Although numerous epidemiological studies are available, the relationship between leukocyte telomere length (LTL) and lung cancer risk is still controversial. This systematic review and meta-analysis, performed according to the PRISMA statement and MOOSE guidelines, aims to summarize the evidence and calculate the risk of lung cancer associated with LTL. The literature search was performed on PubMed, Web of Science, and Scopus databases through May 2024. A random-effects model was used to calculate the pooled risk. Heterogeneity was assessed using I2and Cochran’s Q statistic. Begg’s and Egger’s tests were used to detect publication bias. Based on 8055 lung cancer cases and 854,653 controls (nine prospective studies), longer LTL was associated with a significant 42% increment in all types of lung cancer risk (OR 1.42, 95% CI 1.24–1.63). The effect was even more evident for adenocarcinomas (OR 1.98, 95% CI 1.69–2.31), while no association was observed for squamous cell carcinoma (OR 0.87, 95% CI 0.72–1.06). Significantly, no association was found for current smokers (OR 1.08, 95% CI 0.90–1.30), while it remained high for both never-smokers (OR 1.92, 95% CI 1.62–2.28) and former smokers (OR 1.34, 95% CI 1.11–1.62). No significant publication bias was evidenced. Longer LTL is associated with an increment in lung cancer risk particularly in never-smoker subjects.
尽管已有大量流行病学研究，但白细胞端粒长度（LTL）与肺癌风险之间的关系仍存在争议。本系统综述与荟萃分析遵循PRISMA声明及MOOSE指南，旨在整合现有证据并量化LTL相关的肺癌风险。文献检索覆盖截至2024年5月的PubMed、Web of Science和Scopus数据库。采用随机效应模型计算合并风险，通过I²指数与Cochran’s Q统计量评估异质性，并运用Begg’s与Egger’s检验检测发表偏倚。基于9项前瞻性研究（共8055例肺癌患者及854653名对照）的数据分析显示，较长的LTL与全类型肺癌风险显著增加42%相关（OR 1.42，95% CI 1.24–1.63）。这种关联在腺癌中尤为显著（OR 1.98，95% CI 1.69–2.31），而在鳞状细胞癌中未观察到相关性（OR 0.87，95% CI 0.72–1.06）。值得注意的是，当前吸烟者中未发现显著关联（OR 1.08，95% CI 0.90–1.30），但在从不吸烟者（OR 1.92，95% CI 1.62–2.28）和既往吸烟者（OR 1.34，95% CI 1.11–1.62）中风险升高依然显著。未发现明显发表偏倚。研究结果表明，较长的LTL与肺癌风险增加相关，在从不吸烟人群中这一关联尤为突出。
肿瘤(癌症)患者之家