"中国乌蒙山肺癌":云贵高原燃煤污染相关区域性肺癌的证据链、临床及分子特征
China Wumeng Mountain Lung Cancer:Evidence Chain,Clinical and Molecular Characteristics of Regional Lung Cancer Related to Coal Pollution in the Yunnan-Guizhou Plateau
摘要
Abstract
Background and objective Long-term household coal burning,differences in coal sources and mineral compositions,energy structure,and socioeconomic conditions jointly constitute the regional exposure basis for lung cancer.This study conducts a multi-sectional,multi-dimensional and multi-omics investigation on the correlation between coal-burning pollution in the"Wumeng Mountain region"and"China Wumeng Mountain lung cancer",and explores the concept boundaries,evidence chain,carcinogenic components,clinical and molecular characteristics,as well as the precise prevention and control pathways of"China Wumeng Mountain lung cancer",with the aim of providing evidences and references for the primary,secondary,tertiary and quaternary prevention of lung cancer in high-incidence areas of"China Wumeng Mountain lung cancer",as well as the screening and molecular typing management of high-risk populations.Methods Based on the relatively complete evidence chain established in our previous research,covering household coal smoke exposure,coal source differences,polycyclic aromatic hydrocarbons(PAHs),stove intervention,lung cancer and tumor multi-omics characteristics,a narrative review method was applied for literature search and evidence integration.The search databases included PubMed,Web of Science,Embase,China National Knowledge Infrastructure(CNKI)and Wanfang Database,with the time range from the establishment of each database to May 2026;search terms included:Xuanwei,Fuyuan,Wumeng Mountains,household coal combustion,smoky coal,lung cancer,PAHs,methylated PAHs,stove improvement,never-smoking women,germline susceptibility,microbiome and multi-omics.The evidence integration adopted the"exposure-pollutant component-biological effect-clinical molecular characteristics-prevention transformation"evidence chain.Results(1)PAHs/methylated PAHs,particulate matter 2.5(PM2.5)/black carbon,inorganic minerals/metals,carbonyl compounds and mixed exposure are the main carcinogenic components of coal-burning pollution-related lung cancer;(2)It is prevalent among non-smoking women,with a high proportion of adenocarcinoma,low age of onset,easy early metastasis,multiple lung lesions and family aggregation are the clinical characteristics of coal-burning pollution-related lung cancer in the Wumeng Mountain region;(3)The total epi-dermal growth factor receptor(EGFR)mutation is relatively high,but the proportions of classic EGFR 19 exon deletion and L858R mutation are relatively low,while EGFR-G719X,S768I mutations,Kirsten rat sarcoma viral oncogene homolog(KRAS)G12C mutations,and anaplastic lymphoma kinase(ALK)and c-ROS proto-oncogene 1,receptor tyrosine kinase(ROS1)gene fusion mutations are significantly higher than those in non-Wumeng Mountain lung cancer;(4)Germline mutation genes AR-HGEF5,MYO18B and MUC16 are potential genetic susceptibility genes for coal-burning pollution-related lung cancer in the Wumeng Mountain region,and they interact with telomere length maintenance genes POT1,TERT and TERF2,and may have a close relationship with the existence of lung cancer family aggregation in this region;(5)Indoor coal-burning pollution leads to changes in the microbial community of sputum,and long-term chronic infection of the respiratory tract jointly affect abnor-mal pathways related to the immune microenvironment and pollutant metabolism,increasing the risk of lung cancer.Conclu-sion China Wumeng Mountain lung cancer is a type of lung cancer related to indoor and outdoor coal-burning pollution,with a predilection for never-smoking women,high proportion of adenocarcinoma,low age of onset,multiple lung lesions,as well as special chronic respiratory infections,abnormal pollutant metabolism and immune microenvironment,as well as special driver gene and germline mutation gene mutation spectra.关键词
中国乌蒙山区/区域性肺癌/宣威/富源/家庭燃煤/室内空气污染/多环芳烃/家族肺癌Key words
Wumeng Mountain Area of China/Regional lung cancer/Xuanwei/Fuyuan/Household coal combus-tion/Indoor air pollution/Polycyclic aromatic hydrocarbons/Familial lung cancer引用本文复制引用
中国西部肺癌研究协作中心,陈颖,黄云超,田林玮,周清华.."中国乌蒙山肺癌":云贵高原燃煤污染相关区域性肺癌的证据链、临床及分子特征[J].中国肺癌杂志,2026,29(6):395-411,17.基金项目
本研究受国家自然科学基金项目(No.81572288,No.82272980,No.82360562)、国家重点研发计划(No.2016YEE0103400)、云南省重点研发计划(No.202403AC100015,No.202302AA310039)、昆明医科大学"环境、遗传与肺癌发病机制研究团队"一流学科团队建设项目(No.2024XKTDPY07)、昆明医科大学一流学科团队(No.2024XKTDYS07)、云南省胸部肿瘤防治研究创新团队(No.202405AS350015)和云南省医学学科带头培养计划项目(No.D-2025006)资助 This study was supported by the grants from the National Natural Science Foundation of China(No.81572288,to Qinghua ZHOU （No.81572288,No.82272980,No.82360562）
No.82272980,to Ying CHEN （）
No.82360562,to Yunchao HUANG),the National Key Research and De-velopment Program of China(No.2016YEE0103400,to Qinghua ZHOU),the Key Research and Development Project of Yunnan Province(No.202403AC100015,to Yunchao HUANG （No.2016YEE0103400,to Qinghua ZHOU）
No.202302AA310039,to Yunchao HUANG),First-Class Discipline Team Construction Project of"Research Team on Environment,Genetics and Lung Cancer Pathogenesis"of Kun-ming Medical University(No.2024XKTDPY07,to Ying CHEN),First-class Discipline Team of Kunming Medical University(No.2024XKTDYS07,to Hong YAO),the Yunnan Province Thoracic Tumor Prevention and Treatment Research Innovation Team(No.202405AS350015,to Guangqiang ZHAO)and the Yunnan Province Medical Discipline Leading Training Program Project(No.D-2025006,to Ying CHEN). （No.2024XKTDPY07,to Ying CHEN）
