Risk factors differ for non-small-cell lung cancers with and without EGFR mutation:: assessment of smoking and sex by a case-control study in Japanese
Risk factors differ for non-small-cell lung cancers with and without EGFR mutation:: assessment of smoking and sex by a case-control study in Japanese
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DOI：
10.1111/j.1349-7006.2006.00347.x
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发表时间：
2007-01-01
期刊：
影响因子：
5.7
通讯作者：
Mitsudomi, Tetsuya
中科院分区：
文献类型：
--
作者：
Matsuo, Keitaro;Ito, Hidemi;Mitsudomi, Tetsuya
本研究旨在评估吸烟和性别对有或无表皮生长因子受体（EGFR）突变的非小细胞肺癌（NSCLC）风险的影响。我们对152例EGFR突变型（EGFR（mut））NSCLC患者、283例EGFR野生型（EGFR（wt））NSCLC患者和2175例年龄和性别频率匹配的对照进行了病例对照研究。吸烟是EGFR（wt）NSCLC的显著风险因素（曾吸烟者的比值比[OR]为4.05; 95%置信区间[CI]为2.79-5.88），但EGFR（mut）NSCLC的风险因素并非如此（OR为0.73; CI为0.46-1.14）。性别并不影响这种关联。该关联与其他吸烟相关参数（包括包年）一致。性别是EGFR（mut）NSCLC的唯一风险因素（女性相对于男性的OR，2.19; CI，1.41-3.39），女性与吸烟之间无显著相互作用。相比之下，性别、吸烟及其相互作用在EGFR（wt）NSCLC中具有显著性。性别对EGFR突变状态的影响通过女性生殖史的几个指标进行评估。总生育年限与EGFR（mut）NSCLC呈显著正相关，但与EGFR（wt）NSCLC无显著正相关。其他指标显示类似的趋势，这一结果可能部分解释了EGFR突变获得的性别差异。总之，我们的病例对照研究清楚地表明，吸烟和性别对EGFR（mut）NSCLC风险的影响与EGFR（wt）NSCLC不同。进一步的流行病学评估是必要的。
The present study aimed to assess the impact of smoking and sex for the risk of non-small-cell lung cancer (NSCLC) with or without epidermal growth factor receptor (EGFR) mutation. We conducted a case-control study using 152 patients with EGFR-mutated (EGFR(mut)) NSCLC, 283 with EGFR-wild-type (EGFR(wt)) NSCLC and 2175 age- and sex-frequency-matched controls. Smoking was a significant risk factor for EGFR(wt) NSCLC (odds ratio [OR] for ever-smokers, 4.05; 95% confidence interval [CI], 2.79-5.88) but not for EGFR(mut) NSCLC (OR, 0.73; CI, 0.46-1.14). Sex did not affect this association. The association was observed consistently with other smoking-related parameters including pack-years. Sex was the sole risk factor for EGFR(mut) NSCLC (OR for women relative to men, 2.19; CI, 1.41-3.39) and there was no significant interaction between women and smoking. In contrast, sex, smoking and their interaction were significant in EGFR(wt) NSCLC. The impact of sex on EGFR mutation status was assessed by several indicators of reproductive history among women. Total fertile years showed a significant positive association with EGFR(mut) NSCLC but not with EGFR(wt) NSCLC. Other indicators showed similar trends and this result may partly explain the sexual difference in the acquisition of EGFR mutation. In conclusion, our case-control study clearly demonstrated that the impacts of smoking and sex on the risk of EGFR(mut) NSCLC are different from those for EGFR(wt) NSCLC. Further epidemiological evaluation is warranted.