한빛사 논문
연세대학교 의과대학
Abstract
Young Joo Lee, Byoung Chul Cho, Sun Ha Jee, Jin Wook Moon, Se Kyu Kim, Joon Chang, Kyung Young Chung, In Kyu Park, Sung Ho Choi, Joo-Hang Kim
From the Yonsei Cancer Center; Department of Internal Medicine; Institute for Health Promotion, Department of Epidemiology and Health Promotion, Graduate School of Public Health; Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea; and ISU ABXIS CO, LTD, Seoul, Republic of Korea.
Corresponding author: Byoung Chul Cho, MD, Yonsei Cancer Center, Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, Republic of Korea, CPO Box 8044,120-752
Purpose Active tobacco smoking has been associated with the incidence of epidermal growth factor receptor (EGFR) mutations. However, the impact of environmental tobacco smoke (ETS) on EGFR mutations has been unknown. We investigated an association between ETS exposure and EGFR mutations in never smokers with non?small-cell lung cancer (NSCLC).
Patients and Methods We enrolled 179 consecutive never smokers who were newly diagnosed with NSCLC. The history of ETS exposure was obtained with a standardized questionnaire that included exposure period, place, and duration. The nucleotide sequences of exons 18 to 21 on EGFR gene were determined using nested polymerase chain reaction amplification.
Results The incidence of EGFR mutations was significantly lower in patients with ETS exposure than in those without (38.5% v 61.4%; P = .008). In a logistic regression model that adjusted for sex and histology, an adjusted odds ratio (AOR) for the risk of EGFR mutations with exposure to ETS was 0.40 (95% CI, 0.20 to 0.81; P = .011). In quartile groups based on total smoker-year, the AORs for the lowest- to highest-quartile groups were 0.59 (95% CI, 0.23 to 1.49), 0.50 (95% CI, 0.17 to 1.50), 0.48 (95% CI, 0.20 to 1.18), and 0.22 (95% CI, 0.08 to 0.62; Ptrend = .028). Among the types of ETS exposure, adulthood ETS and household ETS were significantly associated with the incidence of EGFR mutations. Patients with ETS exposure showed a lower response rate to EGFR tyrosine kinase inhibitors than did patients without ETS exposure (24.6% v 44.8%; P = .053).
Conclusion ETS exposure is negatively associated with EGFR mutations in never smokers with NSCLC.
Supported in part by a faculty research grant of Yonsei University College of Medicine for 6-2008-0107, Yonsei University Research Fund of 2008, and the Korean Cancer Foundation.
Presented in part at the 43rd Annual Meeting of the American Society of Clinical Oncology, June 1-5, 2007, Chicago, IL.
Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.
논문정보
관련 링크
연구자 키워드
연구자 ID
관련분야 연구자보기
소속기관 논문보기
관련분야 논문보기
해당논문 저자보기