Differential characteristics of patients with squamous cell carcinoma of the head and neck with no history of tobacco or alcohol use.

OBJECTIVE: The present study aims to analyse the differential characteristics of patients with head and neck squamous cell carcinoma (HNSCC) without a history of consumption of toxic substances such as tobacco and alcohol. MATERIAL AND METHODS: We carried out a retrospective study of 4694 patients with HNSCC located in the oral cavity, oropharynx, hypopharynx or larynx treated in our centre during the period 1985-2019. RESULT: 7.7% of the patients (n = 363) did not report a history of consumption of toxic substances. The group of patients with no toxic history was older, had a higher proportion of women, a higher frequency of cases located in the oral cavity, a higher proportion of cases diagnosed in early stages, and a lower incidence of second neoplasms. The percentage of patients with no history of consumption of toxic substances increased significantly over the study period. The overall survival of patients with no history of consumption of toxic substances was significantly higher than that of patients with toxic substances use. Specific survival for patients with tumours located in the oral cavity without a history of consumption of toxic substances was significantly lower than that of patients with toxic substances use, whereas for patients with oropharyngeal carcinomas the absence of a history of consumption of toxic substances was associated with a better prognosis. CONCLUSIONS: There were differences in the epidemiological and prognostic characteristics of patients with HNSCC according to the history of consumption of toxic substances such as tobacco and alcohol.

Características diferenciales de los pacientes con carcinoma escamoso de cabeza y cuello sin antecedentes de consumo de tabaco ni alcohol / Differential characteristics of patients with squamous cell carcinoma of the head and neck with no history of tobacco or alcohol use

Objetivo: El objetivo del presente estudio es analizar las características diferenciales de los pacientes con un carcinoma escamoso de cabeza y cuello (CECC) sin antecedentes de consumo de tóxicos, como el tabaco y el alcohol.Material y métodosSe llevó a cabo un estudio retrospectivo de 4.694 pacientes con un CECC localizado en la cavidad oral, orofaringe, hipofaringe o laringe tratados en nuestro centro durante el periodo 1985-2019.ResultadoUn 7,7% de los pacientes (n=363) no refirieron el antecedente de consumo de tóxicos. El grupo de pacientes sin antecedentes tóxicos tenía mayor edad, una mayor proporción de mujeres, una mayor frecuencia de casos localizados en la cavidad oral, una mayor proporción de casos diagnosticados en estadios iniciales y una menor incidencia de segundas neoplasias. El porcentaje de pacientes sin antecedentes de consumo de tóxicos aumentó de forma significativa a lo largo del periodo de estudio. La supervivencia global de los pacientes sin antecedentes de consumo de tóxicos fue significativamente más elevada que la de los pacientes con antecedentes tóxicos. La supervivencia específica para los pacientes con tumores localizados en la cavidad oral sin antecedentes tóxicos fue significativamente inferior, en tanto que para los pacientes con carcinomas de orofaringe la ausencia de antecedentes de consumo de tóxicos se asoció a un mejor pronóstico.ConclusionesExistieron diferencias en las características epidemiológicas y pronósticas de los pacientes con CECC en función del antecedente de consumo de tóxicos como el tabaco o el alcohol. (AU)

Objective: The present study aims to analyze the differential characteristics of patients with head and neck squamous cell carcinoma (HNSCC) without a history of consumption of toxic substances such as tobacco and alcohol.Material and methodsWe carried out a retrospective study of 4,694 patients with HNSCC located in the oral cavity, oropharynx, hypopharynx or larynx treated in our center during the period 1985-2019.ResultThe 7.7% of the patients (n=363) did not report a history of consumption of toxic substances. The group of patients with no toxic history was older, had a higher proportion of women, a higher frequency of cases located in the oral cavity, a higher proportion of cases diagnosed in early stages, and a lower incidence of second neoplasms. The percentage of patients with no history of consumption of toxic substances increased significantly over the study period. The overall survival of patients with no history of consumption of toxic substances was significantly higher than that of patients with toxic substances use. Specific survival for patients with tumors located in the oral cavity without a history of consumption of toxic substances was significantly lower than that of patients with toxic substances use, whereas for patients with oropharyngeal carcinomas the absence of a history of consumption of toxic substances was associated with a better prognosis.ConclusionsThere were differences in the epidemiological and prognostic characteristics of patients with HNSCC according to the history of consumption of toxic substances such as tobacco and alcohol. (AU)

