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1.
J Environ Radioact ; 222: 106351, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32892905

RESUMO

Radon, a gaseous radioactive decay product of naturally-occurring uranium is widely distributed in the environment in rocks and soils and, in certain circumstances, can accumulate in the built environment. Initial studies confirmed a direct link between exposure to both radon gas and its short-lived radioactive progeny, and increased lung-cancer incidence, and demonstrated that radon levels in domestic housing can be sufficiently high to expose occupants to increased risk of lung-cancer. Subsequent studies worldwide have shown that it is cost-effective to detect and reduce domestic radon levels in order to reduce this risk. Recent advances in the early detection of lung-cancer, coupled with the development of improved treatment procedures, have progressively improved survival from the disease, with the numbers surviving at 5 years doubling over recent years, during which period the real costs of lung cancer treatment have risen by around 30%. In the meantime, however, in addition to radon and tobacco-smoke, other airborne pollutants have been identified as risk-factors for lung-cancer. This paper reviews both these actual developments and anticipated future trends, and concludes that since these advances in diagnosis and treatment of lung-cancer have had only a modest effect on cost-effectiveness, it is still important to conduct radon monitoring and remediation programmes. While the general increase in life-expectancy improves the cost-effectiveness of radon remediation programmes significantly, reducing tobacco-smoking incidence reduces that cost-effectiveness but with the overall benefit of reducing radon-related lung-cancers. The challenge remains of encouraging affected householders to remediate their homes to reduce radon levels.


Assuntos
Poluição do Ar em Ambientes Fechados , Neoplasias Pulmonares , Monitoramento de Radiação , Radônio , Poluição do Ar em Ambientes Fechados/economia , Poluição do Ar em Ambientes Fechados/prevenção & controle , Análise Custo-Benefício , Habitação , Humanos , Neoplasias Pulmonares/epidemiologia , Reino Unido
2.
Anticancer Res ; 40(10): 5895-5899, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32988920

RESUMO

BACKGROUND: Randomized controlled trials had demonstrated local therapy, such as radiotherapy, can improve outcomes of patients with lung cancer with oligometastatic disease (OMD). However, the definition of OMD is not uniform and the European Society for Radiotherapy and Oncology (ESTRO) and European Organisation for Research and Treatment of Cancer (EORTC) proposed a new classification in 2020 comprising nine subtypes. Therefore, we aimed to investigate the prognostic significance of this European classification for patients with lung OMD treated with definitive radical radiotherapy. PATIENTS AND METHODS: We identified eligible patients via an in-house database. Patient, disease, and treatment characteristics, as well as outcomes, were obtained via chart review plus peer review. Overall and progression-free survival were estimated via the Kaplan-Meier method. Log-rank test was used in univariate analysis and Cox regression in multivariable analyses to investigate the prognostic significance of the subtypes of OMD. RESULTS: We identified 35 eligible patients with six different OMD subtypes treated from 2011 to 2019. After a median follow-up of 23 (range=2-88) months, the median progression-free and overall survival were 11 and 38 months, respectively. The prognosis for patients with the subtype 'induced oligoprogression' was statistically worse than for those without in both univariate (p=0.02) and multivariate (adjusted hazard ratio for death=4.8, 95% confidence interval=1.4-16.2, p=0.01) analyses. CONCLUSION: We found the subtype with induced oligoprogression in the European classification to be associated with worse survival. Further studies are needed to confirm our finding.


Assuntos
Neoplasias Pulmonares/radioterapia , Prognóstico , Radioterapia (Especialidade)/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Europa (Continente)/epidemiologia , Feminino , Humanos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Intervalo Livre de Progressão , Radiocirurgia/efeitos adversos
3.
Cancer Control ; 27(1): 1073274820960467, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32938231

RESUMO

Patients with lung cancer are presumed to be at high risk from COVID-19 infection due to underlying malignancy. A total of 31 COVID-19 patients with pre-diagnosed lung cancer and 186 age and sex matched COVID-19 patients without cancer in 6 hospitals in Wuhan, China were identified in our study. There was a significantly higher level of IL-6 in lung cancer group showed by multifactorial analysis. The restricted mean survival time in 10, 20, and 53 days in COVID-19 patients with lung cancer were ealier than non-cancer COVID-19 patients in the same observation time (all P values < 0.05). Our results indicated that pre-diagnosed lung cancer was associated with higher morbidity and mortality in COVID-19 patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Neoplasias Pulmonares/complicações , Pandemias , Pneumonia Viral/epidemiologia , China/epidemiologia , Infecções por Coronavirus/complicações , Feminino , Hospitalização/tendências , Humanos , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/complicações , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida/tendências
4.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1076-1080, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741174

