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1 From the Departments of Pulmonary Medicine, Internal Medicine, and Epidemiology and Biostatistics at the Marshfield (Wis) Clinic
Objective: To analyze chest radiographic patterns of lung cancer at presentation by cell type. This current series is compared with historic published data.
Design: Retrospective, using a tumor registry.
Setting: Large, rural multispecialty clinic.
Patients: Three hundred forty-five patients with newly diagnosed lung cancers presenting between October 1990 and August 1992.
Methods: Radiographs were interpreted by two radiologists blinded to cell type. Our results were compared statistically to published data from Mayo Clinic patients in the 1950s and 1960s.
Results: (1) Adenocarcinoma: Decreased presentation as a peripheral tumor in current series (49%) compared with historic control at Mayo (72%); (2) squamous cell: increased presentation as peripheral tumor in current series (43%) compared with historic control (31%); and (3) no statistically significant difference between adenocarcinoma (49%) and squamous (43%) for a presentation as a peripheral mass, or between adenocarcinoma (46%) and squamous (52%) for central origin in the current series of cases.
Conclusion: As adenocarcinoma has increased in relative frequency among lung cancers, the percent of cases with peripheral primary tumors is decreased while central tumors have increased. Squamous carcinoma has had a relative increase in peripheral mass presentation. There is now no significant difference between these two cell types in percent presenting as a peripheral mass or central tumor on chest radiograph.
Key Words: bronchogenic cardinoma • chest radiography • lung adenocarcinoma • pleural effusion • squamous cell lung cancer
Submitted on January 30, 1996
Accepted on July 5, 2007
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