Schabath Matthew B, Delclos George L, Martynowicz Marek M, Greisinger Anthony J, Lu Charles, Wu Xifeng, Spitz Margaret R
Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Am J Epidemiol. 2005 Mar 1;161(5):412-22. doi: 10.1093/aje/kwi063.
The authors compared histories of nonmalignant respiratory diseases (asthma, bronchitis, emphysema, hay fever, and pneumonia) in 1,553 lung cancer patients and 1,375 healthy controls enrolled in a Texas case-control study from 1995 to 2003. They incorporated data on two biologically relevant polymorphic genes, matrix metalloproteinase-1 and myeloperoxidase. Emphysema was associated with a statistically significant increased lung cancer risk (odds ratio (OR) = 2.87, 95% confidence interval (CI): 2.20, 3.76), while hay fever had a significant protective effect (OR = 0.58, 95% CI: 0.48, 0.70). Odds ratios were consistent after exclusion of respiratory disease diagnoses made up to 10 years before interview. There was little association between other respiratory diseases and lung cancer risk. Among carriers of "protective" genotypes, emphysema was associated with a 1.7-fold increased risk (95% CI: 0.84, 3.50), as compared with the substantially higher risk for persons possessing one (OR = 4.98, 95% CI: 2.94, 8.44) or two (OR = 4.23, 95% CI: 1.84, 9.73) "adverse" genotypes. For hay fever, significantly decreased risks were evident with one (OR = 0.32, 95% CI: 0.21, 0.50) or two (OR = 0.35, 95% CI: 0.19, 0.66) protective genotypes as compared with none (OR = 0.69, 95% CI: 0.30, 1.59). The biologic role of respiratory disease in lung cancer is unclear. Further study may yield new insights for identification of susceptible subgroups.
作者比较了1995年至2003年在德克萨斯州一项病例对照研究中纳入的1553例肺癌患者和1375例健康对照者的非恶性呼吸道疾病（哮喘、支气管炎、肺气肿、花粉症和肺炎）病史。他们纳入了两个具有生物学相关性的多态性基因——基质金属蛋白酶-1和髓过氧化物酶的数据。肺气肿与肺癌风险在统计学上显著增加相关（优势比（OR）=2.87，95%置信区间（CI）：2.20，3.76），而花粉症具有显著的保护作用（OR = 0.58，95% CI：0.48，0.70）。在排除访谈前10年内做出的呼吸道疾病诊断后，优势比保持一致。其他呼吸道疾病与肺癌风险之间几乎没有关联。在“保护性”基因型携带者中，肺气肿与风险增加1.7倍相关（95% CI：0.84，3.50），相比之下，拥有一个（OR = 4.98，95% CI：2.94，8.44）或两个（OR = 4.23，95% CI：1.84，9.73）“不良”基因型的人风险要高得多。对于花粉症，与没有保护性基因型（OR = 0.69，95% CI：0.30，1.59）相比，拥有一个（OR = 0.32，95% CI：0.21，0.50）或两个（OR = 0.35，95% CI：0.19，0.66）保护性基因型时，风险显著降低。呼吸道疾病在肺癌中的生物学作用尚不清楚。进一步的研究可能会为识别易感亚组带来新的见解。
