Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the world. Not much is known regarding the influence of non-smoking-related risk factors on COPD in Taiwan. We examined the relationship between exposure to particulate matter 38.98 μg/m³) was significantly associated with COPD (OR, 1.29; CI 1.01-1.65) after multivariate adjustments. However, exposures to concentrations of 32.07-38.98 μg/m³ (OR, 1.12 CI 0.88-1.44) and 29.38-32.07 μg/m³ (OR, 1.09 CI 0.84-1.41) showed positive but non-significant associations. However, the test for trend was significant (Ptrend = 0.043). The ORs for exposure to sulfur dioxide (SO₂), ozone (O₃), carbon monoxide (CO) and NOx (nitrogen monoxide (NO were not significant. Based on our data, exposure to PM_2.5 at concentrations greater than 38.98 μg/m³ increased susceptibility to COPD among Taiwanese nonsmokers. Combatting COPD would involve integrating tobacco control and pollution management strategies.

Rationale: Patients of NSCLC with mutated EGFR are relatively sensitive to EGFR-TKI treatment and have longer progression-free survival (PFS) when treated with EGFR-TKI, compared with platinum-based chemotherapy. However, many advanced NSCLC patients with mutated EGFR do not response to first-line EGFR-TKI treatment and still have shorter PFS. Objectives: The aim of this study was to identify genetic variants associated PFS among lung adenocarcinoma (ADC) patients treated with first-line EGFR-TKIs. Methods: A genome-wide association study on PFS was performed in never-smoking women diagnosed with lung adenocarcinoma and treated with first-line EGFR-TKIs (n=128). Significant single nucleotide polymorphisms (SNPs) were selected for follow-up-association analysis (n=198) and for replication assay in another independent cohort (n=153). Measurements and Main Results: We identified SNPs at 4q12 associated with PFS at genome-wide significance (P<10^-8) and with an estimated hazard ratio greater than 4. This association was also replicated in a larger but similar cohort as well as in an independent NSCLC cohort. Follow-up functional analyses showed that these SNPs are associated with the expression of EGFR, which encodes the TKI target, and with a nearby gene NMU, which encodes a GPCR ligand known to be involved in the progression of NSCLC. Considering these as possible prognostic biomarkers in the treatment of late-stage lung cancer patients, we found that these SNPs were not associated with EGFR mutation status, or with BIM polymorphism. Conclusions: Genetic variants in 4q12 merit further investigation to assess their potential as pharmacogenomic predictors for and to understand the biology underlying its influence on PFS in patients treated with TKI therapy.

The nasopharyngeal tract traps mainly coarse particles in inhaled air. Soluble carcinogenic compounds, endotoxins, and trace metals contained in these particles are potential causes of inflammation and oxidative stress which could enhance carcinogenesis. The aim of this study was to determine the association between coarse particulate matter (PM_10-2.5) and nasopharyngeal cancer (NPC). A total of 521,098 men (355 cases and 520,743 non-cases), aged ≥40 years were included in this study. Data were retrieved from the Taiwan Cancer Registry, the Adult Preventive Medical Services Database, and the Air Quality Monitoring Database. PM_10-2.5 was significantly associated with a higher risk of NPC after adjusting for SO₂, NOx, O₃, age, body mass index, smoking, alcohol drinking, betel nut chewing, exercise, hypertension, diabetes, and hyperlipidemia. With PM_10-2.5<20.44 μg/m³ as the reference, the ORs and 95% CIs were 1.47; 1.03–2.11, 1.34; 0.94–1.91, and 1.68; 1.16–2.44 for 20.44≤PM_10-2.5<24.08, 24.08≤PM_10-2.5<29.27, and PM_10-2.5≥29.27 μg/m³, respectively. PM_10-2.5 remained significantly associated with a higher risk of NPC after further adjustments were made for the aforementioned covariates and PM_2.5. The ORs; 95% CIs were 1.42; 0.96 to 2.12, 1.41; 0.94 to 2.10, and 1.71; 1.10 to 2.66 for 20.44≤PM_10-2.5<24.08, 24.08≤PM_10-2.5<29.27, and PM_10-2.5≥29.27 μg/m³, respectively. In conclusion, PM_10-2.5 was significantly associated with a higher risk of NPC in Taiwanese men.

