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

Abstract

BackgroundLung 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.MethodsA 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.ResultsIn 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.ConclusionsTogether, 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.

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“…NSCLC, which includes squamous and nonsquamous cell carcinomas, is the most prevalent type of lung cancer, and each of these types of NSCLC has distinct biological characteristics ( 4 ). Squamous NSCLC is generally more aggressive than nonsquamous NSCLC ( 26 ). The difference in the immune microenvironment between squamous and nonsquamous NSCLC may impact immunotherapy outcomes in patients treated with PD-1/PD-L1 inhibitors ( 27 ).…”

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“…Wang et al. conducted a retrospective study on Chinese patients and found that platelet levels and systemic inflammation indices were significantly higher in LUSC patients than in LUAD patients, which may contribute to the tumor’s development ( 44 ). Additionally, differences in gene expression between LUSC and LUAD involve several ontological subgroups, including cell proliferation, DNA replication, and cytoskeleton.…”

In-depth analysis of immune cell landscapes reveals differences between lung adenocarcinoma and lung squamous cell carcinoma

“…With an estimated 2.2 million new cases and 1.8 million deaths in 2020, lung cancer is currently the leading cause of cancer deaths globally ( 2 ). Non-small-cell lung cancer (NSCLC) accounts for approximately 85% of all cases ( 3 ). Among the different types of NSCLC, lung adenocarcinoma (LUAD) and squamous cell carcinoma (LUSC) are the two major histological subtypes ( 3 ).…”

“…Non-small-cell lung cancer (NSCLC) accounts for approximately 85% of all cases ( 3 ). Among the different types of NSCLC, lung adenocarcinoma (LUAD) and squamous cell carcinoma (LUSC) are the two major histological subtypes ( 3 ). LUAD is more prevalent among non-smokers, while LUSC is strongly associated with a history of smoking, particularly among current or former heavy smokers.…”