RESUMO

Objective: To evaluate the compliance of low-dose computed tomography (LDCT) screening for high-risk groups of lung cancer and influencing factors in urban area of Henan province during 2013-2017. Methods: Cluster sampling method was used to select the residents of 40-74 years old in Henan for cancer risk factor investigation and lung cancer risk assessment. Subjects with high risk of lung cancer received LDCT screening. The differences of LDCT receiving rates between groups were compared with χ(2) tests, and the time trend of rates were tested with the Cochran- Armitage trend test. The potential factors correlating to the compliance of LDCT screening were identified with multivariate logistic regression models. Results: Overall, 35 672 participants who met the inclusion criteria were included in this analysis, and 13 383 of them received LDCT screening, the receiving rate was 37.52%. The receiving rate varied greatly across cities, ranging from 38.47% to 26.73% (P<0.05). Moreover, the receiving rate varied greatly across periods, ranging from 29.22% during 2013-2014 to 43.30% during 2014-2015, and the receiving rate increases gradually as the screening year increases (P<0.001). The multivariate logistic regression analyses showed that: being female, age 45-69 years, with education level of junior high school/high school, previous smoking, drinking or previous drinking, infrequent physical exercise, history of tuberculosis, history of chronic bronchitis, history of emphysema, history of asthma bronchiectasis and family history of lung cancer were positive factors for receiving LDCT screening (All P<0.05). Conclusions: The overall compliance of LDCT screening in high-risk population of lung cancer was still not high in urban area of Henan. Implementation of effective interventions targeting the specific high-risk populations might improve the overall compliance of LDCT screening in the future.


Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Neoplasias Pulmonares/prevenção & controle , Cooperação do Paciente/estatística & dados numéricos , Tomografia Computadorizada por Raios X/métodos , População Urbana , Adulto , Idoso , China/epidemiologia , Feminino , Humanos , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
5.
Medicine (Baltimore) ; 99(30): e21411, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791756

RESUMO

Lung cancer is a common malignancy worldwide, and risk factors include bronchitis, asthma, tuberculosis, smoking, and air pollution. These are also risk factors for spontaneous pneumothorax, a benign disease. We hypothesized that patients who experience a spontaneous pneumothorax have a greater risk to develop lung cancer, and designed a study to determine if this is so.We used the population-based Taiwan Health Insurance Research Database to perform a retrospective cohort study. The database includes more than 99% of the population of Taiwan. We established a 27,405-person pneumothorax cohort and a 109,620 person comparison cohort with data from 2000 to 2009 to evaluate the relationship between spontaneous pneumothorax and lung cancer.Multivariable analysis showed that patients who have had a spontaneous pneumothorax have a greater relative risk to develop lung cancer. The overall hazard ratio was 2.09 (95% confidence interval 1.69-2.58) adjusted by age, gender, hypertension, diabetes mellitus, and chronic lung diseases such as chronic obstructive pulmonary disease, tuberculosis, asthma, bronchitis, and emphysema. A dose effect was present; a high frequency of spontaneous pneumothorax was associated with a greater relative risk to develop lung cancer. If the spontaneous pneumothorax frequency was greater than 2 times per year, the hazard ratio was 34.09 (95% confidence interval 22.74-51.10)Patients with spontaneous pneumothorax have an increased relative risk to develop lung cancer, especially among patients 35 to 49 years of age. The more frequent the occurrence of spontaneous pneumothorax, the greater the relative risk of lung cancer. If the spontaneous pneumothorax frequency was greater than 2 times per year, the increase in risk of lung cancer was more than 30-fold.


