Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, ul. Unii Lubelskiej 1, 71-252, Szczecin, Poland.
Department of Thoracic Surgery and Transplantation, Pomeranian Medical University, ul. A. Sokołowskiego 11, 70-891, Szczecin, Poland.
J Trace Elem Med Biol. 2019 Dec;56:46-51. doi: 10.1016/j.jtemb.2019.07.010. Epub 2019 Jul 26.
Although the results of studies in populations with low selenium status indicate an inverse correlation between body selenium levels and the risk of the lung cancer, the effect of this microelement on survival has not been studied.
We performed a prospective study of 302 patients diagnosed with lung cancer in Szczecin, Poland. Selenium concentration in serum was measured at the time of diagnosis and before treatment. All patients were followed for a maximum of 80 months or until death. Vital status was obtained from the Polish National Death Registry.
Using Cox proportional hazard analysis, performed for all individuals with lung cancer, the hazard ratio (HR) for death from all causes was 1.25 (95% CI: 0.86-1.83, P = 0.99) for patients in the lowest tertile compared to those in the highest tertile of serum selenium levels. Among the patients with stage I disease this relationship was significant (HR-2.73; P = 0.01) for selenium level in tertile 1 (<57 μg/L) compared to tertile 3 (>69 μg/L, reference). The 80 months crude survival after diagnosis was 79.5% (95% CI: 68.5-92.4%) for individuals in the highest tertile and 58.1% (95% CI: 45.1-74.9%) for individuals in the lowest tertile with stage I lung cancer.
These results suggest that in patients undergoing treatment for stage I lung cancer, serum selenium levels at the time of diagnosis (>69 μg/L) may be associated with improved overall survival.
尽管在低硒人群中的研究结果表明，体内硒水平与肺癌风险呈负相关，但该微量元素对生存的影响尚未得到研究。
我们对波兰什切青诊断为肺癌的 302 例患者进行了前瞻性研究。在诊断和治疗前测量血清中的硒浓度。所有患者的随访时间最长为 80 个月或直至死亡。通过波兰国家死亡登记处获取存活状态。
使用针对所有肺癌患者的 Cox 比例风险分析，与血清硒水平最高三分位组相比，最低三分位组的全因死亡风险比（HR）为 1.25（95%CI：0.86-1.83，P=0.99）。在 I 期疾病患者中，这种关系具有统计学意义（HR-2.73；P=0.01），与三分位 1（<57μg/L）相比，三分位 3（>69μg/L，参考）的硒水平。诊断后 80 个月的粗生存率在最高三分位组为 79.5%（95%CI：68.5-92.4%），在 I 期肺癌的最低三分位组为 58.1%（95%CI：45.1-74.9%）。
这些结果表明，在接受 I 期肺癌治疗的患者中，诊断时（>69μg/L）的血清硒水平可能与整体生存改善相关。
