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Dai L, Wang W, Liu Q, Xia T, Wang Q, Chen Q, Zhu N, Cheng Y, Yan Y, Shu J, Qu K. Development and validation of prognostic nomogram for lung cancer patients below the age of 45 years. Bosn J Basic Med Sci 2021; 21:352-363. [PMID: 33091332 PMCID: PMC8112561 DOI: 10.17305/bjbms.2020.5079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 10/11/2020] [Indexed: 12/24/2022] Open
Abstract
This study aimed to establish a nomogram for the prognostic prediction of patients with early-onset lung cancer (EOLC) in both overall survival (OS) and cancer-specific survival (CSS). EOLC patients diagnosed between 2004 and 2015 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database and further divided into training and validation sets randomly. The prognostic nomobgram for predicting 3-, 5- and 10-years OS and CSS was established based on the relative clinical variables determined by the multivariate Cox analysis results. Furthermore, the predictive performance of nomogram was assessed by concordance index (C-index), calibration curve, receiver operating characteristic (ROC) curve and decision curve analysis (DCA) curve. A total of 1,822 EOLC patients were selected and randomized into a training cohort (1,275, 70%) and a validation cohort (547, 30%). The nomograms were established based on the statistical results of Cox analysis. In training set, the C-indexes for OS and CSS prediction were 0.797 (95% confidence interval [CI]: 0.773-0.818) and 0.794 (95% CI: 0.771-0.816). Significant agreement in the calibration curves was noticed in the nomogram models. The results of ROC and DCA indicated nomograms possessed better predict performance compared with TNM-stage and SEER-stage. And the area under the curve (AUC) of the nomogram for OS and CSS prediction in ROC analysis were 0.766 (95% CI: 0.745-0.787) and 0.782 (95% CI: 0.760-0.804) respectively. The prognostic nomogram provided an accurate prediction of 3-, 5-, and 10-year OS and CSS of EOLC patients which contributed clinicians to optimize individualized treatment plans.
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Affiliation(s)
- Lili Dai
- Department of Medicine, Funan County People's Hospital, Anhui, China
| | - Wei Wang
- Department of Respiratory Medicine, Funan County People's Hospital, Anhui, China
| | - Qi Liu
- Department of Endocrinology, Punan Hospital of Pudong District, Shanghai, China
| | - Tongjia Xia
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Qikui Wang
- Department of Chest Surgery, Anhui Chest Hospital, Anhui, China
| | - Qingqing Chen
- Department of Tuberculosis, Anhui Chest Hospital, Anhui, China
| | - Ning Zhu
- Department of Respiratory Medicine, The Second Affiliated Hospital of Xuzhou Medical University, Jiangsu China
| | - Yu Cheng
- Department of Interventional Aulmonary and Endoscopy Center, Anhui Chest Hospital, Anhui, China
| | - Ying Yan
- Department of Oncology, Anhui Cancer Hospital, Anhui, China
| | - Jun Shu
- Department of Respiratory Medicine, The Fourth Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Kaixin Qu
- Department of Respiratory Medicine, Funan County People's Hospital, Anhui, China
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Sanchez-Espiridion B, Chen M, Chang JY, Lu C, Chang DW, Roth JA, Wu X, Gu J. Telomere length in peripheral blood leukocytes and lung cancer risk: a large case-control study in Caucasians. Cancer Res 2014; 74:2476-86. [PMID: 24618342 PMCID: PMC4357479 DOI: 10.1158/0008-5472.can-13-2968] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Telomere dysfunction is a crucial event in malignant transformation and tumorigenesis. Telomere length in peripheral blood leukocytes has been associated with lung cancer risk, but the relationship has remained controversial. In this study, we investigated whether the association might be confounded by study of different histological subtypes of lung cancer. We measured relative telomere lengths in patients in a large case-control study of lung cancer and performed stratified analyses according to the two major histologic subtypes [adenocarcinoma and squamous cell carcinoma (SCC)]. Notably, patients with adenocarcinoma had longer telomeres than controls, whereas patients with SCC had shorter telomeres compared with controls. Long telomeres were associated with increased risk of adenocarcinoma, with the highest risk associated with female sex, younger age (<60 years), and lighter smoking (<30 pack-years). In contrast, long telomeres were protective against SCC, particularly in male patients. Our results extend the concept that telomere length affects risk of lung cancer in a manner that differs with histologic subtype.
