Microbial infections as potential risk factors for lung cancer: Investigating the role of human papillomavirus and chlamydia pneumoniae

Emmanuel Kwateng Drokow; Clement Yaw Effah; Clement Agboyibor; Jemima Twumwaah Budu; Francisca Arboh; Priscilla Akyaa Kyei-Baffour; Yao Xiao; Fan Zhang; Irene XY Wu; Emmanuel Kwateng Drokow; Clement Yaw Effah; Clement Agboyibor; Jemima Twumwaah Budu; Francisca Arboh; Priscilla Akyaa Kyei-Baffour; Yao Xiao; Fan Zhang; Irene XY Wu

doi:10.3934/publichealth.2023044

AIMS Public Health

2023, Volume 10, Issue 3: 627-646. doi: 10.3934/publichealth.2023044

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Research article

Microbial infections as potential risk factors for lung cancer: Investigating the role of human papillomavirus and chlamydia pneumoniae

1.
Hunan Provinical Key Laboratory of Clinical Epidemiology, Central South University, Changsha 410083, Hunan, China
2.
Department of Epidemiology and Biostatistics, Xiangya School of Public Health, Central South University, Changsha 410083, Hunan, China
3.
General ICU, The First Affiliated Hospital of Zhengzhou University, Henan Key Laboratory of Critical Care Medicine, Zhengzhou Key Laboratory of Sepsis, Henan Engineering Research Center for Critical Care Medicine, Zhengzhou 450003, China
4.
School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, China
5.
School of Nursing, Zhengzhou University, 450001 Zhengzhou, China
6.
Department of Health Policy and Management, School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang, 212013 Jiangsu Province, China
7.
Department of General Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
8.
University of Ghana Medical Center, Accra, Ghana
9.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
10.
Department of Gynecology, Xiangya Hospital, Central South University, Changsha, Hunan, China, 410008
These two authors contributed equally.

Received: 10 April 2023 Revised: 22 June 2023 Accepted: 03 July 2023 Published: 03 August 2023

Background
Lung cancer is the leading cause of cancer morbidity and mortality worldwide. Apart from tobacco smoke and dietary factors, microbial infections have been reported as the third leading cause of cancers globally. Deciphering the association between microbiome and lung cancer will provide potential biomarkers and novel insight in lung cancer progression. In this current study, we performed a meta-analysis to decipher the possible association between C. pneumoniae and human papillomavirus (HPV) and the risk of lung cancer.

Methods
Literature search was conducted in most English and Chinese databases. Data were analyzed using CMA v.3.0 and RevMan v.5.3 software (Cochrane-Mantel-Haenszel method) by random-effects (DerSimonian and Laird) model.

Results
The overall pooled estimates for HPV studies revealed that HPV infections in patients with lung cancer were significantly higher than those in the control group (OR = 2.33, 95% CI = 1.57–3.37, p < 0.001). Base on subgroup analysis, HPV infection rate was significantly higher in Asians (OR = 6.38, 95% CI = 2.33–17.46, p < 0.001), in tissues (OR = 5.04, 95% CI = 2.27–11.19, p < 0.001) and blood samples (OR = 1.40, 95% CI = 1.02–1.93, p = 0.04) of lung cancer patients but non-significantly lower in males (OR = 0.84, 95% CI = 0.57–1.22, p =0.35) and among lung cancer patients at clinical stage I-II (OR = 0.95, 95% CI = 0.61–1.49, p = 0.82). The overall pooled estimates from C. pneumoniae studies revealed that C. pneumoniae infection is a risk factor among lung cancer patients who are IgA seropositive (OR = 1.88, 95% CI = 1.30–2.70, p < 0.001) and IgG seropositive (OR = 1.50, 95% CI = 1.10–2.04, p = 0.010). All seronegative IgA (OR = 0.69, 95% CI = 0.42–1.16, p = 0.16) and IgG (OR = 0.66, 95% CI = 0.42–105, p = 0.08) titers are not associative risk factors to lung cancer.

Conclusions
Immunoglobulin (IgA) and IgG seropositive titers of C. pneumoniae and lungs infected with HPV types 16 and 18 are potential risk factors associated with lung cancer.
- microbial infections,
- human papillomavirus,
- chlamydia pneumoniae,
- lung cancer,
- risk association
Citation: Emmanuel Kwateng Drokow, Clement Yaw Effah, Clement Agboyibor, Jemima Twumwaah Budu, Francisca Arboh, Priscilla Akyaa Kyei-Baffour, Yao Xiao, Fan Zhang, Irene XY Wu. Microbial infections as potential risk factors for lung cancer: Investigating the role of human papillomavirus and chlamydia pneumoniae[J]. AIMS Public Health, 2023, 10(3): 627-646. doi: 10.3934/publichealth.2023044

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Abstract

Background

Lung cancer is the leading cause of cancer morbidity and mortality worldwide. Apart from tobacco smoke and dietary factors, microbial infections have been reported as the third leading cause of cancers globally. Deciphering the association between microbiome and lung cancer will provide potential biomarkers and novel insight in lung cancer progression. In this current study, we performed a meta-analysis to decipher the possible association between C. pneumoniae and human papillomavirus (HPV) and the risk of lung cancer.

Methods

Literature search was conducted in most English and Chinese databases. Data were analyzed using CMA v.3.0 and RevMan v.5.3 software (Cochrane-Mantel-Haenszel method) by random-effects (DerSimonian and Laird) model.

Results

The overall pooled estimates for HPV studies revealed that HPV infections in patients with lung cancer were significantly higher than those in the control group (OR = 2.33, 95% CI = 1.57–3.37, p < 0.001). Base on subgroup analysis, HPV infection rate was significantly higher in Asians (OR = 6.38, 95% CI = 2.33–17.46, p < 0.001), in tissues (OR = 5.04, 95% CI = 2.27–11.19, p < 0.001) and blood samples (OR = 1.40, 95% CI = 1.02–1.93, p = 0.04) of lung cancer patients but non-significantly lower in males (OR = 0.84, 95% CI = 0.57–1.22, p =0.35) and among lung cancer patients at clinical stage I-II (OR = 0.95, 95% CI = 0.61–1.49, p = 0.82). The overall pooled estimates from C. pneumoniae studies revealed that C. pneumoniae infection is a risk factor among lung cancer patients who are IgA seropositive (OR = 1.88, 95% CI = 1.30–2.70, p < 0.001) and IgG seropositive (OR = 1.50, 95% CI = 1.10–2.04, p = 0.010). All seronegative IgA (OR = 0.69, 95% CI = 0.42–1.16, p = 0.16) and IgG (OR = 0.66, 95% CI = 0.42–105, p = 0.08) titers are not associative risk factors to lung cancer.

Conclusions

Immunoglobulin (IgA) and IgG seropositive titers of C. pneumoniae and lungs infected with HPV types 16 and 18 are potential risk factors associated with lung cancer.

Acknowledgments

This work was supported by the Project Program of the National Clinical Research Center for Geriatric Disorders (Xiangya Hospital, Grant No. 2022LNJJ19). The Natural Science Foundation of Hunan Province (Reference number: 2023JJ30969).

Conflict of interest

The authors declare no conflict of interest.

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