Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Targeted Tracer Research and Development Laboratory, Med-X Center for Manufacturing, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Thoracic Surgery, Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
BMC Cancer. 2024 Jun 11;24(1):721. doi: 10.1186/s12885-024-12147-3.
BACKGROUND: Pneumonia and lung cancer are both major respiratory diseases, and observational studies have explored the association between their susceptibility. However, due to the presence of potential confounders and reverse causality, the comprehensive causal relationships between pneumonia and lung cancer require further exploration. METHODS: Genome-wide association study (GWAS) summary-level data were obtained from the hitherto latest FinnGen database, COVID-19 Host Genetics Initiative resource, and International Lung Cancer Consortium. We implemented a bidirectional Mendelian randomization (MR) framework to evaluate the causal relationships between several specific types of pneumonia and lung cancer. The causal estimates were mainly calculated by inverse-variance weighted (IVW) approach. Additionally, sensitivity analyses were also conducted to validate the robustness of the causalty. RESULTS: In the MR analyses, overall pneumonia demonstrated a suggestive but modest association with overall lung cancer risk (Odds ratio [OR]: 1.21, 95% confidence interval [CI]: 1.01 - 1.44, P = 0.037). The correlations between specific pneumonia types and overall lung cancer were not as significant, including bacterial pneumonia (OR: 1.07, 95% CI: 0.91 - 1.26, P = 0.386), viral pneumonia (OR: 1.00, 95% CI: 0.95 - 1.06, P = 0.891), asthma-related pneumonia (OR: 1.18, 95% CI: 0.92 - 1.52, P = 0.181), and COVID-19 (OR: 1.01, 95% CI: 0.78 - 1.30, P = 0.952). Reversely, with lung cancer as the exposure, we observed that overall lung cancer had statistically crucial associations with bacterial pneumonia (OR: 1.08, 95% CI: 1.03 - 1.13, P = 0.001) and viral pneumonia (OR: 1.09, 95% CI: 1.01 - 1.19, P = 0.037). Sensitivity analysis also confirmed the robustness of these findings. CONCLUSION: This study has presented a systematic investigation into the causal relationships between pneumonia and lung cancer subtypes. Further prospective study is warranted to verify these findings.
背景:肺炎和肺癌都是主要的呼吸系统疾病,观察性研究已经探讨了它们易感性之间的关系。然而,由于存在潜在的混杂因素和反向因果关系,肺炎和肺癌之间的综合因果关系需要进一步探索。
方法:我们从最新的 FinnGen 数据库、COVID-19 宿主遗传学倡议资源和国际肺癌联合会获得了全基因组关联研究(GWAS)汇总水平数据。我们采用双向孟德尔随机化(MR)框架来评估几种特定类型的肺炎和肺癌之间的因果关系。因果估计主要通过逆方差加权(IVW)方法计算。此外,还进行了敏感性分析以验证因果关系的稳健性。
结果:在 MR 分析中,总体肺炎与总体肺癌风险呈弱相关(比值比[OR]:1.21,95%置信区间[CI]:1.01-1.44,P=0.037)。特定肺炎类型与总体肺癌之间的相关性并不显著,包括细菌性肺炎(OR:1.07,95%CI:0.91-1.26,P=0.386)、病毒性肺炎(OR:1.00,95%CI:0.95-1.06,P=0.891)、哮喘相关肺炎(OR:1.18,95%CI:0.92-1.52,P=0.181)和 COVID-19(OR:1.01,95%CI:0.78-1.30,P=0.952)。相反,以肺癌为暴露因素,我们发现总体肺癌与细菌性肺炎(OR:1.08,95%CI:1.03-1.13,P=0.001)和病毒性肺炎(OR:1.09,95%CI:1.01-1.19,P=0.037)具有统计学上的显著关联。敏感性分析也证实了这些发现的稳健性。
结论:本研究系统地探讨了肺炎和肺癌亚型之间的因果关系。需要进一步的前瞻性研究来验证这些发现。
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