Assuntos
Neoplasias Pulmonares/epidemiologia , Pneumotórax/epidemiologia , Adulto , Idoso , Feminino , Humanos , Neoplasias Pulmonares/etiologia , Masculino , Pessoa de Meia-Idade , Pneumotórax/complicações , Estudos Retrospectivos , Taiwan/epidemiologia
7.
N Engl J Med ; 383(7): 640-649, 2020 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-32786189

RESUMO

BACKGROUND: Lung cancer is made up of distinct subtypes, including non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC). Although overall mortality from lung cancer has been declining in the United States, little is known about mortality trends according to cancer subtype at the population level because death certificates do not record subtype information. METHODS: Using data from Surveillance, Epidemiology, and End Results (SEER) areas, we assessed lung-cancer mortality and linked deaths from lung cancer to incident cases in SEER cancer registries. This allowed us to evaluate population-level mortality trends attributed to specific subtypes (incidence-based mortality). We also evaluated lung-cancer incidence and survival according to cancer subtype, sex, and calendar year. Joinpoint software was used to assess changes in incidence and trends in incidence-based mortality. RESULTS: Mortality from NSCLC decreased even faster than the incidence of this subtype, and this decrease was associated with a substantial improvement in survival over time that corresponded to the timing of approval of targeted therapy. Among men, incidence-based mortality from NSCLC decreased 6.3% annually from 2013 through 2016, whereas the incidence decreased 3.1% annually from 2008 through 2016. Corresponding lung cancer-specific survival improved from 26% among men with NSCLC that was diagnosed in 2001 to 35% among those in whom it was diagnosed in 2014. This improvement in survival was found across all races and ethnic groups. Similar patterns were found among women with NSCLC. In contrast, mortality from SCLC declined almost entirely as a result of declining incidence, with no improvement in survival. This result correlates with limited treatment advances for SCLC in the time frame we examined. CONCLUSIONS: Population-level mortality from NSCLC in the United States fell sharply from 2013 to 2016, and survival after diagnosis improved substantially. Our analysis suggests that a reduction in incidence along with treatment advances - particularly approvals for and use of targeted therapies - is likely to explain the reduction in mortality observed during this period.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/mortalidade , Neoplasias Pulmonares/mortalidade , Carcinoma Pulmonar de Células não Pequenas/epidemiologia , Feminino , Humanos , Incidência , Neoplasias Pulmonares/epidemiologia , Masculino , Mortalidade/tendências , Programa de SEER , Fatores Sexuais , Estados Unidos/epidemiologia
8.
PLoS One ; 15(8): e0236736, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785269

RESUMO

Quantifying the association between lifetime exposures and the risk of developing a chronic disease is a recurrent challenge in epidemiology. Individual exposure trajectories are often heterogeneous and studying their associations with the risk of disease is not straightforward. We propose to use a latent class mixed model (LCMM) to identify profiles (latent classes) of exposure trajectories and estimate their association with the risk of disease. The methodology is applied to study the association between lifetime trajectories of smoking or occupational exposure to asbestos and the risk of lung cancer in males of the ICARE population-based case-control study. Asbestos exposure was assessed using a job exposure matrix. The classes of exposure trajectories were identified using two separate LCMM for smoking and asbestos, and the association between the identified classes and the risk of lung cancer was estimated in a second stage using weighted logistic regression and all subjects. A total of 2026/2610 cases/controls had complete information on both smoking and asbestos exposure, including 1938/1837 cases/controls ever smokers, and 1417/1520 cases/controls ever exposed to asbestos. The LCMM identified four latent classes of smoking trajectories which had different risks of lung cancer, all much stronger than never smokers. The most frequent class had moderate constant intensity over lifetime while the three others had either long-term, distant or recent high intensity. The latter had the strongest risk of lung cancer. We identified five classes of asbestos exposure trajectories which all had higher risk of lung cancer compared to men never occupationally exposed to asbestos, whatever the dose and the timing of exposure. The proposed approach opens new perspectives for the analyses of dose-time-response relationships between protracted exposures and the risk of developing a chronic disease, by providing a complete picture of exposure history in terms of intensity, duration, and timing of exposure.


Assuntos
Asbestos/efeitos adversos , Neoplasias Pulmonares/induzido quimicamente , Neoplasias Pulmonares/epidemiologia , Exposição Ocupacional/efeitos adversos , Fumar/efeitos adversos , Adulto , Idoso , Doença Crônica/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
9.
PLoS One ; 15(8): e0237723, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32857771

