Park Eun Young, Lim Min Kyung, Park Eunjung, Oh Jin-Kyoung, Lee Do-Hoon
Division of Cancer Prevention and Early Detection, National Cancer Control Institute, National Cancer Center, Goyang-si, South Korea.
Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, South Korea.
Front Oncol. 2021 Mar 22;11:611674. doi: 10.3389/fonc.2021.611674. eCollection 2021.
No published studies have prospectively evaluated the association between urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) levels and lung cancer risk in the general population. Here, we conducted a prospective community-based cohort study in the Republic of Korea to evaluate the relationship between urinary NNAL levels and lung cancer risk using prediagnostic urine samples. This prospective cohort study was based on the Korean National Cancer Center Community Cohort. During the follow-up period, 173 primary lung cancer cases were identified. Total urinary NNAL levels were measured by liquid chromatography-tandem mass spectrometry, and data were analyzed using multivariable Cox proportional hazards regression models. The risk of lung cancer was significantly increased per unit of natural log-transformed urinary NNAL (HR, 1.27; 95% CI, 1.09-1.48), after adjusting for age, region, entry year into the cohort, education achievement, alcohol consumption status, BMI, smoking status, and urinary cotinine levels. Cox proportional-hazards models with NNAL quartiles also showed positive dose-response relationships with risk of lung cancer. A significantly increased risk of lung cancer was found in the fourth quartile of urinary NNAL levels (HR, 3.27; 95% CI, 1.37-7.79, P for trend < 0.01). After stratification with sex, the significant association remained in only men. Urinary NNAL levels are associated with the risk of lung cancer in the general population, and this association is independent from the quantification of cigarette smoking and nicotine uptake.
尚无已发表的研究前瞻性评估普通人群中尿4-(甲基亚硝胺基)-1-(3-吡啶基)-1-丁醇(NNAL)水平与肺癌风险之间的关联。在此，我们在大韩民国进行了一项基于社区的前瞻性队列研究，以使用诊断前尿液样本评估尿NNAL水平与肺癌风险之间的关系。这项前瞻性队列研究基于韩国国立癌症中心社区队列。在随访期间，共确定了173例原发性肺癌病例。通过液相色谱-串联质谱法测量尿总NNAL水平，并使用多变量Cox比例风险回归模型分析数据。在校正年龄、地区、队列进入年份、教育程度、饮酒状况、BMI、吸烟状况和尿可替宁水平后，每单位自然对数转换的尿NNAL肺癌风险显著增加(HR, 1.27; 95% CI, 1.09 - 1.48)。NNAL四分位数的Cox比例风险模型也显示与肺癌风险呈正剂量反应关系。在尿NNAL水平的第四个四分位数中发现肺癌风险显著增加(HR, 3.27; 95% CI, 1.37 - 7.79, 趋势P<0.01)。按性别分层后，仅在男性中仍存在显著关联。尿NNAL水平与普通人群的肺癌风险相关，且这种关联独立于吸烟量和尼古丁摄入量的量化。
