Zhang J, Ma Z M, Wang H, Fu Y T, Ji C, Zhu M, Shen H B, Ma H X
Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2023 Aug 6;57(8):1147-1152. doi: 10.3760/cma.j.cn112150-20221115-01112.
To investigate the association between chronic lung diseases and the risk of lung cancer. Using UK Biobank (UKB) survey data, 472 397 participants who had not previously been diagnosed with cancer and whose self-reported sex was consistent with their genetic sex were studied. Information on the prevalence of previous chronic lung diseases, general demographic characteristics and the prevalence of lung cancer was collected using baseline questionnaires and national health system data. The multivariate Cox proportional risk regression model was used to analyze the association between four previous chronic lung diseases (asthma, chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis and interstitial pulmonary disease) and the risk of lung cancer. A total of 458 526 participants with genotype data in the observational study were selected as research objects, and the closely related and independent genetic loci with four chronic lung diseases were selected as instrumental variables, and the association between four chronic lung diseases and the risk of lung cancer was analyzed by Mendelian randomization (MR). The dose-response relationship between genetic risk score and the risk of lung cancer in different chronic lung diseases was evaluated using a restricted cubic spline function. The age [ (, )] of the subjects was 57 (50, 63) years old, and there were 3 516 new cases of lung cancer (0.74%) during follow-up. The multivariate Cox proportional hazard regression model analysis showed that previous chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis were associated with the risk of lung cancer, about 1.61 (1.49-1.75) and 2.61 (1.24-5.49), respectively. MR Studies showed that genetically predicted chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis were associated with the risk of lung cancer, with (95%) of 1.10 (1.03-1.19) and 1.04 (1.01-1.08), respectively. The results of restricted cubic spline function analysis showed that the risk of lung cancer increased linearly with the increase of genetic risk scores for chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis (<0.05). Neither observational studies nor Mendelian randomization analysis found an association between previous asthma or interstitial lung disease and the risk of lung cancer (both values>0.05). Chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis are potential risk factors for lung cancer.
为研究慢性肺部疾病与肺癌风险之间的关联。利用英国生物银行（UKB）的调查数据，对472397名既往未被诊断患有癌症且自我报告的性别与其基因性别一致的参与者进行了研究。通过基线调查问卷和国家卫生系统数据收集了既往慢性肺部疾病的患病率、一般人口统计学特征以及肺癌的患病率信息。采用多变量Cox比例风险回归模型分析四种既往慢性肺部疾病（哮喘、慢性阻塞性肺疾病、特发性肺纤维化和间质性肺疾病）与肺癌风险之间的关联。在观察性研究中，共选取458526名具有基因数据的参与者作为研究对象，选取与四种慢性肺部疾病密切相关且独立的基因位点作为工具变量，通过孟德尔随机化（MR）分析四种慢性肺部疾病与肺癌风险之间的关联。使用受限立方样条函数评估不同慢性肺部疾病中基因风险评分与肺癌风险之间的剂量反应关系。受试者的年龄[（，）]为57（50，63）岁，随访期间有3516例新发肺癌病例（0.74%）。多变量Cox比例风险回归模型分析显示，既往慢性阻塞性肺疾病和特发性肺纤维化与肺癌风险相关，分别约为1.61（1.49 - 1.75）和2.61（1.24 - 5.49）。MR研究表明，基因预测的慢性阻塞性肺疾病和特发性肺纤维化与肺癌风险相关，分别为（95%）1.10（1.03 - 1.19）和1.04（1.01 - 1.08）。受限立方样条函数分析结果显示，慢性阻塞性肺疾病和特发性肺纤维化的肺癌风险随基因风险评分的增加呈线性增加（<0.05）。观察性研究和孟德尔随机化分析均未发现既往哮喘或间质性肺疾病与肺癌风险之间存在关联（两者值均>0.05）。慢性阻塞性肺疾病和特发性肺纤维化是肺癌的潜在危险因素。