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Affiliation(s)
| | - Meng Chen
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Joe Y. Chang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Charles Lu
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David W. Chang
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jack A. Roth
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Xifeng Wu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jian Gu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Kazmi N, Márquez-Garbán DC, Aivazyan L, Hamilton N, Garon EB, Goodglick L, Pietras RJ. The role of estrogen, progesterone and aromatase in human non-small-cell lung cancer. Lung Cancer Manag 2012; 1:259-272. [PMID: 23650476 DOI: 10.2217/lmt.12.44] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Lung cancer is the leading cause of cancer-related deaths in both men and women worldwide. Despite advances in treatment, patients have few effective therapeutic options and survival rates remain low. Emerging evidence suggests that the hormones estrogen and progesterone play a key role in the progression of non-small-cell lung cancer (NSCLC). The aromatase enzyme, which is responsible for a key step in estrogen biosynthesis, elicits higher levels of estrogen in lung tumors as well as in metastases compared with nonmalignant tissues. Thus, aromatase may prove to be a key predictive biomarker for treatment of NSCLC. Epidemiologic and preclinical data show estrogens play a critical role in lung tumor development and progression. Two estrogen receptors, α and β, are expressed in normal and in cancerous lung epithelium, and estrogen promotes gene transcription that stimulates cell proliferation and inhibits cell death. Furthermore, expression of both forms of estrogen receptor, progesterone receptor and aromatase in NSCLC specimens has been correlated with worse clinical outcomes. Combination therapies that include estrogen receptor downregulators and aromatase inhibitors are currently being assessed in Phase I-II clinical trials among patients with advanced NSCLC. Results will help guide future lung cancer management decisions, with a goal of achieving more effective and less toxic treatments for patients.
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Affiliation(s)
- Nadiyah Kazmi
- UCLA Geffen School of Medicine, Department of Medicine, Division of Hematology/Oncology, Factor Building 11-934, 700 Tiverton Avenue, Los Angeles, CA 90095-16781, USA
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Gao Y, Goldstein AM, Consonni D, Pesatori AC, Wacholder S, Tucker MA, Caporaso NE, Goldin L, Landi MT. Family history of cancer and nonmalignant lung diseases as risk factors for lung cancer. Int J Cancer 2009; 125:146-52. [PMID: 19350630 PMCID: PMC2865851 DOI: 10.1002/ijc.24283] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Family history (FH) of lung cancer is an established risk factor for lung cancer, but the modifying effect of smoking in relatives has been rarely examined. Also, the role of FH of nonmalignant lung diseases on lung cancer risk is not well known. We examined the role of FH of cancer and nonmalignant lung diseases in lung cancer risk overall, and by personal smoking, FH of smoking and histology in 1,946 cases and 2,116 population-based controls within the Environment And Genetics in Lung cancer Etiology (EAGLE) study. Odds ratios (ORs) and 95% CI from logistic regression were calculated adjusting for age, gender, residence, education and cigarette smoking. FH of lung cancer in any family member was associated with increased lung cancer risk (OR = 1.57, 95% CI = 1.25-1.98). The odds associated with fathers', mothers' and siblings' history of lung cancer were 1.41, 2.14 and 1.53, respectively. The associations were generally stronger in never smokers, younger subjects and for the adenocarcinoma and squamous cell carcinoma subtypes. FH of chronic bronchitis and pneumonia was associated with increased (OR = 1.49, 95% CI = 1.23-1.80) and decreased (OR = 0.73, 95% CI = 0.61-0.87) lung cancer risk, respectively. FH of lung cancer and nonmalignant lung diseases affected lung cancer risk independently, and did not appear to be modified by FH of smoking.
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Affiliation(s)
- Ying Gao
- Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | - Alisa M. Goldstein
- Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | - Dario Consonni
- EPOCA, Epidemiology Research Center, University of Milan, and Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena
| | - Angela C. Pesatori
- EPOCA, Epidemiology Research Center, University of Milan, and Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena
| | - Sholom Wacholder
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | - Margaret A. Tucker
- Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | - Neil E. Caporaso
- Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | - Lynn Goldin
- Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | - Maria Teresa Landi
- Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
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Liam C, Lim K, Wong CM. Lung cancer in patients younger than 40 years in a multiracial Asian country. Respirology 2008. [DOI: 10.1111/j.1440-1843.2000.00275.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Chong‐Kin Liam
- Division of Respiratory Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Kim‐Hatt Lim
- Division of Respiratory Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Catherine Mee‐Ming Wong
- Division of Respiratory Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
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Baron-Epel O, Andreev H, Barhana M, Green MS. Differences in trends of lung carcinoma by histology type in Israeli Jews and Arabs, 1981-1995. Eur J Epidemiol 2002; 17:11-8. [PMID: 11523571 DOI: 10.1023/a:1010916325886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Between 1981 and 1995 the national cancer register in Israel received reports on 13,600 new cases of lung cancer. We evaluated the trends in total lung cancer and the histologic subtypes, in Jewish and Arab Israelis. During this period, the age-adjusted incidence of lung cancer increased in the male Arab population, while for male Jews there was a non-significant decrease, for women in both population groups the rates were stable. When analyzed by age group, there was a significant decrease in incidence rates in Jewish males aged 75 years and older. An analysis by histologic subtypes showed two different trends. In the Jewish population, the age adjusted incidence rates of squamous cell carcinoma (SQCC) decreased and the incidence rates of adenocarcinoma (AC) increased, whereas in the Arab population the incidence rates of both subtypes increased, although statistically significantly only for SQCC. The changes found in the Jewish population are similar to those found in other western countries, where the rates of AC are increasing and the rates of SQCC are decreasing. The trends in the Arab population in Israel are different. This may be due to different trends in the prevalence of smoking in the two populations.
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Affiliation(s)
- O Baron-Epel
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer.
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