Comparative Study Of Lung Cancer In Smokers And Nonsmokers

Objective: To compare the similarities and differences of gender distribution,age of onset,pathological type,TNM staging,PS score,EGFR,K-ras and ALK mutation between lung cancer in smokers and nonsmokers by the evidence provided in the literature Published.Methods:Literature search was conducted through Wanfang Database,Weipu Chinese Biomedical Journal,Chinese Journal Full-text Database(CNKI),and PUMBED Database.The following terms are used jointly:“??/???”,“??”,“???”,“lung cancer/lung carcinoma”,“smokers”,“never smokers”,“nonsmokers”to search for case-control literature of lung cancer in smokers and nonsmokers,and an extended literature search was performed according to the corresponding characteristics.Also consult the references included in the literature to supplement any studies that may have been missed.Rev Man5.3 was used for meta-analysis,and its odds ratio(OR)and 95%confidence interval(CI)were calculated.Result:Of the 51,681 lung cancer cases included in the study,37,390(72.3%)were in the smoking group and 14,291(27.7%)in the nonsmoking group.In Asia,nonsmokers accounted for 31% of all the lung cancer patients,higher than 18.9% that in Europe.However,the gender distribution of never-smoking lung cancer patients in Europe and Asia are similar,with the proportion of women being 68.1% and 70.3% respectively.Lung cancer in smokers and nonsmokers have different characteristics in gender distribution,age of onset,pathological type,TNM stage,PS score,EGFR,K-ras,ALK mutation and other aspects.1.In terms of gender distribution,lung cancer in smokers shows a male-dominated nature,while lung cancer in nonsmokers shows a female “dominance”.2.There was no significant difference in the average age of onset;if ?45 years old was defined as a young patient,lung cancer in nonsmokers have a higher proportion of young patients than smokers.3.On the histological type,adenocarcinoma has a clear advantage ratio in nonsmokers,while squamous cell carcinoma is more common in smokers.4.In the TNM staging,there was no significant difference in the early stage of lung cancer between smokers and nonsmokers,but there were more nonsmokers patients in the proportion of TNM IV period.5.In terms of PS scores,PS scores of 0 points and 0-1 points have a higher proportion of nonsmokers,while scores of 3-4 points and 4 points are higher among smoking patients.6.In the gene mutations,EGFR mutations,ALK fusion gene mutations are more common in nonsmokers,and K-ras mutations are more common in smokers.Conclusion1.Lung cancer in smokers and nonsmokers are a subset of lung cancers that share the same nature but have different characteristics.2.The different biological characteristics of lung cancer in smokers and nonsmokers are accompanied by different clinical behaviors.The reasons for these differences need to be further explored.