathologic findings for the respective Papanicolaou smears with the diagnosis of each subtype of AGUS through the follow-up period were as follows: benign lesions in 56.1%, 0%, and 1.2%; squamous intraepithelial lesions 2.4%, 0%, and 1.2%; glandular intraepithelial lesions 0%, 0%, and 17.1%; endometrial simple hyperplasia 1.2%, 0%, and 0%; and carcinoma 0%, 9.8%, and 11%, respectively. In conclusion, AGUS, on cervical cytologic screening, was correlated with significant pathologic findings in 41.5% of the patients (37.8% with preinvasive or invasive glandular lesions and 9.6% with combined squamous intraepithelial lesions). It is thought that intensive follow-up studies, including colposcopy, cervical biopsy, and curettage, should be recommended for complete evaluation of AGUS.
Adenocarcinoma/epidemiology/*pathology ; Adult ; Aged ; Biopsy ; Cervix Neoplasms/epidemiology/*pathology ; Cervix Uteri/pathology ; Endometrial Hyperplasia/epidemiology/*pathology ; Female ; Human ; Incidence ; Middle Age ; Prevalence ; Vaginal Smears

OBJECTIVETo analyze the clinical features of patients with gallbladder cancer from 17 hospitals in 5 Northwestern provinces (autonomous region) of China from 2009 to 2013.

METHODSA total of 2 379 cases with gallbladder cancer in 17 tertiary hospitals from 5 Northwestern provinces of China from January 2009 to December 2013 were reviewed retrospectively. The clinical data was collected by standardized "Questionnaire for Clinical Survey of Gallbladder Cancer in Northwestern Area of China". χ² test was used to analyze the data.

RESULTS(1) Gallbladder cancer from 17 hospitals accounted for 1.6%-6.8% of all bile tract diseases from 2009 to 2013 in Northwestern China, average was 2.7%. Gallbladder cancer accounted for 0.4%-0.9% of abdominal surgery, average was 0.7%. (2) The incidence of gallbladder cancer was higher in the aged females, the ration of female to male was 1.0 to 2.1. The average age of gallbladder cancer was (64 ± 11) years. The occupation of patients was mainly farmers (χ² = 147.10, P < 0.01). (3) 57.2% of the gallbladder cancers were associated with gallstones. (4) The main pathological patterns of gallbladder cancer were moderate and poor differentiated adenocarcinoma, showing an aggressive malignancy. TNM stage IV accounted for 55.1% of all cases, which was associated with the poor prognosis. (5) The curative resection rate was 30.4%.

CONCLUSIONSGallbladder cancer is common in the aged females and mainly at advanced stage. The screening and follow-up of high-risk groups with ultrasound and other methods regularly could increase the early diagnosis rate of gallbladder cancer, aggressive surgical resection combined with other comprehensive treatment could improve the prognosis of patients.

Adenocarcinoma ; epidemiology ; pathology ; Aged ; China ; epidemiology ; Female ; Gallbladder Neoplasms ; epidemiology ; pathology ; Gallstones ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

OBJECTIVE: To investigate trends in the incidence of epithelial ovarian cancer (EOC), according to histologic subtypes, in Korean women between 1999 and 2012. METHODS: Data from the Korea Central Cancer Registry recorded between 1999 and 2012 were evaluated. The incidences of EOC histologic subtypes were counted. Age-standardized incidence rates (ASRs) and annual percentage changes (APCs) in incidence rates were calculated. Patient data were divided into three groups based on age (<40, 40 to 59, and >59 years), and age-specific incidence rates were compared. RESULTS: Overall, the incidence of EOC has increased. Annual EOC cases increased from 922 in 1999 to 1,775 in 2012. In 1999, the ASR was 3.52 per 100,000 and increased to 4.79 per 100,000 in 2012 (APC, 2.53%; p<0.001). The ASRs in 2012 and APCs between 1999 and 2012 for the four major histologic subtypes were as follows (in order of incidence): serous carcinoma (ASR, 2.32 per 100,000; APC, 4.34%; p<0.001), mucinous carcinoma (ASR, 0.73 per 100,000; APC, -1.05%; p=0.131), endometrioid carcinoma (ASR, 0.51 per 100,000; APC, 1.48%; p=0.032), and clear cell carcinoma (ASR, 0.50 per 100,000; APC, 8.13%; p<0.001). In the sub-analyses based on age, clear cell carcinoma was confirmed as the histologic subtype whose incidence had increased the most since 1999. CONCLUSION: The incidence of EOC is increasing in Korea. Among the histologic subtypes, the incidence of clear cell carcinoma has increased markedly across all age groups since 1999.
Adenocarcinoma, Clear Cell/epidemiology/pathology ; Adenocarcinoma, Mucinous/epidemiology/pathology ; Adult ; Age Distribution ; Aged ; Carcinoma, Endometrioid/epidemiology/pathology ; Cystadenocarcinoma, Serous/epidemiology/pathology ; Databases, Factual ; Female ; Humans ; Incidence ; Middle Aged ; Neoplasms, Glandular and Epithelial/*epidemiology/pathology ; Ovarian Neoplasms/*epidemiology/pathology ; Registries ; Republic of Korea/epidemiology

OBJECTIVETo evaluate the changing trends in clinicopathological characteristics of patients with gastric carcinoma undergoing surgery between 1979 and 2008.

