Combined and interaction effect of Chlamydia pneumoniae infection and smoking on lung cancer: a case-control study in southeast China
Abstract Objective: This case-control study investigated the role of Chlamydia pneumoniae (Cpn) infection in the pathogenesis of lung cancer and the combined and interaction effect of Chlamydia pneumoniae infection and smoking or other environmental factors.Methods: The study was comprised of 449 lung cancer patients and 512 age- and gender-matched healthy controls. All participants provided a 5-ml fasting peripheral venous blood sample for testing Cpn-specific IgG and IgA by using micro-immunofluorescence. Besides analyzing the associations between Cpn and lung cancer, combined effect analysis, logistic regression, and the excel table made by Andersson were used to analyze the combined and interaction effects of Cpn and environmental factors on lung cancer.Results: Compared to those with no evidence of serum Cpn IgA or Cpn IgG, those with both Cpn IgG+ and IgA+ had 2.00 times the risk (95% CI: 1.34 - 3.00) of developing lung cancer. Smokers with Cpn IgG+ or IgA+ were associated with a significantly increased risk of lung cancer, the adjusted OR was 1.79 (95% CI: 1.10-2.91) or 2.27(95% CI:1.38-3.72), respectively. Those exposed to passive smoking with Cpn IgG+ or IgA+ also increased the risk of lung cancer, the adjusted OR was 1.82 (95% CI: 1.20-2.77) or 1.87(95% CI:1.22-2.87), respectively. The similar results were also observed among alcohol drinking people. Multiplicative and additive interactions were not observed between Cpn infection and environmental factors. The combined effects of Cpn IgG+ or IgA+ and smoking, passive smoking, family history of cancer were found on lung cancer.Conclusion: The Cpn infection was potentially associated with primary lung cancer in the Chinese Han population and had combined effects with smoking, passive smoking, and the family history of cancer.