What's the difference between lung adenocarcinoma and lung squamous cell carcinoma? Evidence from a retrospective analysis in a cohort of Chinese patients

Abstract

Background: Lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC) are the two most common subtypes of lung cancer. Previously, they were categorized into one histological subtype known as non-small cell lung cancer (NSCLC) and often treated similarly. However, increasing evidence suggested that LUAD and LUSC should be classified and treated as different cancers. But yet, detailed differences in clinical features between LUAD and LUSC have not been well described.

Methods: A cohort of 142 Chinese patients with 111 LUAD and 31 LUSC cases were consecutively enrolled from April 2019 to October 2020 in Hunan Provincial People's Hospital. The clinical features of the patients were retrospectively analyzed and compared in the terms of general information, clinicopathologic characteristics, imaging findings and laboratory data.

Results: In comparison with LUAD, LUSC patients had a significantly higher proportion of males, smokers, drinkers, higher-stage cases. The mean tumor size in LUSC patients was significantly larger than that in LUAD patients. Compared with LUAD patients, more of patients with LUSC had cough, fever and abundant sputum symptoms. Besides that, more bacterial infections and fungal infections were found in LUSC patients than that in LUAD patients. Imaging data shows that ground-glass opacity and patchy shadows in radiological films were more frequent in LUAD patients than that in LUSC patients. In addition to initial laboratory data, LUSC patients had higher levels of leukocytes, platelets, and creatinine that of LUAD patients.

Conclusions: Together, these results suggested that there exist distinct differences between LUAD and LUSC subtypes; LUSC may be a more malignant type in comparison with LUAD. Our findings may have potential implications in clinical settings. However, further multicenter studies are needed to validate these findings in a larger sample size.

Keywords: clinicopathologic characteristics; laboratory data; lung adenocarcinoma; lung squamous cell carcinoma; radiological features.

Figure 1

Comparison of laboratory data between LUAD and LUSC. Comparison of the number of blood cells: (A) platelets, (B) erythrocytes, (C) leukocytes and (D) lymphocytes. Comparison of the level of physiological indexes: (E) AST, (F) ALT, (G) total bilirubin, (H) creatinine, (I) triglyceride and (J) hemoglobin. AST, aspartate transaminase; ALT, alanine aminotransferase. Data were analyzed by the 2-tailed Student’s t test. *P < 0.05, ***P < 0.001; ns, not significant (p -value > 0.05).