室外空气污染、生活方式、遗传因素与肺癌风险的关联：一项前瞻性队列研究。
Association of outdoor air pollution, lifestyle, genetic factors with the risk of lung cancer: A prospective cohort study.
作者信息
Liang Huaying, Zhou Xin, Zhu Yiqun, Li Dianwu, Jing Danrong, Su Xiaoli, Pan Pinhua, Liu Hong, Zhang Yan
机构信息
Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital of Central South University, Changsha, 410008, Hunan, China; Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, 410008, Hunan, China; Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, 410008, Hunan, China; Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, 410008, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, 410008, Hunan, China.
Department of Dermatology, Xiangya Hospital of Central South University, Changsha, 410008, Hunan, China.
出版信息
Environ Res. 2023 Feb 1;218:114996. doi: 10.1016/j.envres.2022.114996. Epub 2022 Dec 5.
OBJECTIVES
The effect of air pollution exposure on incident lung cancer remains uncertain, and the modifying role of lifestyle and genetic susceptibility in association between air pollution and lung cancer is ambiguous.
METHODS
A total of 367,623 participants from UK biobank cohort were enrolled in the analysis. The concentrations of particle matter (PM, PM), nitrogen dioxide (NO), and nitrogen oxides (NO), were evaluated by land-use regression model. Cox proportional hazard model was applied to assess the associations between air pollution and incident lung cancer. A lifestyle risk score and a polygenic risk score were established to investigate whether lifestyle and heritable risk could modify the effect of air pollution on lung cancer risk.
RESULTS
Per interquartile range (IQR) increment in annual concentrations of PM (HR = 1.22, 95% CI, 1.15∼1.30), NO (HR = 1.19, 95% CI, 1.10∼1.27), and NO (HR = 1.14, 95% CI, 1.09∼1.20) were associated with increased risk of lung cancer. We observed an additive interaction between air pollution including PM and NO and lifestyle or genetic risk. Individuals with high air pollution exposure, poor lifestyle and high genetic risk had the highest risk of incident lung cancer.
CONCLUSION
Long-term exposures to air pollution is associated with increased risk of lung cancer, and this effect was modified by lifestyle or genetic risk. Integrated interventions for environmental pollution by government and adherence to healthy lifestyle by individuals are advocated for lung cancer prevention.
目的
空气污染暴露对肺癌发病的影响尚不确定，生活方式和遗传易感性在空气污染与肺癌关联中的调节作用也不明确。
方法
对英国生物银行队列中的367,623名参与者进行分析。采用土地利用回归模型评估颗粒物（PM、PM）、二氧化氮（NO）和氮氧化物（NO）的浓度。应用Cox比例风险模型评估空气污染与肺癌发病之间的关联。建立生活方式风险评分和多基因风险评分，以研究生活方式和遗传风险是否会改变空气污染对肺癌风险的影响。
结果
PM年浓度每增加一个四分位数间距（IQR）（风险比[HR]=1.22，95%置信区间[CI]为1.15至1.30）、NO（HR=1.19，95%CI为1.10至1.27）和NO（HR=1.14，95%CI为1.09至1.20）与肺癌风险增加相关。我们观察到包括PM和NO在内的空气污染与生活方式或遗传风险之间存在相加交互作用。空气污染暴露高、生活方式差且遗传风险高的个体患肺癌的风险最高。
结论
长期暴露于空气污染与肺癌风险增加相关，且这种影响会因生活方式或遗传风险而改变。提倡政府对环境污染进行综合干预以及个人坚持健康的生活方式以预防肺癌。
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