TAILIEUCHUNG - Lung Cancer Edited by Barbara Driscoll Volume II Diagnostic and Therapeutic Methods and Reviews

Lung cancer is the leading cause of cancer death among men and women in the United States with 170,000 deaths per year. This exceeds the sum of the next three leading causes of death due to cancer: breast, colon, and prostate. There are over 1 million deaths worldwide due to lung cancer, making it truly an epidemic. Fewer than 15% achieve a 5-yr survival. The vast majority (85%) present with advanced disease, although stage I patients may have a 5-yr survival approaching 70% (1). 80% of the lung cancers are non-small cell lung cancer (NSCLC; adenocarcinomas, squamous cell, bronchoalveolar and large cell carcinomas) and 20% are small cell. | 1 Molecular and Genetic Aspects of Lung Cancer William N. Rom and Kam-Meng Tchou-Wong 1. Introduction Lung cancer is the leading cause of cancer death among men and women in the United States with 170 000 deaths per year. This exceeds the sum of the next three leading causes of death due to cancer breast colon and prostate. There are over 1 million deaths worldwide due to lung cancer making it truly an epidemic. Fewer than 15 achieve a 5-yr survival. The vast majority 85 present with advanced disease although stage I patients may have a 5-yr survival approaching 70 1 . 80 of the lung cancers are non-small cell lung cancer NSCLC adenocarcinomas squamous cell bronchoalveolar and large cell carcinomas and 20 are small cell lung cancer SCLC . Cigarette smoking constitutes 80 of the attributable risk and asbestos radon other occupational and environmental exposures and genetic factors contribute to the rest. The purpose of this state of the art review is to introduce the molecular genetics of lung cancer for the clinician in this rapidly progressing field. Many of the basic science concepts to follow already are being studied in clinical trials of new chemotherapeutic agents or gene therapy. 2. Diagnosis Clinical and Molecular Approaches James Alexander Miller the first Director of the Bellevue Chest Service reviewed primary carcinoma of the lung in 1930 2 . He presented 32 cases from Bellevue Hospital and noted that the disease appeared to be due to urban dust and bronchial irritation but did not explicitly indict tobacco or cigarette smoking. In 1939 Ochsner and DeBakey presented a case series of seven lung cancers treated surgically by pneumonectomy and discussed the possibility that smoking caused lung cancer by irritating the bronchial mucosa 3 . From Methods in Molecular Medicine vol. 75 Lung Cancer Vol. 2 Diagnostic and Therapeutic Methods and Reviews Edited by B. Driscoll Humana Press Inc. Totowa NJ 3 4 Rom and Tchou-Wong Lung cancer can progress significantly

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