Abstract：
There is a lack of evidence from cohort studies on the causal association of long-term exposure to ambient fine particulate matter (PM2.5) and its chemical components with the risk of nasopharyngeal carcinoma (NPC) recurrence. Based on a 10-year prospective cohort of 1184 newly diagnosed NPC patients, we comprehensively evaluated the potential causal links of ambient PM2.5 and its chemical components including black carbon (BC), organic matter (OM), sulfate (SO4 2-), nitrate (NO3 -), and ammonium (NH4 +) with the recurrence risk of NPC using a marginal structural Cox model adjusted with inverse probability weighting. We observed 291 NPC patients experiencing recurrence during the 10-year follow-up and estimated a 33% increased risk of NPC recurrence (hazard ratio [HR]: 1.33, 95% confidence interval [CI]: 1.02-1.74) following each interquartile range (IQR) increase in PM2.5 exposure. Each IQR increment in BC, NH4 +, OM, NO3 -, and SO4 2- was associated with HRs of 1.36 (95%CI: 1.13-1.65), 1.35 (95%CI: 1.07-1.70), 1.33 (95%CI: 1.11-1.59), 1.32 (95%CI: 1.06-1.64), 1.31 (95%CI: 1.08-1.57). The elderly, patients with no family history of cancer, no smoking history, no drinking history, and those with severe conditions may exhibit a greater likelihood of NPC recurrence following exposure to PM2.5 and its chemical components. Additionally, the effect estimates of the five components are greater among patients who were exposed to high concentration than in the full cohort of patients. Our study provides solid evidence for a potential relationship between long-term exposure to PM2.5 and its components and the risk of NPC recurrence.
摘要：
队列研究缺乏证据表明长期暴露于环境细颗粒物（PM2.5）及其化学成分与鼻咽癌（NPC）复发风险的因果关系。基于1184例新诊断的NPC患者的10年前瞻性队列，我们全面评估了环境PM2.5及其化学成分（包括黑碳（BC））的潜在因果关系，有机质(OM)，硫酸盐(SO4-)，硝酸盐（NO3-），和铵（NH4）与NPC的复发风险使用边际结构Cox模型进行逆概率加权调整。我们观察到291例NPC患者在10年的随访期间经历了复发，并估计在PM2.5暴露的每个四分位距（IQR）增加后，NPC复发的风险增加了33％（风险比[HR]：1.33，95％置信区间[CI]：1.02-1.74）。BC中的每个IQR增量，NH4+,OM,NO3-,SO42-与1.36（95CI：1.13-1.65）的HR相关，1.35（95CI：1.07-1.70），1.33（95CI：1.11-1.59），1.32（95CI：1.06-1.64），1.31（95CI：1.08-1.57）。老人,没有癌症家族史的患者，无吸烟史,没有饮酒史,而那些患有严重疾病的患者在暴露于PM2.5及其化学成分后可能表现出更大的NPC复发可能性。此外,在暴露于高浓度的患者中,5种成分的效应估计值比在整个队列中的患者更大.我们的研究为长期暴露于PM2.5及其成分与NPC复发风险之间的潜在关系提供了坚实的证据。
