职业石棉暴露与肺癌患者的生存率。
Occupational asbestos exposure and survival among lung cancer patients.
发表日期：2023 Mar 23
作者：
Hugo Noelle, Olivia Pérol, Maurice Pérol, Virginie Avrillon, Elodie Belladame, Jérôme Fayette, Françoise Fournié, Aurélie Swalduz, Juliette Dessemon, Jean-Yves Blay, Eve-Marie Neidhardt, Pierre Saintigny, Mayeul Tabutin, Maxime Boussageon, Delphine Praud, Barbara Charbotel, Beatrice Fervers
来源：
Brain Structure & Function
摘要：
本研究调查了职业石棉暴露（OAE）与组织学证实的肺癌（LC）患者的生存率之间的关联。该单中心研究在法国里昂的Léon Bérard综合癌症中心进行。自2014年以来，使用自评问卷对所有在多学科LC委员会从2014年到2019年期间诊断出组织学证实的LC的新患者进行了职业致癌物暴露的系统筛查。当医生怀疑问卷中包括工作史的与工作相关的暴露时，进行职业致癌监测以详细评估致癌物曝露情况并评估LC是否与工作有关。从医疗记录中提取人口统计学、临床特征和生存数据。通过Cox比例危险回归估计石棉暴露与总生存期（危险比和95%置信区间）之间的关联。总共有702名患者符合本研究条件，其中包括180名OAE患者。在粗略分析中，与没有OAE或对OAE归因度较低的LC相比，被评估为中度或高度归因于OAE的LC与较低的总生存率相关（HR = 1.32，95％CI 1.04-1.67）（中位随访28.8个月）。调整混淆因素（诊断时的年龄、吸烟状况、分期、脑转移和组织学）后，OAE与总生存期的关联不再具有统计学意义（HR = 1.21，95％CI 0.94-1.56）。与未暴露于石棉的LC患者相比，职业石棉暴露的LC患者的总生存期可能会降低，需要在更大的研究中进行进一步调查。版权所有© 2023 Elsevier B.V.
This study investigated the association between occupational asbestos exposure (OAE) and survival in patients with histologically confirmed lung cancer (LC).This monocentric study was conducted in the Comprehensive Cancer Centre Léon Bérard, Lyon, France. A systematic screening has been in place since 2014 for occupational exposure to carcinogens using a self-assessment questionnaire sent to all patients newly diagnosed with histologically confirmed LC identified through the multidisciplinary LC board from 2014 to 2019. When the physician suspected a work-related exposure from the questionnaire including job history, an occupational cancer consultation was carried out to detail carcinogen exposures and assess if the LC was work-related. Demographics, clinical characteristics and survival data were extracted from medical records. The association between asbestos exposure and overall survival (hazard ratio and 95% confidence intervals) was estimated by Cox proportional hazards regression.Overall, 702 patients were eligible to the present study, including 180 patients with OAE. In the crude analysis, LCs assessed as moderately or highly attributable to OAE were associated with decreased overall survival (HR = 1.32, 95 %CI 1.04-1.67) compared to LC without OAE or with a low degree of imputability to OAE (median follow-up 28.8 months). After adjustment for confounding (age at diagnosis, smoking status, stage, brain metastasis at diagnosis, and histology), the association of OAE with overall survival was no longer statistically significant (HR = 1.21, 95 %CI 0.94-1.56).Overall survival in occupationally asbestos exposed LC patients may be decreased in comparison with non-exposed LC patients, warranting further investigations in larger studies.Copyright © 2023 Elsevier B.V. All rights reserved.