Chinese never smokers with adenocarcinoma of the lung are younger and have fewer lymph node metastases than smokers

Longyu Shan, Liang Zhang, Xiaolei Zhu, Zhilin Wang, Shaohan Fang, Junfeng Lin, Jianweng Wang, Ning Li, Hongming Liu, Xiaowen Zhang, Yihui Feng, Jingwei Liu, Jianyun Pan, Guanzhi Ye, Xiuyi Yu, Amanda Tufman, Alexander Katalinic, Torsten Goldmann, Frank Petersen, Jie JiangGuojun Geng, Xinhua Yu


BACKGROUND: Lung cancers arising in never smokers have been suggested to be substantially different from lung cancers in smokers at an epidemiological, genetic and molecular level. Focusing on non-small cell lung cancer (NSCLC), we characterized lung cancer patients in China looking for demographic and clinical differences between the smoking and never-smoking subgroups.

METHODS: In total, 891 patients with NSCLC, including 841 with adenocarcinoma and 50 with squamous cell carcinoma, were recruited in this study. Association of smoking status with demographic and clinical features of NSCLC was determined, and risk factors for lymph node metastasis and TNM stage were evaluated using Multivariate logistic regression analysis.

RESULTS: In patients with adenocarcinoma, never smokers showed a younger age at diagnosis (54.2 ± 12.7vs. 59.3 ± 9.4, padjusted<0.001), a lower risk for lymph node metastasis than smokers (7,6% vs. 19.5%, padjusted<0.001) and less severe disease as indicated by lower percentages of patients with TNM stage of III or IV (5.5% vs. 14.7%, padjusted<0.001 ). By contrast, these associations were not observed in 50 patients with squamous cell carcinoma. Multivariate logistic regression analysis showed that smoking status was a risk factor for lymph node metastasis (OR = 2.70, 95% CI: 1.39-5.31, p = 0.004) but not for TNM stage (OR = 1.18, 95% CI: 0.09-14.43, p = 0.896) in adenocarcinoma.

CONCLUSION: This study demonstrates that lung adenocarcinoma in never smokers significantly differ from those in smokers regarding both age at diagnosis and risk of lymph node metastasis, supporting the notion that they are distinct entries with different etiology and pathogenesis.

Original languageEnglish
Article number293
JournalRespiratory Research
Issue number1
Pages (from-to)293
Publication statusPublished - 12.2022

Research Areas and Centers

  • Research Area: Center for Population Medicine and Public Health (ZBV)


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