Xiao Haijun, Ding Jie, Gao Shan, Yang Shujuan, Huang Yuchuan
Shanghai Neurologic Research Institute of Anhui University of Science and Technology, Shanghai, China.
Asian Pac J Cancer Prev. 2011;12(10):2807-9.
It is well-known that tobacco smoke is a definite causative agent important for human health. Epidemiological research has proven that smoking is a cause of various serious and fatal diseases. However, never-smokers comprise a high proportion of non-small-cell lung cancer (NSCLC) patients. To determine whether lung cancer patients in never smokers have different genetic mutations from their counterparts in smokers, we comprehensively searched the Cochrane Library, Medline and EMbase from 1966 to Jun 2010 for the following terms: ("non- smoker" or "never-smoker") and ("lung cancer") and ("gene") limited to English and clinical trials. Although a significant fraction of lung cancers in never smokers may also be attributable to tobacco, many such cancers arise in the absence of detectable tobacco exposure, and may follow a very different molecular pathway of malignant formation, including EGFR gene mutation, P53 mutation and metabolic gene CYP1AIIle462Val polymorphism. These genes will help doctors to separate never-smoker lung cancer from smokers, and may present promising targets for therapy of never-smoker lung cancers. Future efforts should focus on further delineation of underlying biologic differences, identifying potential non-tobacco-related risk factors, and refining treatment strategies for different groups of lung cancer patients.
众所周知，烟草烟雾是对人类健康有重要影响的明确致病因素。流行病学研究已证实吸烟是多种严重致命疾病的病因。然而，非小细胞肺癌（NSCLC）患者中不吸烟者占比很高。为了确定不吸烟的肺癌患者与吸烟的肺癌患者是否存在不同的基因突变，我们在1966年至2010年6月期间全面检索了Cochrane图书馆、Medline和EMbase，检索词如下：（“非吸烟者”或“从不吸烟者”）以及（“肺癌”）和（“基因”），限定语言为英语且检索范围为临床试验。尽管不吸烟者中相当一部分肺癌可能也归因于烟草，但许多此类癌症在没有可检测到的烟草暴露情况下发生，并且可能遵循非常不同的恶性形成分子途径，包括表皮生长因子受体（EGFR）基因突变、P53突变和代谢基因细胞色素P450 1A1（CYP1A1）异亮氨酸462缬氨酸多态性。这些基因将有助于医生区分不吸烟肺癌患者和吸烟肺癌患者，并且可能为不吸烟肺癌患者的治疗提供有前景的靶点。未来的工作应集中在进一步阐明潜在的生物学差异、识别潜在的非烟草相关风险因素以及完善针对不同肺癌患者群体的治疗策略。
