Dept of Respiratory Medicine, Lyon Sud Hospital, Hospices Civils de Lyon, Lyon, France Faculty of Medicine Lyon-Sud Charles Mérieux, Lyon 1 University, Lyon, France Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada Dept of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
Dept of Respiratory Medicine, Lyon Sud Hospital, Hospices Civils de Lyon, Lyon, France Faculty of Medicine Lyon-Sud Charles Mérieux, Lyon 1 University, Lyon, France.
Eur Respir J. 2015 May;45(5):1403-14. doi: 10.1183/09031936.00097214. Epub 2015 Feb 5.
Lung cancer in never-smokers (LCINS) (fewer than 100 cigarettes in lifetime) is considered as a distinct entity and harbours an original molecular profile. However, the epidemiological and molecular features of LCINS in Europe remain poorly understood. All consecutive newly diagnosed LCINS patients were included in this prospective observational study by 75 participating centres during a 14-month period. Each patient completed a detailed questionnaire about risk factor exposure. Biomarker and pathological analyses were also collected. We report the main descriptive overall results with a focus on sex differences. 384 patients were included: 65 men and 319 women. 66% had been exposed to passive smoking (significantly higher among women). Definite exposure to main occupational carcinogens was significantly higher in men (35% versus 8% in women). A targetable molecular alteration was found in 73% of patients (without any significant sex difference): EGFR in 51%, ALK in 8%, KRAS in 6%, HER2 in 3%, BRAF in 3%, PI3KCA in less than 1%, and multiple in 2%. We present the largest and most comprehensive LCINS analysis in a European population. Physicians should track occupational exposure in men (35%), and a somatic molecular alteration in both sexes (73%).
不吸烟肺癌（LCINS）（一生中吸烟少于 100 支）被认为是一种独特的实体，具有原始的分子特征。然而，欧洲 LCINS 的流行病学和分子特征仍知之甚少。在 14 个月的时间里，75 个参与中心的所有连续新诊断的 LCINS 患者都被纳入了这项前瞻性观察研究。每位患者都填写了一份关于危险因素暴露的详细问卷。还收集了生物标志物和病理分析。我们报告了主要的描述性总体结果，并重点介绍了性别差异。共纳入 384 例患者：65 例男性和 319 例女性。66%的人曾接触过被动吸烟（女性明显更高）。明确接触主要职业致癌物的比例男性明显更高（35%比女性 8%）。在 73%的患者中发现了可靶向的分子改变（无明显性别差异）：EGFR 占 51%，ALK 占 8%，KRAS 占 6%，HER2 占 3%，BRAF 占 3%，PI3KCA 占不到 1%，2%的患者存在多种改变。我们展示了欧洲人群中最大和最全面的 LCINS 分析。医生应关注男性（35%）的职业暴露，以及两性的体细胞分子改变（73%）。
