The implication of background anthracosis in the development and progression of pulmonary adenocarcinoma

Abstract

In order to characterize the relationship between background anthracosis and pulmonary adenocarcinogenesis, surgically resected tissues of 66 cases of stage I pulmonary adenocarcinoma, 4 cm or less at their greatest dimension, were examined. These cases were diagnosed based on the classification of small-sized adenocarcinoma of the lung (Noguchi et al., Cancer 75, 1995). Thirteen cases were diagnosed as types A (localized bronchioloalveolar adenocarcinoma, LBAC) and B (LBAC with alveolar collapse), 40 cases as type C (LBAC with a focus of fibroblastic proliferation), 8 as type D (poorly differentiated adenocarcinoma) and 5 as types E (bronchial gland type adenocarcinoma) and F (true papillary adenocarcinoma). The 5-year survival rate of types A and B cases was 100%, while those of type C, type D and types E and F were 52%, 48% and 39%, respectively. Nuclear accumulation of abnormal p53 protein in non-replacement type adenocarcinomas (types D, E and F) was detected more frequently than that in replacement type adenocarcinomas (types A, B and C) (P < < < <0.05). In each case, black dusty material was extracted from tumorous lesions and non-tumorous regions and blotted onto a nitrocellulose membrane. The anthracotic index (AI) was calculated with a densitometer. AIs of non-tumorous regions in early and replacement type adenocarcinomas (types A and B) were significantly less than in relatively advanced (type C) and poorly differentiated (type D) adenocarcinomas (P < < < <0.05). These results indicated that adenocarcinoma developing in heavily anthracotic lungs readily progresses to an advanced stage, or that adenocarcinoma with a less favorable prognosis tends to develop in severely anthracotic lungs. (Cancer Sci 2003; 94: 707-711) ulmonary adenocarcinoma is the most common histological type of lung cancer in Japan, the USA and other countries. Its incidence is increasing, but the reason for this is not understood.1, 2) Some researchers have hypothesized that there are two, possibly related, reasons: one is the advances in diagnostic technology for lung cancer, such as thin-slice computed tomography (CT), which may have led to an apparently greater incidence owing to improved detection; the other is changes in cigarette design or smoking habits.3) However, the role of cigarette smoke is still controversial in comparison with the cases of squamous cell carcinoma and small cell carcinoma. [4][5][6] With the recent advances in radiology, many small early adenocarcinomas are now being detected by mass screening. Small adenocarcinomas have been clinicopathologically subclassified into 6 subtypes by Noguchi et al. 7) Briefly, the tumors were classified into two groups: replacement type adenocarcinoma and non-replacement type adenocarcinoma. The former is subdivided into three subtypes: localized bronchioloalveolar carcinoma (LBAC) (type A), LBAC with alveolar collapse (type B), and LBAC with foci of fibroblastic proliferation (type C). The nonreplacement type is also subdivided into three subtypes: poorly differentia...

Epigenetic clustering of lung adenocarcinomas based on DNA methylation profiles in adjacent lung tissue: Its correlation with smoking history and chronic obstructive pulmonary disease

“…Histological diagnosis and grading were based on the 2004 World Health Organization classification 24. When, within a tumor, black dusty material25 is seen to have accumulated in foci of active fibroblast proliferation, reflecting active cancer–stromal interaction associated with a poorer outcome in LADC patients,26 the tumor is considered to be tumor anthracosis-positive (Supporting Information Fig. S1).…”

Anthracotic index and DNA methylation status of sputum contents can be used for identifying the population at risk of lung carcinoma

“…Black dust matter and DNA samples were extracted according to the method reported previously, with some modifications 2–4. After morphologic examination and diagnosis, the remaining sputum specimen was stored in Saccamano's solution17 until black dust particles and DNA specimens were extracted.…”

“…Black matter deposition (anthracosis) is correlated closely with exposure to chemical carcinogens such as polycyclic aromatic hydrocarbons 1. Hou et al2, 3 and Wang et al4 examined background anthracosis in pulmonary adenocarcinoma using autopsy cases and surgically treated patients, respectively, and demonstrated a strong correlation between the degree of black dust matter deposition and histologic differentiation of the adenocarcinomas and/or histologic subtypes of small‐sized adenocarcinoma. They indicated that patients with severe anthracosis tended to have a poorer prognosis than those with mild anthracosis and that adenocarcinoma that develops in heavily anthracotic lungs readily progresses to an advanced stage or that adenocarcinoma with a less favorable prognosis tends to develop in severely anthracotic lungs.…”

The association between bronchial anthracofibrosis and pneumoconiosis: A retrospective cross‐sectional study

“…Other studies have observed the opposite relationship 7,19) . There are possible explanations for a lower prevalence of BAF/BAC with lung cancer.…”