Background: Cigarette smoking and particulate matter (PM) with aerodynamic diameter < 2.5 μm (PM_2.5) are major preventable cardiovascular mortality and morbidity promoters. Their joint role in metabolic syndrome (MS) pathogenesis is unknown. We determined the risk of MS based on PM_2.5 and cigarette smoking in Taiwanese adults.Methods: The study included 126,366 Taiwanese between 30 and 70 years old with no personal history of cancer. The Taiwan Biobank (TWB) contained information on MS, cigarette smoking, and covariates, while the Environmental Protection Administration (EPA), Taiwan, contained the PM_2.5 information. Individuals were categorized as current, former, and nonsmokers. PM_2.5 levels were categorized into quartiles: PM_2.5 ≤ Q1, Q1 < PM_2.5 ≤ Q2, Q2 < PM_2.5 ≤ Q3, and PM_2.5 > Q3, corresponding to PM_2.5 ≤ 27.137, 27.137 < PM_2.5 ≤ 32.589, 32.589 < PM_2.5 ≤ 38.205, and PM_2.5 > 38.205 μg/m³.Results: The prevalence of MS was significantly different according to PM_2.5 exposure (p-value = 0.0280) and cigarette smoking (p-value < 0.0001). Higher PM_2.5 levels were significantly associated with a higher risk of MS: odds ratio (OR); 95% confidence interval (CI) = 1.058; 1.014–1.104, 1.185; 1.134–1.238, and 1.149; 1.101–1.200 for 27.137 < PM_2.5 ≤ 32.589, 32.589 < PM_2.5 ≤ 38.205, and PM_2.5 > 38.205 μg/m³, respectively. The risk of MS was significantly higher among former and current smokers with OR; 95% CI = 1.062; 1.008–1.118 and 1.531; 1.450–1.616, respectively, and a dose-dependent p-value < 0.0001. The interaction between both exposures regarding MS was significant (p-value = 0.0157). Stratification by cigarette smoking revealed a significant risk of MS due to PM_2.5 exposure among nonsmokers: OR (95% CI) = 1.074 (1.022–1.128), 1.226 (1.166–1.290), and 1.187 (1.129–1.247) for 27.137 < PM_2.5 ≤ 32.589, 32.589 < PM_2.5 ≤ 38.205, and PM_2.5 > 38.205 μg/m³, respectively. According to PM_2.5 quartiles, current smokers had a higher risk of MS, regardless of PM_2.5 levels (OR); 95% CI = 1.605; 1.444–1.785, 1.561; 1.409–1.728, 1.359; 1.211–1.524, and 1.585; 1.418–1.772 for PM_2.5 ≤ 27.137, 27.137 < PM_2.5 ≤ 32.589, 32.589 < PM_2.5 ≤ 38.205, and PM_2.5 > 38.205 μg/m³, respectively. After combining both exposures, the group, current smokers; PM_2.5 > 38.205 μg/m³ had the highest odds (1.801; 95% CI =1.625–1.995).Conclusion: PM_2.5 and cigarette smoking were independently and jointly associated with a higher risk of MS. Stratified analyses revealed that cigarette smoking might have a much higher effect on MS than PM_2.5. Nonetheless, exposure to both PM_2.5 and cigarette smoking could compound the risk of MS.

The eighth edition of the American Joint Committee on Cancer (AJCC) staging system for lung cancer was introduced in 2017 and included major revisions, especially of stage III. For the subgroup stage IIIA-N2 non-small-cell lung cancer (NSCLC), surgical resection remains controversial due to heterogeneous disease entity. The aim of this study was to evaluate the clinicopathologic features and prognostic factors of patients with completely resected stage IIIA-N2 NSCLC. We retrospectively evaluated 77 consecutive patients with pathologic stage IIIA-N2 NSCLC (AJCC eighth edition) who underwent surgical resection with curative intent in China Medical University Hospital between 2006 and 2014. Survival analysis was conducted, using the Kaplan–Meier method. Prognostic factors predicting overall survival (OS) and disease-free survival (DFS) were analyzed, using log-rank tests and multivariate Cox proportional hazards models. Of the 77 patients with pathologic stage IIIA-N2 NSCLC examined, 35 (45.5%) were diagnosed before surgery and 42 (54.5%) were diagnosed unexpectedly during surgery. The mean age of patients was 59 years, and the mean length of follow-up was 38.1 months. The overall one-, three-, and five-year OS rates were 91.9%, 61.3%, and 33.5%, respectively. Multivariate analysis showed that tumor size <3 cm (hazards ratio (HR): 0.373, p = 0.003) and video-assisted thoracoscopic surgery (VATS) approach (HR: 0.383, p = 0.014) were significant predictors for improved OS. For patients with surgically treated, pathologic stage IIIA-N2 NSCLC, tumor size <3 cm and the VATS approach seemed to be associated with better prognosis.