Chronic obstructive lung diseases and risk of non-small cell lung cancer in women.
Chronic obstructive lung diseases and risk of non-small cell lung cancer in women.
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DOI：
10.1097/jto.0b013e3181951cd1
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发表时间：
2009-03
期刊：
影响因子：
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通讯作者：
Soubani AO
中科院分区：
文献类型：
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作者：
Schwartz AG;Cote ML;Wenzlaff AS;Van Dyke A;Chen W;Ruckdeschel JC;Gadgeel S;Soubani AO
尽管肺癌和慢性阻塞性肺病在妇女发病率和死亡率中所占比例很大且不断增加，但尚未对妇女肺癌和慢性阻塞性肺病之间的联系进行充分研究。我们在一项基于人群的女性病例对照研究中评估了COPD与非小细胞肺癌（NSCLC）之间的关系，并构建了慢性肺部疾病与肺癌发病相关的时间进程。562名年龄在18-74岁之间的诊断为NSCLC的女性和564名基于人群的对照者参加了研究。多变量非条件Logistic回归模型用于估计与COPD、慢性支气管炎或肺气肿病史相关的风险。有COPD病史的白色女性的肺癌风险显著增加（OR=1.85; 95% CI 1.21-2.81），但这在非洲裔美国女性中未观察到。当在25岁或更早诊断时，与慢性支气管炎病史相关的风险最强（OR=2.35，95%CI 1.17-4.72）;在肺癌9年内诊断的肺气肿也与相当大的风险相关（OR=6.36，95%CI 2.36-17.13）。在肺癌病例中，种族、吸烟包年数、成年后暴露于环境烟草烟雾、儿童哮喘和暴露于石棉与COPD病史相关。在女性中，COPD与肺癌风险的相关性因种族而异。要弄清COPD是在因果通路中还是仅仅共享风险因素，需要未来的研究关注特定的COPD特征，同时探索这些疾病的潜在遗传易感性。
The link between lung cancer and chronic obstructive lung diseases (COPD) has not been well studied in women even though lung cancer and COPD account for significant and growing morbidity and mortality among women. We evaluated the relationship between COPD and non-small cell lung cancer (NSCLC) in a population-based case-control study of women and constructed a time course of chronic lung diseases in relation to onset of lung cancer. Five hundred sixty-two women aged 18–74, diagnosed with NSCLC and 564 population-based controls matched on race and age participated. Multivariable unconditional logistic regression models were used to estimate risk associated with a history of COPD, chronic bronchitis or emphysema. Lung cancer risk increased significantly for white women with a history of COPD (OR=1.85; 95% CI 1.21–2.81), but this was not seen in African American women. Risk associated with a history of chronic bronchitis was strongest when diagnosed at age 25 or earlier (OR=2.35, 95% CI 1.17–4.72); emphysema diagnosed within nine years of lung cancer was also associated with substantial risk (OR=6.36, 95% CI 2.36–17.13). Race, pack-years of smoking, exposure to environmental tobacco smoke as an adult, childhood asthma and exposure to asbestos were associated with a history of COPD among lung cancer cases. In women, COPD is associated with risk of lung cancer differentially by race. Untangling whether COPD is in the causal pathway or simply shares risk factors will require future studies to focus on specific COPD features while exploring underlying genetic susceptibility to these diseases.