P1.01-013 Emphysematous Changes and Pulmonary Function for Asbestos-Related Lung Cancer in Japan

Abstract

Smoking accelerates the incidence of asbestos-related lung cancer. We evaluated emphysematous changes by chest CT and pulmonary function for asbestos-related lung cancer in Japan. Two hundred and twenty-two patients of asbestos-related lung cancer compensated by Japanese compensation law were evaluated as age, gender, smoking index, histology, survival, therapy and occupational history including first asbestos exposed age, asbestos exposing terms and latency from the first asbestos exposure to lung cancer． Radiographic evaluation was done by chest CT using Goddard classification of emphysema. Pulmonary function test was done by spirometry and flow-volume curve. Ages range from 49 to 92 years with a median of 75 years. Male occupied 97.7%. Non-smoker is only 13 patients and other 209 are smokers with Brinkman Index ranges from 45 to 3000 of a median of 900. For histology of lung cancer, 60.4% are adenocarcinoma and 22.4% of squamous cell carcinoma, 12.6% of small cell carcinoma and 1.8 of large cell carcinoma and 2.6% of pleomorphic carcinoma et al. Eighty seven patients were operated and other 87 patients performed chemotherapy. Best supportive therapy is 34 patients. Median survival was 15.8 months. For asbestos histories, median first exposed age was 23 years, asbestos exposing term was 32 years and the latency of lung cancer was 50 years. For Goddard score of emphysematous changes, 28% showed 0 point and 33% of 1∼4 points and more than 21 points occupied only 4%, which means very low percentages of emphysematous changes for these asbestos-related lung cancer, nonetheless of high percentages of heavy smokers. For pulmonary function test, FEV1.0% is 70.5%±11.3% and % FEV1.0 is 85.6±22.2%. More than half patients are normal pulmonary function except more than 1,000 of Brinkman index or more than 15 points of Goddard score. From the classification of GOLD criteria, 54.1% are normal, stage 1 is 20.7%, stage 2 is 22.5 % stage 3 is 1.8% and stage 4 is only 0.9%. Almost all of asbestos-related lung cancer in Japan are heavy smoker, but 61% showed none or low grade of emphysematous changes by chest CT and only 2.7% had severe pulmonary dysfunction.