Vnitr Lek 1993, 39(11):1044-1051

[Carcinoma of the lung in patients with pneumoconiosis].

J Kohout, A Motánová, F Sefrna: Klinika pracovního lékarství Fakultní nemocnice Plzen.

From 614 patients with notified pneumoconiosis who died in 1964-1992 on necropsy carcinoma of the lungs was found in 87, i.e. 14.1% (in 48 it was the cause of death). The incidence in individual years did not differ significantly; on evaluation in relation to the diagnosis of pneumoconiosis an insignificantly more frequent incidence was found in complicated pneumoconiosis of miners. On evaluation by work places miners in black coal mines and workers in quarries were affected more frequently, the difference being at the borderline of statistical significance. As to the histological aspect, most frequently squamous cell carcinoma was involved, the site was most frequently in both upper lobes. The carcinoma was seven times associated with silicotic lesions, with anthracofibrotic lesions six times (a total of 14.9%). In lifetime carcinoma was detected in 55 of the patients who died, i.e. in 63.2%. As to aetiopathogenetic influences, the relationship with smoking is significant. The aetiopathogenesis of carcinoma of the lungs in patients with pneumoconiosis is most probably not uniform-the influence of smoking is beyond doubt, the carcinogenic effect of silica should be considered in patients with carcinoma in the scar. With regard to the repeatedly proved more frequent incidence of carcinoma of the lungs in patients with pneumoconiosis, frequent check-ups of patients with pneumoconiosis focused on possible detection of lung cancer are essential.