Radon, Tobacco Exposure and Non-Small Cell Lung Cancer Risk Related to BER and NER Genetic Polymorphisms / El radón, la exposición al tabaco y el riesgo de desarrollar cáncer de pulmón de células no pequeñas en relación con polimorfismos genéticos de BER y NER

Introduction: Tobacco consumption and radon exposure are considered the first and second most common causes of lung cancer, respectively. The aim of this study was to analyze both whether selected genetic polymorphisms in loci that are in DNA repair pathways, are related to non-small-cell lung cancer (NSCLC) and whether they may modulate the association between residential radon exposure and lung cancer in both smokers and never smokers.Methods: A multicentre, hospital-based, case–control study with 826 cases and 1201 controls was designed in a radon-prone area. Genotyping was determined in whole blood and residential radon exposure was measured in participants’ dwellings.Results: Attending to tobacco exposure, the variant in the gene NBN (rs1805794) was associated with lung cancer in never smokers (OR 2.72; 95%1.44–5.2) and heavy smokers (OR 3.04; 95%CI 1.21–7.69). The polymorphism with the highest lung cancer association was OGG1 (rs125701), showing an OR of 8.04 (95%CI 1.64–58.29) for its homozygous variant genotype in heavy smokers. Attending to indoor radon exposure (>200Bq/m3), rs1452584, for its homozygous variant genotype, showed the highest association (OR 3.04 (95%CI 1.15–8.48).Conclusion: The genes analyzed seem to have no association with the fully adjusted model, but they might modulate lung cancer association when different categories of tobacco consumption are considered (i.e. heavy smokers). This association may similarly be elevated for those individuals having high indoor radon exposures, though at a minor extent. (AU)

Introducción: El consumo de tabaco y la exposición al radón se consideran la primera y la segunda causa más frecuentes de cáncer de pulmón, respectivamente. El objetivo de este estudio fue analizar si determinados polimorfismos genéticos en los loci que forman parte de la cascada de reparación del ADN se asocian con el cáncer de pulmón de célula no pequeña, y también si es posible que modifiquen la asociación entre la exposición al radón en el hogar y el cáncer de pulmón tanto en fumadores como en no fumadores.Métodos: Se diseñó un estudio multicéntrico hospitalario de casos y controles con 826 casos y 1.201 controles en un área proclive a la presencia de radón. Se determinó el genotipo en sangre y se midió la exposición al radón en el lugar de residencia de los participantes.Resultados: Analizando la exposición al tabaco, la variante del gen NBN (rs1805794) se asoció con el cáncer de pulmón en no fumadores (OR 2,72; IC 95% 1,44-5,2) y grandes fumadores (OR 3,04; IC 95% 1,21-7,69). El polimorfismo con mayor asociación con el cáncer de pulmón fue OGG1 (rs125701), con una OR de 8,04 (IC 95% 1,64-58,29) para la variante genotípica en homocigosis en grandes fumadores. En cuanto a la exposición al radón en interiores (>200Bq/m3), rs1452584 en homocigosis mostró la asociación más fuerte (OR 3,04; IC 95% 1,15-8,48).Conclusión: Los genes que se analizaron no muestran asociación con el modelo completamente ajustado, pero podrían modificar la asociación con el cáncer de pulmón cuando se consideran diferentes categorías de consumo de tabaco (esto es, grandes fumadores). Esta asociación podría aumentar de forma similar en aquellos individuos que están expuestos al radón en interiores, aunque en menor medida. (AU)

Radon, Tobacco Exposure and Non-Small Cell Lung Cancer Risk Related to BER and NER Genetic Polymorphisms.

INTRODUCTION: Tobacco consumption and radon exposure are considered the first and second most common causes of lung cancer, respectively. The aim of this study was to analyze both whether selected genetic polymorphisms in loci that are in DNA repair pathways, are related to non-small-cell lung cancer (NSCLC) and whether they may modulate the association between residential radon exposure and lung cancer in both smokers and never smokers. METHODS: A multicentre, hospital-based, case-control study with 826 cases and 1201 controls was designed in a radon-prone area. Genotyping was determined in whole blood and residential radon exposure was measured in participants' dwellings. RESULTS: Attending to tobacco exposure, the variant in the gene NBN (rs1805794) was associated with lung cancer in never smokers (OR 2.72; 95%1.44-5.2) and heavy smokers (OR 3.04; 95%CI 1.21-7.69). The polymorphism with the highest lung cancer association was OGG1 (rs125701), showing an OR of 8.04 (95%CI 1.64-58.29) for its homozygous variant genotype in heavy smokers. Attending to indoor radon exposure (>200Bq/m3), rs1452584, for its homozygous variant genotype, showed the highest association (OR 3.04 (95%CI 1.15-8.48). CONCLUSION: The genes analyzed seem to have no association with the fully adjusted model, but they might modulate lung cancer association when different categories of tobacco consumption are considered (i.e. heavy smokers). This association may similarly be elevated for those individuals having high indoor radon exposures, though at a minor extent.

