Characteristics of Familial Lung Cancer in Yunnan-Guizhou Plateau of China
Characteristics of Familial Lung Cancer in Yunnan-Guizhou Plateau of China
复制标题
中国云贵高原家族性肺癌特征
DOI：
10.3389/fonc.2018.00637
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发表时间：
2018-12-18
影响因子：
4.7
通讯作者：
Ning, Huanqi
中科院分区：
文献类型：
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作者：
Ding, Xiaojie;Chen, Ying;Ning, Huanqi
背景：肺癌具有遗传易感性并具有家族聚集性，家族性肺癌的特点表现出群体异质性。尽管之前有研究，但对中国云贵高原的家族性肺癌的研究仍然不足。方法： 2015年至2017年，纳入1023名肺癌患者（云贵高原居民），其他参数不限，其中152名受试者患有家族性肺癌。对临床病理参数进行了分析和比较，使用来自 NCI-GDC 的 4,754 名肺癌患者代表一般人群。结果：家族性肺癌（FLC）受试者表现出独特的特征：发病早；女性、腺癌、IV期及其他癌症病史的比例增加；解剖部位不平衡；所有这些都排除了吸烟状况的显着差异。还发现了共存疾病或症状分布不平衡。 FLC患者在生命早期更容易出现良性病变（息肉、结节、囊肿），尤其是早期生长的多发性肺结节发生频率更高。糖尿病、高血压等有家族史的典型疾病在 FLC 人群中也有所增加。与 GDC 数据相比，我们的受试者群体更年轻：FLC 组的年龄峰值在 50-59 岁；我们零星群体的年龄高峰在 60 岁左右；而GDC患者的年龄高峰在60-69岁。重要的是，最大的差异发生在 40-49 岁之间：我们的 FLC 组和零星组的比例分别是 GDC 人群的 3 倍和 2 倍。此外，我们的FLC男性和FLC女性的年龄峰值都在50-59岁之间；而我们零星女性的年龄高峰在50-59岁，远早于零星男性（大约60-69岁）；反映了我们的研究对象中特定性别或特定年龄的特征。结论：我国云贵高原家族性肺癌具有独特的临床病理特征，在性别、年龄、组织学类型、TNM分期以及合并疾病或症状方面存在差异。识别导致肺癌风险增加的遗传因素将是一个具有科学和临床意义的挑战。
Background: Lung cancer has inherited susceptibility and show familial aggregation, the characteristics of familial lung cancer exhibit population heterogeneity. Despite previous studies, familial lung cancer in China's Yunnan-Guizhou plateau remains understudied. Methods: Between 2015 and 2017, 1,023 lung cancer patients (residents of Yunnan-Guizhou plateau) were enrolled with no limitation on other parameters, 152 subjects had familial lung cancer. Clinicopathologic parameters were analyzed and compared, 4,754 lung cancer patients from NCI-GDC were used to represent a general population. Results: Familial lung cancer (FLC) subjects showed unique characters: early-onset; increased rate of female, adenocarcinoma, stage IV and other cancer history; unbalance in anatomic sites; all ruling out significant difference in smoking status. Unbalanced distribution of co-existing diseases or symptoms was also discovered. FLC patients were more likely to develop benign lesions (polyps, nodules, cysts) early in life, especially early-growth of multiple pulmonary nodules at higher frequency. Typical diseases with family history like diabetes and hypertension were also increased in FLC population. Compared to GDC data, our subject population was younger: the age peak of our FLC group was in 50–59; our sporadic group had an age peak around 60; while GDC patients' age peak was in 60–69. Importantly, the biggest difference happened in age 40–49: our FLC group and sporadic group had 3 times and 2 times higher ratio than GDC population, respectively. Moreover, the age peaks of our FLC males and FLC females were both in 50–59; while our sporadic females had the age peak in 50–59, much earlier than sporadic males (around 60–69); reflecting gender-specific or age-specific characters in our subject population. Conclusions: Familial lung cancer in China's Yunnan-Guizhou plateau showed unique clinicopathologic characters, differences were found in gender, age, histologic type, TNM stage and co-existing diseases or symptoms. Identification of hereditary factors which lead to increased lung cancer risk will be a challenge of both scientific and clinical significance.