[Early cancer and related changes in the bronchial epithelium of former mustard gas workers]

The bronchial epithelium taken in stepwise transverse sections was examined histologically in 66 autopsy cases, composed of groups consisting of 19 mustard gas (MG) ex-workers with lung cancer, 17 MG ex-workers with non-lung cancer, 10 non-MG lung cancer cases, and 20 non-MG non-lung cancer cases. An additional 5 surgical lung cancer specimens removed from MG ex-workers were also examined. From these groups, foci of moderate or severe atypia including cellular atypia, dysplasia and carcinoma in situ (CIS), detected in the total number of slides for each autopsy group, were counted as 146 out of 3,485, 72 out of 2,226, 70 out of 3,797, and 18 out of 4,611, respectively. Seven CIS lesions were detected from among all MG-exposed cases and 1 CIS lesion was found in a non-MG lung cancer case. Six of these occurred with dysplasia and 4 were associated with early invasion. Among 62 autopsy cases with known smoking histories, multivariate analysis revealed a significant correlation between the incidence rate of atypia and MG exposure only in non-lung cancer cases: the incidence rate of atypia was also influenced significantly by smoking and age. Among lung cancer cases, the incidence rate of atypia was significantly higher (p less than 0.01) in cases of squamous cell carcinoma than those of small cell carcinoma.