RESUMO

PURPOSE: This study investigated nicotine dependence as an independent risk factor for upper aerodigestive tract (UADT) cancers, including lung and head and neck cancers (HNC). The study aimed to isolate the direct effect of nicotine dependence, independent of tobacco smoking. METHODS: A case-control study with a total of 4957 participants was conducted in Ontario, Canada, of which 2964 categorized as either current or former smokers were used in the analysis. Nicotine dependence of ever-smokers (2360 UADT cases and 604 controls) was measured using the Fagerström Test for Nicotine Dependence. Using mediation analyses and adjusted logistic regression models, we decomposed the direct effect of nicotine dependence and the mediated effect of smoking duration to quantify the risks of lung and HNC. The role of human papillomavirus (HPV) and cancer subtypes were assessed. RESULTS: Most individual nicotine dependence behaviours showed positive associations with lung cancer with approximately 1.8 to 3.5-fold risk increase, and to lesser extent with 1.4 to 2.3-fold risk for HNC. Nicotine dependence is partially accountable for increased risks of lung cancer (OR = 1.20, 95%CI = 1.13-1.28) and HNC (1.12, 95%CI = 1.04-1.19). Nicotine dependence had a greater effect on the risk of HPV-negative oropharyngeal cancer (OR = 3.06, 95%CI = 1.65-5.66) in comparison to HPV-positive oropharyngeal cancer (OR = 1.05, 95%CI = 0.67-1.65). The direct effects of nicotine dependence remained significant after accounting for cumulative tobacco exposures. CONCLUSION: Nicotine dependence increases the risks of lung and HNC cancers after accounting for tobacco smoking, suggesting potential toxic effects of nicotine. These results are informative for the safety consideration of nicotine exposures.


Assuntos
Neoplasias de Cabeça e Pescoço/epidemiologia , Neoplasias Pulmonares/epidemiologia , Nicotina/efeitos adversos , Tabagismo/epidemiologia , Idoso , Estudos de Casos e Controles , Feminino , Neoplasias de Cabeça e Pescoço/etiologia , Humanos , Neoplasias Pulmonares/etiologia , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Medição de Risco , Fatores de Risco , Fatores de Tempo , Tabagismo/complicações
11.
Interact Cardiovasc Thorac Surg ; 31(3): 339-341, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32728692

RESUMO

Coronavirus disease-19 (COVID-19) has rapidly spread to more than 200 countries all around the world, which are facing challenges in controlling its spread. The Italian Government initiated an unprecedented public health intervention to contain the epidemic by shutting down all people movements. Two weeks after the start of the lockdown period, the daily rate of patient admissions to hospitals significantly decreased. After 2 months, the quarantine progressively came to an end. A practical issue at this time is when and how the lockdown interventions should be relaxed since, without an effective vaccine, the general public still remains vulnerable. However, patient should not be placed at an increased risk of dying of lung cancer just to avoid COVID-19. Attention must be paid to all types of cancers and people should not hesitate to go to the hospital to be treated in time. All necessary actions should be taken by hospitals to minimize the risks of potential contagion, by designating differentiated routes and areas for patients potentially affected by COVID-19, while maintaining the highest standard of oncological care. If this 'cancer amnesia' situation persists, the mortality from lung neoplasms would far exceed that directly associated with the COVID-19 pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Gerenciamento Clínico , Neoplasias Pulmonares/complicações , Pneumonia Viral/complicações , Quarentena/métodos , Infecções por Coronavirus/epidemiologia , Humanos , Incidência , Itália/epidemiologia , Neoplasias Pulmonares/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia
12.
N Z Med J ; 133(1518): 73-78, 2020 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-32683434

RESUMO

Overseas, emerging research has shown that where erionite is present in bedrock as a zeolite, and then subsequently disturbed and blown into the atmosphere, resulting exposure is associated with health effects similar to those caused by asbestos, including malignant mesothelioma (MM). Erionite-induced MM is thought to be particularly prevalent in the construction and quarrying industries, in regions where rock containing erionite is disturbed. In 2015, the then Government Chief Scientist, Sir Peter Gluckman, reported that erionite was a more potent carcinogen than asbestos, and more recent studies have established its presence in the Auckland Region. However, globally at present, there are no established occupational exposure limits for erionite, standard sampling and analytical methods or exposure mitigation guidelines. Given the many major construction projects being carried out in Auckland at the present time, which involve the removal of large quantities of bedrock containing erionite, an assessment of the health risks such activities pose to the public is needed.