METHODSTwo thousand seven hundred and fifteen patients with gastric cancer who received operation in Liaocheng People's hospital between 1979 and 2008 were analyzed retrospectively, and were compared to 168 patients between 1974 and 1978. Categorical data were evaluated with Chi-squared or Fisher's exact test. Quantitative data were analyzed with nonparametric test. Time series analysis was used to evaluate the changing trend of data.

RESULTSThe male to female ratio during 1979-2008 was 3.393, which was higher than that (1.897) during 1974-1978 (χ2=12.193, P<0.01). The median age (59 years) during 1979-2008 was higher than that (53.5 years) during 1974-1978 (z=-6.294 P<0.01). Comparing the tumor distribution of gastric cancer during 1979-2008 with that during 1974-1978, proportion of gastric cardia and fundus cancer was higher (45.7% vs. 13.0%, χ2=56.596, P<0.01), while the proportion of gastric antrum cancer was lower (44.9% vs. 73.2%, χ2=53.980, P<0.01). There was no significant difference in gastric body cancer (13.8% vs. 9.4%, χ2=2.026, P=0.155). Compared to 1994-1998, there were more poorly differentiated adenocarcinomas during 2004-2008 (62.1% vs. 51.7%, χ2=12.267, P<0.01), and there were less tubular adenocarcinomas during 2004-2008 (23.9% vs. 31.8%, χ2=8.78, P<0.01). Time series analysis showed the patient age during 1979 to 2008 increased (Root mean square error=1.275, R-square=0.702), gastric cardia and fundus cancer was increasing and antrum cancer was decreasing (Root mean square error=0.055, R-square=0.798).

CONCLUSIONSIn the past 30 years from 1979 to 2008, the male to female ratio and the median age of surgical patients with gastric cancer increased with time. The gastric cardia and fundus cancer increased over time, however antrum cancer decreased with time. In the past 15 years from 1994 to 2008, the proportion of poorly differentiated adenocarcinoma increased, and that of tubular adenocarcinoma declined.

Adenocarcinoma ; epidemiology ; pathology ; surgery ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sex Ratio ; Stomach Neoplasms ; epidemiology ; pathology ; surgery

Sixteen cases of male breast cancer seen over a 20-year period were reviewed. The causes of cancer of the male breast are no better understood, but major alterations in hormonal environment could be a significant factor. Some clinical characteristics correspond well with the results of other series. The median age at presentation was 61.7 years. The most frequent initial symptom was a painless mass, and the incidences of nipple discharge, central tumor location, and axillary node involvement were high. Males also had a higher incidence of local advancement which was associated with a longer delay in seeking treatment and small breast tissue. The pathologic type was infiltrating ductal type in all cases except one, and all cases showed favorable nuclear grade. Estrogen receptor analysis was performed from the tumor of 2 patients. Both of them showed a high receptor level. There was no locoregional relapse in 5 patients who received adjuvant radiotherapy in contrast to the 2 relapses in 3 patients who underwent surgery alone. And three of the five patients who received radiotherapy suffered from systemic metastasis which suggested the important role of adjuvant chemotherapy as well as radiotherapy. In light of the encouraging results about adjuvant chemotherapy in the treatment for female breast cancer with axillary lymph node involvement, it would be desirable to extend this policy to male breast cancer.
Adenocarcinoma/epidemiology ; Adult ; Aged ; Breast Neoplasms/*epidemiology/pathology/therapy ; Carcinoma, Intraductal, Noninfiltrating/*epidemiology/pathology/therapy ; Combined Modality Therapy ; Human ; Korea/epidemiology ; Lymphatic Metastasis ; Male ; Middle Age ; Neoplasms, Multiple Primary ; Retrospective Studies

Esophageal cancer is the 7th leading cause of cancer deaths worldwide. While squamous cell carcinoma is the most prevalent histology internationally, adenocarcinoma of the distal esophagus accounts for nearly 50% of cases in developed countries due to the differences in the etiologic factors such as gastroesophageal reflux disease (GERD) and obesity that predominate. While surgery is the mainstay of treatment of this disease, the utilization of chemoradiation, either used postoperatively or neoadjuvantly, has become a standard practice in the United States. What is the optimal management approach is still an area of contention, however, and may be different in different regions around the world. This article reviews some of these controversies, including the role for surgery in patients treated with definitive chemoradiation. At the end, we will also outline recommendations regarding radiotherapy procedures and techniques.
Adenocarcinoma ; diagnosis ; epidemiology ; pathology ; therapy ; Carcinoma, Squamous Cell ; diagnosis ; epidemiology ; pathology ; therapy ; Chemoradiotherapy ; Esophageal Neoplasms ; diagnosis ; epidemiology ; pathology ; therapy ; Esophagectomy ; methods ; Humans ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Risk Factors