Risk factors shared by COPD and lung cancer and mediation effect of COPD: two center case-control studies
Risk factors shared by COPD and lung cancer and mediation effect of COPD: two center case-control studies
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COPD与肺癌共有的危险因素及COPD的中介作用：两项中心病例对照研究
DOI：
10.1007/s10552-014-0475-2
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发表时间：
2015
影响因子：
2.3
通讯作者：
Lu Jiachun
中科院分区：
文献类型：
--
作者：
Yang Lei;Lu Xiaoxiao;Deng Jieqiong;Zhou Yumin;Huang Dongsheng;Qiu Fuman;Yang Xiaorong;Yang Rongrong;Fang Wenxiang;Ran Pixin;Zhong Nanshan;Zhou Yifeng;Fang Shenying;Lu Jiachun
目的揭示慢性阻塞性肺疾病（COPD）与肺癌的共同危险因素，分析COPD在肺癌发生中的中介作用。方法采用4项独立的病例对照研究，包括1,511例COPD患者和1,677例肺功能正常对照，1,559例肺癌患者和1例肺功能正常对照。结果8个因素与两种疾病的风险相关，包括既存结核病、吸烟、被动吸烟、职业性金属毒物暴露、房屋通风不良、生物质燃烧、腌肉消费、很少吃蔬菜和水果。此外，吸烟和生物质燃烧对先前存在COPD的个体的肺癌风险影响显著高于未存在COPD的个体。COPD在吸烟、被动吸烟和生物质燃烧诱发肺癌过程中也有明显的介导作用，依次解释了吸烟、被动吸烟和生物质燃烧对肺癌发生的12.0%、3.8%和6.1%的影响。而COPD在肺癌发展过程中起着介导作用。这些观察结果应考虑预防这两种疾病。
PurposeTo reveal the shared risk factors for chronic obstructive pulmonary disease (COPD) and lung cancer, and to analyze the mediation effect of COPD during lung carcinogenesis.MethodsWe conducted four independent case–control studies included 1,511 COPD patients and 1,677 normal lung function controls and 1,559 lung cancer cases and 1,679 cancer-free controls during 2002–2011 in southern and eastern Chinese.ResultsEight factors were observed to be consistently associated with both diseases risk, including pre-existing tuberculosis, smoking, passive smoking, occupational exposure to metallic toxicant, poor housing ventilation, biomass burning, cured meat consumption, and seldom vegetables/fruits consumption. Furthermore, smoking and biomass burning conferred significantly higher risk effects on lung cancer in individuals with pre-existing COPD than those without. COPD also had significant mediation effects during lung carcinogenesis caused by smoking, passive smoking, and biomass burning, which explained about 12.0 % of effect, 3.8 % of effect, and 6.1 % of effect of these factors on lung tumorigenesis in turn.ConclusionOur study mapped a shared spectrum of etiological factors for both COPD and lung cancer in Chinese, and COPD acts as a mediator during lung cancer development. These observations should be in consideration for the prevention of both diseases.