Pulmonary Unit, Department of Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea.
Department of Statistics, Kyungpook National University, 80 Daehakro, Bukgu, Daegu, Republic of Korea.
Eur J Cancer. 2019 Nov;122:101-108. doi: 10.1016/j.ejca.2019.09.010. Epub 2019 Oct 18.
Epidermal growth factor receptor (EGFR) mutation is the most frequently encountered oncogenic driver in lung cancer. Risk factors for EGFR mutation may help prevention, surveillance and diagnosis strategies of EGFR-mutated lung cancer.
A nationwide, retrospective, longitudinal, cohort study was performed between January 2002 and December 2015. Patient data were collected from the Korean National Health Insurance Database. The lung cancer group included EGFR tyrosine kinase inhibitor (TKI)-treated patients. Controls were randomly selected from people without a history of lung cancer and determined to be four times the number of patients with EGFR-mutated advanced lung cancer. The risk model of developing EGFR-mutated lung cancer was constructed by multiple logistic regression analysis.
Among the 2010 new cases of lung cancer treated in 2010-2015, 214 cases were classified as EGFR-mutated advanced lung cancer. The risk of developing EGFR-mutated advanced lung cancer was higher in patients in their 50s (odds ratio [OR]: 3.42; 95% confidence interval [CI]: 1.68-6.93), 60s (OR: 7.04; 95% CI: 3.35-14.77) and 70s (OR: 10.27; 95% CI: 4.73-22.30) and in those aged >80 years (OR: 5.98; 95% CI: 2.25-15.92) than those in their 40s. The risk of developing EGFR-mutated lung cancer was also higher in hospitalised patients with a history of pneumonia (OR: 5.22; 95% CI: 1.88-14.46) and those with gastroesophageal reflux disease (OR: 2.02; 95% CI: 1.32-3.07).
Patients with EGFR-mutated advanced lung cancer were associated with ageing, history of being hospitalised for pneumonia and gastroesophageal reflux disease.
表皮生长因子受体(EGFR)突变是肺癌中最常见的致癌驱动因素。EGFR 突变的危险因素有助于 EGFR 突变型肺癌的预防、监测和诊断策略。
本研究为 2002 年 1 月至 2015 年 12 月进行的一项全国性、回顾性、纵向队列研究。患者数据来自韩国国家健康保险数据库。肺癌组包括接受 EGFR 酪氨酸激酶抑制剂(TKI)治疗的患者。对照组是从没有肺癌病史的人群中随机选择的,数量是 EGFR 突变型晚期肺癌患者的 4 倍。通过多因素 logistic 回归分析构建 EGFR 突变型肺癌的发病风险模型。
在 2010-2015 年治疗的 2010 例新肺癌病例中,214 例被归类为 EGFR 突变型晚期肺癌。50 多岁(优势比[OR]:3.42;95%置信区间[CI]:1.68-6.93)、60 多岁(OR:7.04;95%CI:3.35-14.77)、70 多岁(OR:10.27;95%CI:4.73-22.30)和 80 岁以上(OR:5.98;95%CI:2.25-15.92)的患者发生 EGFR 突变型晚期肺癌的风险较高。有肺炎住院史(OR:5.22;95%CI:1.88-14.46)和胃食管反流病(OR:2.02;95%CI:1.32-3.07)住院史的患者发生 EGFR 突变型肺癌的风险也较高。
患有 EGFR 突变型晚期肺癌的患者与年龄增长、肺炎住院史和胃食管反流病有关。