Relación entre tabaquismo y las principales enfermedades no transmisibles en El Salvador / Relationship between smoking and the main non-communicable diseases in El Salvador

El tabaquismo es considerado un factor desencadenante de las principales enfermedades no transmisibles (ENT), como enfermedades cardiovasculares, enfermedad pulmonar obstructiva crónica, cáncer de pulmón, diabetes mellitus, insuficiencia renal, entre otras; así también, el tabaquismo se considera la principal causa de muerte que se puede prevenir a nivel mundial. En un estudio llevado a cabo en El Salvador se mencionan las principales ENT con antecedente de tabaquismo en el 2016, entre las que se encontraron la enfermedad isquémica del corazón, la enfermedad pulmonar obstructiva crónica, infecciones respiratorias, cáncer de pulmón, diabetes mellitus (DM), enfermedad cardiovascular hemorrágica, enfermedad hipertensiva y otras enfermedades cardiovasculares5. En este sentido, existe evidencia de una posible relación del tabaquismo con principales diagnósticos de ENT en el país; sin embargo, es necesario actualizar la información científica y estimar esta relación, sobre todo en grupos de personas que asisten a consulta en los principales centros de salud del primer nivel de atención en el país

Smoking is considered a triggering factor for the main noncommunicable diseases (NCDs), such as cardiovascular diseases, chronic obstructive pulmonary disease, lung cancer, diabetes mellitus, kidney failure, among others; Likewise, smoking is considered the main cause of death that can be prevented worldwide. In a study carried out in El Salvador, the main NCDs with a history of smoking in 2016 are mentioned, among which are ischemic heart disease, chronic obstructive pulmonary disease, respiratory infections, lung cancer, diabetes mellitus (DM), hemorrhagic cardiovascular disease, hypertensive disease and other cardiovascular diseases5. In this sense, there is evidence of a possible relationship between smoking and the main diagnoses of NCDs in the country; however, it is necessary to update the scientific information and estimate this relationship, especially in groups of people who attend consultations in the main health centers of the first level of care in the country

Respuesta vacunal frente a SARS-CoV-2 en trabajadores de un hospital / Vaccine response to SARS-CoV-2 in hospital workers

Introducción: Evaluar la inmunidad de los trabajadores de un hospital tras haber completado la vacunación Pfizer-BionTech, y su relación con factores individuales. También describir los efectos adversos de la vacuna. Método: Estudio transversal de una muestra de los trabajadores del Hospital General Universitario de Castellón vacunados con dos dosis en enero y febrero de 2021. Un mes después se detectaron: anticuerpos IgG frente a la proteína N (IgG-NP), de IgM frente a la proteína S (IgM-S) y detección cuantitativa de IgG frente a la proteína S (IgG-Quant). Se utilizó un cuestionario para recoger datos demográficos, factores de riesgo y efectos secundarios. En el análisis estadístico se utilizaron modelos de regresión múltiple. Resultados: La participación fue del 96,8% (275/284). Presentaron IgG-Quant el 99,6%, 14,9% IgM-S, y 4,4% IgG-NP. El nivel ajustado de IgG-Quant aumentó significativamente con la obesidad, en no fumadores y con positividad IgM-S y/o IgG-NP. La prevalencia de IgM-S era mayor en varones, y se asociaba con los mismos factores que la IgG-Quant. De los infectados por COVID-19, el 42,9% no presentaron IgG-NP. Un 86,5% sufrió algún efecto secundario que se asoció a tener IgG-NP, mayores niveles de IgG-Quant, y fue más frecuente en jóvenes y mujeres. Conclusiones: Todos los participantes desarrollaron inmunidad humoral excepto uno. Tuvieron mayores niveles de anticuerpos los que habían padecido la COVID-19. Un porcentaje alto desarrolló efectos secundarios leves, más frecuentes en los que habían padecido la enfermedad (AU)

