Punturieri Antonello, Szabo Eva, Croxton Thomas L, Shapiro Steven D, Dubinett Steven M
Division of Lung Diseases, National Heart, Lung, and Blood Institute, 6701 Rockledge Drive, Bethesda, MD 20892-7952, USA.
J Natl Cancer Inst. 2009 Apr 15;101(8):554-9. doi: 10.1093/jnci/djp023. Epub 2009 Apr 7.
Lung cancer and chronic obstructive pulmonary disease (COPD) are leading causes of morbidity and mortality in the United States and worldwide. They share a common environmental risk factor in cigarette smoke exposure and a genetic predisposition represented by the incidence of these diseases in only a fraction of smokers. The presence of COPD increases the risk of lung cancer up to 4.5-fold. To investigate commonalities in disease mechanisms and perspectives for disease chemoprevention, the National Heart, Lung, and Blood Institute (NHLBI) and the National Cancer Institute (NCI) held a workshop. The participants identified four research objectives: 1) clarify common epidemiological characteristics of lung cancer and COPD; 2) identify shared genetic and epigenetic risk factors; 3) identify and validate biomarkers, molecular signatures, and imaging-derived measurements of each disease; and 4) determine common and disparate pathogenetic mechanisms. These objectives should be reached via four research approaches: 1) identify, publicize, and enable the evaluation and analysis of existing datasets and repositories of biospecimens; 2) obtain phenotypic and outcome data and biospecimens from large studies of subjects with and/or at risk for COPD and lung cancer; 3) develop and use animal and other preclinical models to investigate pathogenetic links between the diseases; and 4) conduct early-phase clinical trials of potential chemopreventive agents. To foster much needed research interactions, two final recommendations were made by the participants: 1) incorporate baseline phenotyping and outcome measures for both diseases in future longitudinal studies of each disease and 2) expand collaborative efforts between the NCI and NHLBI.
肺癌和慢性阻塞性肺疾病（COPD）是美国乃至全球发病和死亡的主要原因。它们有一个共同的环境风险因素，即接触香烟烟雾，以及一种遗传易感性，表现为这些疾病仅在一小部分吸烟者中发生。COPD的存在会使肺癌风险增加至4.5倍。为了研究疾病机制的共性以及疾病化学预防的前景，美国国立心肺血液研究所（NHLBI）和美国国立癌症研究所（NCI）举办了一次研讨会。与会者确定了四个研究目标：1）阐明肺癌和COPD的共同流行病学特征；2）识别共同的遗传和表观遗传风险因素；3）识别并验证每种疾病的生物标志物、分子特征和影像学测量指标；4）确定共同和不同的发病机制。这些目标应通过四种研究方法来实现：1）识别、公布并促进对现有数据集和生物样本库的评估与分析；2）从对COPD和肺癌患者及/或有风险人群的大型研究中获取表型和结局数据以及生物样本；3）开发并使用动物和其他临床前模型来研究疾病之间的发病联系；4）开展潜在化学预防剂的早期临床试验。为促进急需的研究互动，与会者提出了两项最终建议：1）在未来每种疾病的纵向研究中纳入两种疾病的基线表型分析和结局测量指标；2）扩大NCI和NHLBI之间的合作努力。