Assuntos
Neoplasias Pulmonares/induzido quimicamente , Mesotelioma/induzido quimicamente , Exposição Ocupacional/efeitos adversos , Saúde do Trabalhador , Saúde Pública , Zeolitas/efeitos adversos , Humanos , Incidência , Neoplasias Pulmonares/epidemiologia , Mesotelioma/epidemiologia , Nova Zelândia/epidemiologia
13.
Anticancer Res ; 40(7): 4137-4145, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620663

RESUMO

BACKGROUND/AIM: Lung diseases are common in patients with abdominal aortic aneurysms (AAA). This study evaluates the prevalence of lung cancer (LC) in high-risk patients screened for AAA. PATIENTS AND METHODS: Six hundred and one male patients (≥65 years of age, cardiovascular high-risk profile) were enrolled and followed prospectively over a median of 16.5 months. RESULTS: In 29 patients (4.8%) LC and in another 50 patients (8.3%) AAA were found. The prevalence of LC among patients with AAA was even higher (9 of 50, 18.0%). Twenty-one patients had an initial diagnosis of LC, with an incidence of 12.0% (6 of 50) in patients with AAA. During follow-up, 14 of 70 patients with AAA and/ or LC (20.0%) deceased. The highest mortality was found in patients with LC only (8 of 20, 40.0%), followed by patients with both AAA and LC (3 of 9, 33.3%), while patients with AAA only had the lowest mortality rate (3 of 41, 7.3%). CONCLUSION: In patients with a high cardiovascular risk profile, a high prevalence of both AAA and LC were found, whereby the prognosis is largely determined by the LC. Therefore, LC is of particular importance in the setting of screening and surveillance of AAA.


Assuntos
Aneurisma da Aorta Abdominal/epidemiologia , Neoplasias Pulmonares/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Diabetes Mellitus/epidemiologia , Humanos , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Incidência , Masculino , Programas de Rastreamento , Prevalência , Prognóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fatores de Risco , Fumar/epidemiologia
14.
Public Health ; 185: 189-195, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32645506

RESUMO

OBJECTIVES: Lung cancer is the most commonly diagnosed cancer in Canada. This study aims to assess trends in income and education inequalities in the incidence of lung cancer in Canada. STUDY DESIGN: The study design is a time-trend analysis of nationally collected data. METHODS: Using a linked data set of the Canadian Cancer Registry (CCR) data file, the Canadian Census of Population and National Household Survey, we calculated the incidence of lung cancer in Canada over the period between 1992 and 2010. The age-adjusted concentration index (C), which captures socio-economic inequality across a continuous spectrum of socio-economic status, was used to measure income and education inequalities in the incidence of lung cancer in men and women. RESULTS: The crude incidence rate for men decreased significantly over time in Canada from 85 to 78 per 100,000 population from 1992 to 2010, respectively. For women, the crude incidence rate increased significantly over time in Canada from 45 to 67 per 100,000 population from 1992 to 2010, respectively. The age-adjusted C indicated a higher concentration of lung cancer incidence among low income and less educated Canadians over the study period. Although income inequality in lung cancer incidence decreased significantly over time for men, education inequality increased significantly for both men and women. CONCLUSIONS: Increased occurrence of lung cancer among the poor and less educated populations in Canada remains a challenge in Canada. Income and education gradients in the lung cancer incidence are likely explained by variations in known risk factors especially smoking across socio-economic groups. Continuous efforts are required to reduce the causes of lung cancer among low socio-economic status Canadians.


Assuntos
Escolaridade , Renda/tendências , Neoplasias Pulmonares/epidemiologia , Canadá/epidemiologia , Feminino , Humanos , Incidência , Renda/estatística & dados numéricos , Masculino , Pobreza , Sistema de Registros , Fatores de Risco , Fatores Sexuais , Classe Social , Fatores Socioeconômicos
15.
PLoS One ; 15(7): e0236475, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32726334

RESUMO

A historical cohort study in workers occupationally exposed to chrysotile was set up in the town of Asbest, the Russian Federation, to study their cause-specific mortality, with a focus on cancer. Chrysotile has different chemical and physical properties compared with other asbestos fibres; therefore it is important to conduct studies specifically of chrysotile and in different geographical regions to improve the knowledge about its carcinogenicity. Setting was the town of Asbest, Sverdlovsk oblast, the Russian Federation. Participants were all current and former employees with at least one year of employment between 1/1/1975 and 31/12/2010 in the mine, enrichment factories, auto-transport and external rail transportation departments, the central laboratory, and the explosives unit of the company. Of the 35,837 cohort members, 12,729 (35.5%) had died (2,373 of them of cancer, including 10 of mesothelioma), 18,799 (52.5%) were known to be alive at the end of the observation period (2015), and 4,309 (12.0%) were censored before the end of 2015. Mean follow-up duration was 21.7 years in men and 25.9 years in women. The mean age at death was 59.4 years in men and 66.5 years in women. This is the largest occupational cohort of chrysotile workers to date, and the only one with a large proportion of exposed female workers.


