Lim Jeong Uk, Yoon Hyoung Kyu
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
J Thorac Dis. 2022 Feb;14(2):553-563. doi: 10.21037/jtd-21-655.
To review the association and pathophysiological link between lung cancer in never smokers and ambient particulate matter (PM).
Although the association between exposure to PM and lung cancer development is well known, the pathophysiological background is yet to be studied in depth. Never smokers comprise a large proportion of newly diagnosed lung cancer cases and account for 25% of all cases. Considering the carcinogenic nature of ambient PM and the fact that many patients with lung cancer are never smokers, it is necessary to evaluate the interrelation and possible clinical background, in order to effectively prevent lung cancer development in this subgroup.
An online search of literature was conducted. The National Center for Biotechnology Information (NCBI), PubMed, Google Scholar, Cochrane Library and EMBASE were searched.
In never smokers, the risk of lung cancer was dose-dependent with the concentration of ambient air pollutants. Regarding the pathophysiological link, involvement of epithelial mesenchymal transition (EMT) and chronic inflammation has been mentioned, but further studies are necessary to enable therapeutic interventions to prevent cancer development. Considering the significant burden of PM on lung cancer development, both public and clinical approaches to cancer prevention are essential. To prevent lung cancer more effectively, clinicians should develop a more individualized approach in patients, focusing on gender and genetic background.
回顾从不吸烟者肺癌与环境颗粒物（PM）之间的关联及病理生理联系。
尽管暴露于PM与肺癌发生之间的关联已为人所知，但其病理生理背景仍有待深入研究。从不吸烟者占新诊断肺癌病例的很大比例，占所有病例的25%。鉴于环境PM的致癌性质以及许多肺癌患者为从不吸烟者这一事实，有必要评估它们之间的相互关系及可能的临床背景，以便有效预防该亚组人群的肺癌发生。
进行文献在线检索。检索了美国国立生物技术信息中心（NCBI）、PubMed、谷歌学术、考克兰图书馆和EMBASE。
在从不吸烟者中，肺癌风险与环境空气污染物浓度呈剂量依赖性。关于病理生理联系，已提及上皮间质转化（EMT）和慢性炎症的参与，但需要进一步研究以实现预防癌症发生的治疗干预。鉴于PM对肺癌发生的重大影响，公共和临床层面的癌症预防方法都至关重要。为了更有效地预防肺癌，临床医生应针对患者制定更个体化的方法，关注性别和遗传背景。
