Lung cancer molecular markers by sex: intergroup study

描述（由申请人提供）：我们建议在男性和女性肺癌患者中进行病例系列研究，研究易感性、生物有效剂量和肿瘤组织改变的分子标记。将根据有关主动和被动吸烟、职业接触以及生殖和激素因素的接触数据对这些标志进行评价，以便阐明吸烟和不吸烟妇女中肺癌，特别是腺癌增加的原因。为了优化我们招募非吸烟者肺癌患者的能力，我们将与西南肿瘤组肺委员会调查人员和NCI肺intergroup的合作成员合作，确定大量肺癌患者，招募120名不吸烟的肺癌女性和同等数量的男性，以及200名吸烟的女性和男性。我们有两个主要的假设：基于新陈代谢的可变性，女性由于对烟草烟雾致癌物的易感性而面临更高的风险。我们提出，肺癌环境和遗传风险因素相互作用的标记物（DNA加合物）以及肿瘤组织中的遗传改变（p53和kras突变）将反映男性和女性、吸烟者和非吸烟者之间暴露和易感性的差异，并将阐明性别和吸烟状况在风险方面的不成比例的差异。我们的第二个假设是类固醇激素，它似乎在肺癌中起作用，对女性的影响大于男性，对从不吸烟的人的影响大于吸烟者。我们预测，肿瘤HER2扩增和雌激素受体将因性别和吸烟状况而异，特别是与环境和遗传（致癌物和类固醇激素代谢途径中的snp）危险因素有关。将在这些患有肺癌的女性和男性的血液和肿瘤组织中检测暴露、易感性和影响的生物标志物，并根据问卷数据进行评估，以检验提出的假设。这项研究是迄今为止规模最大的评估易感性和影响的生物标志物的研究，其结果可能会阐明吸烟和不吸烟女性肺癌（尤其是腺癌）发病率上升的原因。

DESCRIPTION (provided by applicant): We propose to conduct a case-series study in men and women with lung cancer, investigating molecular markers of susceptibility, biologically effective dose, and tumor tissue alterations. These markers will be evaluated in relation to exposure data on active and passive smoke exposure, occupational exposures and reproductive and hormonal factors, in order to elucidate reasons for the increase in lung cancer, particularly adenocarcinoma, in both smoking and non-smoking women. To optimize our capabilities to enroll nonsmokers with lung cancer, we will work with the Lung Committee investigators of the Southwest Oncology Group and collaborating members of the NCI lung intergroup to identify large numbers of patients with lung cancer, enrolling 120 never-smoking women with lung cancer and an equal number of males, as well as 200 each of ever smoking females and males. We have two primary hypotheses: that women are at higher risk due to susceptibility to tobacco-smoke carcinogens, based on metabolic variability. We propose that markers of the interactions of environmental and genetic risk factors for lung cancer (DNA adducts), as well as genetic alterations in tumor tissue (p53 and kras mutations), will reflect differences in exposures and susceptibility between men and women, smokers and non-smokers, and will elucidate the disproportionate variability in risk by gender and smoking status. Our second hypothesis is that steroid hormones, which appear to play a role in lung carcinogeneis, will have a greater effect in women than in men and in never smokers rather than smokers. We predict that tumor HER2 amplification and estrogen receptors will vary by gender and smoking status, particularly in relation to environmental and genetic (SNPs in carcinogen and steroid hormone metabolism pathways) risk factors. Biomarkers of exposure, susceptibility, and effect will be assayed in the blood and tumor tissue of these women men with lung cancer and evaluated in relation to questionnaire data to test the proposed hypotheses. Results from this study, the largest to date to evaluate biomarkers of susceptibility and effect, will likely elucidate reasons for the rise in lung cancer, particularly adenocarcinomas, in smoking and non-smoking women.