Assuntos
Asbestos Serpentinas/efeitos adversos , Neoplasias Pulmonares/epidemiologia , Mesotelioma/epidemiologia , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Adulto , Asbestos/efeitos adversos , Estudos de Coortes , Feminino , Humanos , Neoplasias Pulmonares/induzido quimicamente , Neoplasias Pulmonares/patologia , Masculino , Mesotelioma/induzido quimicamente , Mesotelioma/patologia , Pessoa de Meia-Idade , Doenças Profissionais/induzido quimicamente , Doenças Profissionais/patologia , Federação Russa/epidemiologia
16.
PLoS One ; 15(6): e0233445, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497048

RESUMO

OBJECTIVE: The present study aims to explore the role of smoking factors in the risk of lung cancer and screen the feature risk pathways of smoking-induced lung cancer. METHODS: The expression profiles of the patient data from GEO database were standardized, and differentially expressed genes (DEGs) were analyzed by limma algorithm. Samples and genes were analyzed by Unsupervised hierarchical clustering method, while GO and KEGG enrichment analyses were performed on DEGs. The data of the protein-protein interaction (PPI) network were downloaded from the BioGrid and HPRD databases, and the DEGs were mapped into the PPI network to identify the interaction relationship. The enriched significant pathways were used to calculate the anomaly score and RFE method was used to optimize the feature sets. The model was trained using the support vector machine (SVM) and the predicted results were plotted into ROC curves. The AUC value was calculated to evaluate the predictive performance of the SVM model. RESULTS: A total of 1923 DEGs were obtained, of which 826 were down-regulated and 1097 were up-regulated. Unsupervised hierarchical clustering analysis showed that the diagnosis accuracy of lung cancer smokers was 74%, and that of non-lung cancer smokers was 75%. Five optimal feature pathway sets were obtained by screening, the clinical diagnostic ability of which was detected by SVM model with the accuracy improved to 84%. The diagnostic accuracy was 90% after combining clinical information. CONCLUSION: We verified that five signaling pathways combined with clinical information could be used as a feature risk pathway for identifying lung cancer smokers and non-lung cancer smokers and increased the diagnostic accuracy.


Assuntos
Perfilação da Expressão Gênica , Neoplasias Pulmonares/etiologia , Fumar/efeitos adversos , Máquina de Vetores de Suporte , Área Sob a Curva , Análise por Conglomerados , DNA de Neoplasias/análise , DNA de Neoplasias/genética , Bases de Dados Genéticas , Ontologia Genética , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/genética , Mapeamento de Interação de Proteínas , Curva ROC , Fatores de Risco , Transdução de Sinais
17.
Arkh Patol ; 82(3): 18-23, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32593262

RESUMO

AIM OF STUDY: To determine a diagnostic algorithm for detecting translocation of the ALK gene and its frequency in the Moscow region. MATERIALS AND METHODS: During the priod between 2014 and 2018 (inclusive), 488 patients without activating mutations in the EGFR gene in the Moscow region were tested. To detect translocation of the ALK gene, fluorescence in situ hybridization (FISH) methods, an immunohistochemical method, and, in some cases, a polymerase chain reaction were used. RESULTS: Revealed ALK gene rearrangement in a population of patients with lung adenocarcinoma amounted to an average of 7.6% of cases. With this, the main method that we used was immunohistochemical method, applicable in more than 80% of cases. The use of other methods for verification of abnormalities in the ALK gene was found necessary in rare cases (3.3%). CONCLUSIONS: Using the algorithm presented in the article, it was possible to detect ALK gene rearrangement in a population of patients with lung adenocarcinoma in the Moscow region in an average of 7.6% of cases.


