Division of Pulmonary Medicine, Department of Internal Medicine, Hsinchu Cathay General Hospital, Hsinchu, Taiwan; Department and Graduate Institute of Pharmacology, College of Medicine, National Taiwan University, Taipei, Taiwan.
Health Data Research Center, National Taiwan University, Taipei, Taiwan.
Int J Infect Dis. 2019 Nov;88:8-13. doi: 10.1016/j.ijid.2019.07.030. Epub 2019 Jul 30.
Previous animal studies have shown that certain respiratory oncoviruses can lead to tumorigenesis, especially influenza virus. However, no clinical studies other than animal studies have been conducted to test this hypothesis.
To investigate the association between influenza and the risk of lung cancer using the Taiwan Cancer Registry Database (TCRD) and Taiwan's National Health Insurance Research Database (NHIRD).
We identified a study cohort consisting of patients aged 40 years or above who were enrolled in the NHIRD between 1 January 2012 and 31 December 2014. Among them, we identified patients with lung cancer (cases) and their matched controls (matched by age, sex, and disease risk score (DRS) at a ratio of 1:10). Multivariate conditional logistic regression models were used to evaluate the association between exposure to influenza (timing and cumulative number) and risk of lung cancer.
We identified 32,063 cases and 320,627 matched controls. Influenza was associated with a 1.09-fold increased risk of lung cancer (aOR 1.09, 95% CI 1.04-1.14, p<0.0001). The risk of lung cancer increased slightly with cumulative exposure to influenza (1-2 exposures: aOR 1.05, 95% CI 1.00-1.11; 3-4 exposures: aOR 1.12, 95% CI 1.00-1.25; 5+ exposures: aOR 1.25, 95% CI 1.13-1.39).
Exposure to influenza was associated with an increased risk of lung cancer and the risk increased with cumulative exposure to influenza. However, the lack of valid information on smoking could lead to confounding, and future studies collecting patients' smoking histories are warranted to validate the association between influenza and lung cancer.
先前的动物研究表明，某些呼吸道致癌病毒会导致肿瘤形成，尤其是流感病毒。然而，除了动物研究外，尚未进行任何临床研究来验证这一假说。
利用台湾癌症登记数据库（TCRD）和台湾全民健康保险研究数据库（NHIRD）调查流感与肺癌风险之间的关联。
我们确定了一个研究队列，包含 2012 年 1 月 1 日至 2014 年 12 月 31 日期间纳入 NHIRD 的年龄在 40 岁及以上的患者。在这些患者中，我们确定了肺癌（病例）患者及其匹配对照（按照年龄、性别和疾病风险评分（DRS）以 1:10 的比例进行匹配）。采用多变量条件逻辑回归模型评估流感（时间和累积数量）暴露与肺癌风险之间的关联。
我们确定了 32063 例病例和 320627 名匹配对照。流感与肺癌的风险增加 0.99 倍（比值比 1.09，95%置信区间 1.04-1.14，p<0.0001）相关。随着流感暴露的累积，肺癌的风险略有增加（1-2 次暴露：比值比 1.05，95%置信区间 1.00-1.11；3-4 次暴露：比值比 1.12，95%置信区间 1.00-1.25；5 次及以上暴露：比值比 1.25，95%置信区间 1.13-1.39）。
暴露于流感与肺癌风险增加相关，且风险随流感暴露的累积而增加。然而，由于缺乏关于吸烟的有效信息，可能导致混杂，未来需要收集患者吸烟史的研究来验证流感与肺癌之间的关联。
