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环境 PM 暴露对肺叶切除术后肺癌患者生存的影响。

The effect of ambient PM exposure on survival of lung cancer patients after lobectomy.

机构信息

Office for DRGs (Diagnosis Related Groups), Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, PO Box 0061, No. 127 Dongming Rd, 450008, Zhengzhou, China.

International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Environ Health. 2023 Mar 7;22(1):23. doi: 10.1186/s12940-023-00976-x.

Abstract

Exposure to fine particulate matter (PM) is linked to lung cancer incidence and mortality. However, the impact of PM exposure on lung cancer patients after lobectomy, which remains the primary treatment for early-stage lung cancer, is unknown. Therefore, we investigated the correlation between PM exposure and the survival of lung cancer patients after lobectomy. This study included 3,327 patients with lung cancer who underwent lobectomy procedures. We converted residential addresses into coordinates and estimated individual patients' daily PM and O exposure levels. A Cox multivariate regression model was used to analyze the specific monthly association between PM exposure and lung cancer survival. Every 10 μg/m increase in monthly PM concentration in the first and second months after lobectomy increased the risk of death (hazard ratio [HR]: 1.043, 95% confidence interval [CI]: 1.019-1.067 and HR: 1.036, 95% CI: 1.013-1.060, respectively). Non-smokers, younger patients, and patients with longer hospitalization durations had worse survival rates when exposed to greater concentrations of PM. High postoperative PM exposure immediately after lobectomy reduced the survival of patients with lung cancer. Patients living in areas with high PM should be offered the opportunity to transfer to areas with better air quality after undergoing lobectomies, to prolong their survival times.

摘要

细颗粒物(PM)暴露与肺癌发病率和死亡率有关。然而,对于接受肺叶切除术的肺癌患者(肺叶切除术仍然是早期肺癌的主要治疗方法),PM 暴露的影响尚不清楚。因此,我们调查了 PM 暴露与肺叶切除术后肺癌患者生存之间的相关性。这项研究包括 3327 名接受肺叶切除术的肺癌患者。我们将居住地址转换为坐标,并估计了每位患者的每日 PM 和 O 暴露水平。采用 Cox 多变量回归模型分析了 PM 暴露与肺癌生存之间的特定月度关联。肺叶切除术后第一个和第二个月每月 PM 浓度每增加 10μg/m,死亡风险增加(风险比[HR]:1.043,95%置信区间[CI]:1.019-1.067 和 HR:1.036,95%CI:1.013-1.060)。非吸烟者、年轻患者和住院时间较长的患者在暴露于更高浓度的 PM 时,生存率更差。肺叶切除术后立即暴露于高浓度的术后 PM 降低了肺癌患者的生存率。应向接受肺叶切除术的患者提供机会,在手术后转移到空气质量较好的地区,以延长他们的生存时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31ba/9990243/74df79a17ff5/12940_2023_976_Fig1_HTML.jpg

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