Assuntos
Quinase do Linfoma Anaplásico/genética , Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Adenocarcinoma , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/epidemiologia , Carcinoma Pulmonar de Células não Pequenas/genética , Rearranjo Gênico , Humanos , Hibridização in Situ Fluorescente , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/genética , Moscou , Mutação , Receptores Proteína Tirosina Quinases
18.
Ann Epidemiol ; 46: 14-19, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32532368

RESUMO

BACKGROUND: Lung cancer remains a major cause of death worldwide. While in the past it was considered to primarily afflict males, in recent decades the number of female patients has risen, such that rates among females are similar to those among males. Nevertheless, it has been found previously (e.g., in cardiovascular disease) that when there is a sex-specific stereotype to a disease, it may remain entrenched in medical diagnostic processes, so as to cause belated diagnosis among the other sex. Gender-based differences in incidence and diagnosis are likely to exist with respect to lung cancer because of smoking habits and stereotypes, geographic and socioeconomic differences, and past epidemiologic differences between the sexes. Here we aim to characterize the effects of gender on lung cancer diagnosis and whether such effects have changed over time. METHODS: The SEER (Statistics, Epidemiology, and End Results) database was used to check for sex-based differences by tumor type and stage at diagnosis and to investigate whether these patterns have changed with time by comparing staging data in different age cohorts over time. Results were stratified by location and analyzed with data regarding possible confounders such as smoking and socioeconomic factors. RESULTS: We examined 458,132 cases of lung cancer from the years 2004-2012; 243,021 (53%) in males and 215,111 (47%) in females. Lung cancer rates were 73.8 (73.5-74.1) per 100k in males and 51.6 (51.4-51.8) per 100k in females. Of these, 400,800 had the stage listed, 214,479 (54%) in males, and 186,321 (46%) in females. Total lung cancer rates were higher in males than females at all disease stages. Male patients were more likely than female patients to be diagnosed at stage 3-4, consistent across lung cancer types, cancer registries, smoking, and socioeconomic backgrounds. The difference between the percentage of males versus females diagnosed in stages 3-4 correlated negatively with increased female ever-smokers and with squamous and small cell carcinoma and were not correlated with the rate of cancer in females, or the difference between male and female cancer rates. CONCLUSIONS: Our study showed that there is no belated diagnosis of lung cancer in females. Results appear to point to the fact that smoking females are more likely to be diagnosed at later stages, which is consistent with the current literature.


Assuntos
Diagnóstico Tardio/estatística & dados numéricos , Neoplasias Pulmonares/patologia , Fatores Sexuais , Fumar/efeitos adversos , Adulto , Idoso , Feminino , Humanos , Incidência , Neoplasias Pulmonares/classificação , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Sistema de Registros , Programa de SEER , Fatores Socioeconômicos , Estados Unidos/epidemiologia
20.
Chemosphere ; 257: 127153, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32531486

RESUMO

The Yangtze River Delta region (YRD) is one of the most densely populated regions in the world, and is frequently influenced by fine particulate matter (PM2.5). Specifically, lung cancer mortality has been recognized as a major health burden associated with PM2.5. Therefore, this study developed a multistage approach 1) to first create dasymetric population data with moderate resolution (1 km) by using a random forest algorithm, brightness reflectance of nighttime light (NTL) images, a digital elevation model (DEM), and a MODIS-derived normalized difference vegetation index (NDVI), and 2) to apply the improved population dataset with a MODIS-derived PM2.5 dataset to estimate the association between spatiotemporal variability of long-term population exposure to PM2.5 and lung cancer mortality attributable to PM2.5 across YRD during 2010-2016 for microscale planning. The created dasymetric population data derived from a coarse census unit (administrative unit) were fairly matched with census data at a fine spatial scale (street block), with R2 and RMSE of 0.64 and 27,874.5 persons, respectively. Furthermore, a significant urban-rural difference of population exposure was found. Additionally, population exposure in Shanghai was 2.9-8 times higher than the other major cities (7-year average: 192,000 µg·people/m3·km2). More importantly, the relative risks of lung cancer mortality in high-risk areas were 28%-33% higher than in low-risk areas. There were 12,574-14,504 total lung cancer deaths attributable to PM2.5, and lung cancer deaths in each square kilometer of urban areas were 7-13 times higher than for rural areas. These results indicate that moderate-resolution information can help us understand the spatiotemporal variability of population exposure and related health risk in a high-density environment.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricos , Neoplasias Pulmonares/epidemiologia , Material Particulado/análise , China/epidemiologia , Cidades , Exposição Ambiental , Feminino , Humanos , Rios
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