Clinic-pathologic features and gene fusion pattern of ALK and ROS1 in non-small cell lung cancer show association with household coal combustion

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Abstract

Background

Lung cancer induced by burning coal can be etiologically and clinically different from lung cancer caused by smoking. Despite previous work, the gene fusion patterns in lung cancer patients affected by household coal combustion still deserve further study.

Methods

Non-small cell lung cancer (NSCLC) patients exposed to household coal use (HCU) were recruited from rural areas in China’s Yunnan Province, certain areas in this region had notably high lung cancer rate nationwide. Reverse transcription-polymerase chain reaction (RT-PCR) was used for detection of ALK, ROS1, RET and NTRK1 rearrangements. Eighteen studies on ALK fusions were summarized and compared with present work.

Results

Among the 205 patients, there were 112 (54.6%) coal users and 96 (46.8%) smokers, union set had 145 (70.7%) subjects, in which 63 (30.7%) were double-positive for HCU and smoking. HCU patients featured with younger age and advanced stage. Union set patients covered larger age span (range, 40–82 years old), showed clear early-onset, and made the majority of stage IIIA–IV cases. Double-positive individuals were mainly in later stage, but with wider age span (range, 38–75 years old). In addition, 18 patients (8.8%) had EML4-ALK rearrangement, with apparently higher-than-average variant 3 ratio (77.8% vs. 44%). Five ROS1 fusion cases (2.5%) were identified, all were CD74-ROS1 (E6/E34), and had HCU experience. ALK and ROS1 fusions were mutually exclusive. Both ALK fusions and total gene rearrangement events (ALK and ROS1) showed association with HCU and overall exposure (tobacco and coal). Suggesting there could be unique gene fusion patterns in lung cancer patients affected by coal use.

Conclusions

Present study found clinic-pathologic features and gene fusion patterns in NSCLC showed association with household coal combustion. Our findings may help evaluate the impact of coal use on the pathogenesis of lung cancer, and also highlight the significance of integrating different exposure histories into clinical and theoretical research.

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Most cited references 38

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A third of the world's population uses solid fuel derived from plant material (biomass) or coal for cooking, heating, or lighting. These fuels are smoky, often used in an open fire or simple stove with incomplete combustion, and result in a large amount of household air pollution when smoke is poorly vented. Air pollution is the biggest environmental cause of death worldwide, with household air pollution accounting for about 3·5-4 million deaths every year. Women and children living in severe poverty have the greatest exposures to household air pollution. In this Commission, we review evidence for the association between household air pollution and respiratory infections, respiratory tract cancers, and chronic lung diseases. Respiratory infections (comprising both upper and lower respiratory tract infections with viruses, bacteria, and mycobacteria) have all been associated with exposure to household air pollution. Respiratory tract cancers, including both nasopharyngeal cancer and lung cancer, are strongly associated with pollution from coal burning and further data are needed about other solid fuels. Chronic lung diseases, including chronic obstructive pulmonary disease and bronchiectasis in women, are associated with solid fuel use for cooking, and the damaging effects of exposure to household air pollution in early life on lung development are yet to be fully described. We also review appropriate ways to measure exposure to household air pollution, as well as study design issues and potential effective interventions to prevent these disease burdens. Measurement of household air pollution needs individual, rather than fixed in place, monitoring because exposure varies by age, gender, location, and household role. Women and children are particularly susceptible to the toxic effects of pollution and are exposed to the highest concentrations. Interventions should target these high-risk groups and be of sufficient quality to make the air clean. To make clean energy available to all people is the long-term goal, with an intermediate solution being to make available energy that is clean enough to have a health impact.

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Author and article information

Journal

Journal ID (nlm-ta): Transl Cancer Res

Journal ID (iso-abbrev): Transl Cancer Res

Journal ID (publisher-id): TCR

Title: Translational Cancer Research

Publisher: AME Publishing Company

ISSN (Print): 2218-676X

ISSN (Electronic): 2219-6803

Publication date (Print and electronic): September 2019

Publication date (Print): September 2019

Volume: 8

Issue: 5

Pages: 2164-2174

Affiliations

[1 ]Department of Thoracic Surgery I, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center) , Kunming 650106, China

[2 ]The Key Laboratory of Lung Cancer Research, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center) , Kunming 650106, China

Author notes

Contributions: (I) Conception and design: Y Chen, X Tan, X Ding; (II) Administrative support: Y Huang; (III) Provision of study materials or patients: H Ning, X Chen, X Tan; (IV) Collection and assembly of data: Y Chen, H Ning, X Chen, X Tan; (V) Data analysis and interpretation: Y Chen, X Ding; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

Correspondence to: Xiangxiu Tan. Department of Thoracic Surgery I, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), 519 Kunzhou Road, Kunming 650106, China. Email: 278296909@ 123456qq.com ; Xiaojie Ding. The Key Laboratory of Lung Cancer Research, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), 519 Kunzhou Road, Kunming 650106, China. Email: dingxj2001@ 123456163.com .

Article

Publisher ID: tcr-08-05-2164

DOI: 10.21037/tcr.2019.09.37

PMC ID: 8799241

PubMed ID: 35116966

SO-VID: 7538519b-fd2d-4f36-b05b-4dd00f40d7bf

License:

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

History

Date received : 24 February 2019

Date accepted : 28 August 2019

Funding

Funded by: National Natural Science Foundation of China

Award ID: No. 81702274

Award ID: 81960335

Funded by: Yunnan Applied Basic Research Projects-Union Foundation

Award ID: No. 2017FE468 (-159)

Award ID: 2015FB069

Award ID: 2017FE467 (-187)

Award ID: 2017FE468 (-214)

Award ID: 2018FE001 (-259)

Funded by: Internal Organization Research Projects of Yunnan Cancer Hospital

Award ID: No. 2017NS198

Funded by: Doctor Research Foundation of Yunnan Cancer Hospital

Award ID: No. BSKY201705

Funded by: Scientific Research Foundation Projects of Yunnan Provincial Department of Education

Clinic-pathologic features and gene fusion pattern of ALK and ROS1 in non-small cell lung cancer show association with household coal combustion

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Abstract

Background

Methods

Results

Conclusions

Related collections

Inflamed lung in vitro co-culture models

Most cited references 38

Global cancer statistics.

Lung cancer in never smokers--a different disease.

Respiratory risks from household air pollution in low and middle income countries.

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