Introduction: The aim of this study was to measure anti-SARS-CoV-2 immunity of hospital workers after a completed 2-dose Pfizer-BionTech vaccination, and to examine factors potentially associated with immunity status. Side effects of the vaccine were also studied. Method: This was a cross-sectional study of a representative sample of General University Hospital of Castellon workers, vaccinated with two doses in January and February 2021. We measured IgG antibodies against protein N (IgG-NP), IgM against protein S (IgM-S), and quantitative levles of IgG against protein S (IgG-Quant) one month after the last dose. We obtained information on demographic, risk factors, and vaccine side effects via a self-completed questionnaire. For the statistical analysis we used multiple regression models. Results: Two hundred seventy-five workers participated (96.8%, 275/284). Positive IgG-Quant, IgM-S, and IgG-NP were 99.6%, 14.9% and 4.4%, respectively. Adjusted IgG-Quant levels increased significantly with obesity, nonsmoking status, positive IgM-S, and/or IgG-NP. The prevalence of IgM-S was higher in males, and associated with the same factors as those for IgG-Quant. Among those with a history of COVD-19 infection, 42.9% did not have IgG-NP. Overall 86.5% of participants had side effects, which were associated with positive IgG-NP, high IgG-Quant levels, younger age, and being female. Conclusions: All but one participant developed immunity. Those who had suffered from COVID-19 infection had higher antibody levels. A high proportion of participants had mild secondary effects, especially those with previous COVID-19 infection (AU)

[Prevalence and characteristics of chronic obstructive pulmonary disease in non-smokers]. / Prevalencia y características de la enfermedad pulmonar obstructiva crónica en no fumadores.

OBJECTIVE: The objective of the study was to know the profile of patients diagnosed with chronic obstructive pulmonary disease (COPD) and who have never been smokers. DESIGN: A transversal study. LOCATION: Primary Care Centre of Pla d'Urgell (Primary care setting in Lleida, Spain). PARTICIPANTS: 512 patients older than 40 years with COPD from Primary Care Centre of Pla d'Urgell with a compatible spirometry [forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ratio <0.7) to the beginning of the study. MAIN MEASUREMENTS: The dependent variable was de COPD in non-smokers and the independents were variables collected from the information on the respiratory clinical history, the risk factors of the patients and on quality of life. We designed a predictor model of COPD in non-smokers compared to smokers. RESULTS: 33.2% of COPD patients had never been smokers, 59.4% of whom were women. The average FEV1 for non-smokers was 70.5 (SD=17.1), higher than 62.6 (SD=18.5) for smokers/former smokers (p<0.001). The coverage of pneumococcal vaccination 23V was better in non-smokers (75.3%), p<0.001. COPD in non-smokers (compared to smokers/former smokers) were: mostly women (OR=16.46), older (OR=1.1), with better FEV1 (OR=1.1), better perception of quality, EuroQoL-5D (OR=0.8), with lower prevalence of diabetes (OR=0.5), lower level of studies (OR=0.2), and with fewer previous hospitalizations (OR=0.3). CONCLUSIONS: The study evidences a high proportion of non-smokers in COPD patients. Our study aims that older women with less severity would be associated with an increased risk of COPD in non-smokers. It seems to indicate that COPD in non-smokers would appear at later ages and would be milder than smoking-related COPD.

Cáncer de pulmón en no fumadores: [revisión] / Lung cancer in nonsmokers: [review]

Estudios provenientes de muchos países asiáticos establecen que los pacientes con cáncer de pulmón no fumadores (CPNF) constituyen un grupo de pacientes que no deben ser ignorados. Afecta mayormente a mujeres, y los factores de riesgo propuestos incluyenla exposición ambiental al humo de tabaco, radón, asbestos, vapores de aceites, infección viral por papiloma y susceptibilidad genética. El adenocarcinoma es el subtipohistológico predominante reportado, y las mutaciones del receptor del factor de crecimiento epidérmico (RFCE) han sido detectadas frecuentemente en este grupo. Mejores tasas de respuestas al tratamiento con inhibidores del RFCE en pacientes con CPNF avanzado indican un comportamiento distinto en estos pacientes. El propósito de estarevisión es evaluar las implicancias prácticas que podrían tener estas diferencias.

Studies from many Asian countries report that the group of patients with lung cancer and are never smokers (LCNS) should not be ignored. It affects mostly women, and the known risk factors include environmental exposure to tobacco smoke, radon, asbestosand oil fumes, human papillomavirus infection and genetic susceptibility.Adenocarcinoma is the predominant histologic subtype reported, and epidermal growth factor receptor (EGFR) mutations have frequently been detected in this group. Best response rates to treatment with EGFR inhibitors in patients with advanced LCNS indicatea different prognosis in these patients. The purpose of this review is to assess the practical implications that this difference could have.