Yang Lei, Hong Yang, Zeng TingTing, Yue HongMei, Jiang DePeng
Department of Respiratory Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Endocrinology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Med (Lausanne). 2025 Jan 24;12:1460956. doi: 10.3389/fmed.2025.1460956. eCollection 2025.
The incidence of lung cancer is closely associated with diabetes; however, it remains unclear whether diabetes influences the genetic mutations present in lung cancer. Therefore, we will compare the genetic mutations in patients with lung adenocarcinoma (ADC) who have diabetes against those who do not.
We included 279 patients diagnosed with lung adenocarcinoma (143 with diabetes and 136 without diabetes) at the Second Affiliated Hospital of Chongqing Medical University between 2016 and 2023, and analyzed the clinical characteristics and genetic mutation profiles of all participants.
In comparison to ADC patients without diabetes, those with diabetes exhibited a lower overall gene mutation rate (49.7% vs. 65.4%, = 0.008). Female ADC patients demonstrated a higher total gene mutation rate and EGFR gene mutation rate than their male counterparts (49.3% vs. 66.9%, = 0.003; 27.6% vs. 58.3%, < 0.001, respectively), although their TP53 gene mutation rate was lower (8.6% vs. 2.4%, = 0.027). ADC patients without a smoking history had a higher gene mutation rate and EGFR gene mutation rate than those with a smoking history (62.6% vs. 47.4%, = 0.014; 51.6% vs. 22.7%, < 0.001, respectively), but a lower KRAS gene mutation rate (4.4% vs. 14.4%, = 0.003). Conversely, ADC patients with a drinking history had a lower EGFR gene mutation rate than those without (48% vs. 62.6%, = 0.018; 31.0% vs. 47.5%, = 0.007), yet a higher KRAS gene mutation rate (14.0% vs. 4.5%, = 0.005). Univariate and multivariate linear regression analyses revealed that being female, having no smoking history, and being in phase II or IV of tumor stage were associated with gene mutation. Subgroup analysis indicated that the rate of gene mutation in male smoking lung adenocarcinoma patients with diabetes was significantly lower than in those without diabetes.
This retrospective study of real-world data suggests that patients with lung adenocarcinoma and diabetes may have a reduced likelihood of developing genetic mutations, particularly among male smokers. Furthermore, gender, smoking history, and tumor stage may be correlated with the presence of gene mutations.
肺癌发病率与糖尿病密切相关；然而，糖尿病是否会影响肺癌中的基因突变仍不清楚。因此，我们将比较患有糖尿病的肺腺癌（ADC）患者与未患糖尿病的患者的基因突变情况。
我们纳入了2016年至2023年在重庆医科大学附属第二医院被诊断为肺腺癌的279例患者（143例患有糖尿病，136例未患糖尿病），并分析了所有参与者的临床特征和基因突变谱。
与未患糖尿病的ADC患者相比，患有糖尿病的患者总体基因突变率较低（49.7%对65.4%，P = 0.008）。女性ADC患者的总基因突变率和表皮生长因子受体（EGFR）基因突变率高于男性患者（分别为49.3%对66.9%，P = 0.003；27.6%对58.3%，P < 0.001），尽管其TP53基因突变率较低（8.6%对2.4%，P = 0.027）。无吸烟史的ADC患者的基因突变率和EGFR基因突变率高于有吸烟史的患者（分别为62.6%对47.4%，P = 0.014；51.6%对22.7%，P < 0.001），但KRAS基因突变率较低（4.4%对14.4%，P = 0.003）。相反，有饮酒史的ADC患者的EGFR基因突变率低于无饮酒史的患者（48%对62.6%，P = 0.018；31.0%对47.5%，P = 0.007），但KRAS基因突变率较高（14.0%对4.5%，P = 0.005）。单因素和多因素线性回归分析显示，女性、无吸烟史以及处于肿瘤分期的II期或IV期与基因突变有关。亚组分析表明，患有糖尿病的男性吸烟肺腺癌患者的基因突变率显著低于未患糖尿病的患者。
这项基于真实世界数据的回顾性研究表明，患有肺腺癌和糖尿病的患者发生基因突变的可能性可能降低，尤其是在男性吸烟者中。此外，性别、吸烟史和肿瘤分期可能与基因突变的存在相关。
