The validity and value of histological and cytological classifications of lung cancer

Abstract

morphic appearance, the common denominator being undifferentiation and a minimal amount of cytoplasm.T h e undifferentiated large cell group consisted of those in which the cells had more abundant cytoplasm without secretory activity or acinar formation and without any significant degree of keratinization or development of intercellular bridges.In the majority, the cells were fairly uniform in appearance but i n a few they were quite bizarre and irregular in size and shape.Squamous carcinomas embraced those formed of epidermoid cells and cells with prickles or keratin, possibly including some undifferentiated large cell areas: adenocarcinomas were those with mucus or showing columnar cells and acini.Although it was originally thought that these categories indicated different behavior characteristics, it became suspected that in operability and survival, no essential difference existed between the groups being classified as squamous carcinoma and as undifferentiated large cell carcinoma.Support for the classification in use was therefore sought in literature, when it became clear that no 2 authorities were in agreement.Apparently because of the poor prognosis of the disease as a whole, and the few months survival that separate the least malignant from the most malignant types (Table l), some have suggested that nothing beyond the simplest descriptive classification of squamous carci-TABLE 1 AVERAGE AND 5-YEAR SURVIVALS I N LUNG CANCER