Longitudinal analysis of quality of life in primary lung cancer patients with chlamydia pneumoniae infection: a time-to-deterioration model

Zishan Chen; Jinman Zhuang; Maolin Liu; Xinying Xu; Yuhang Liu; Shuyan Yang; Jinbao Xie; Nanlong Lin; Fancai Lai; Fei He

doi:10.1186/s12890-024-02860-x

Longitudinal analysis of quality of life in primary lung cancer patients with chlamydia pneumoniae infection: a time-to-deterioration model

BMC Pulm Med. 2024 Jan 17;24(1):36. doi: 10.1186/s12890-024-02860-x.

Authors

Zishan Chen¹, Jinman Zhuang¹, Maolin Liu¹, Xinying Xu¹, Yuhang Liu¹, Shuyan Yang¹, Jinbao Xie², Nanlong Lin², Fancai Lai², Fei He³

Affiliations

¹ Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and CancerSchool of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China.
² Department of Thoracic Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
³ Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and CancerSchool of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China. i.fei.he@fjmu.edu.cn.

Abstract

Background: Chlamydia pneumoniae (Cpn) IgG and IgA has been strongly linked to lung cancer, but its impact on patients' quality of life remains unclear. Our objective was to investigate the relationship between pre-treatment Cpn IgG and IgA and time to deterioration (TTD) of the HRQoL in patients with primary lung cancer.

Methods: A prospective hospital-based study was conducted from June 2017 to December 2018, enrolling 82 patients with primary lung cancer admitted to the First Affiliated Hospital of Fujian Medical University for questionnaire surveys. Cpn IgG and IgA was detected by microimmunofluorescence method. HRQoL was assessed at baseline and during follow-up using the EORTC Quality of Life Questionnaire version 3.0 (EORTC QLQ-C30) and EORTC Quality of Life Questionnaire-Lung Cancer (EORTC QLQ-LC13). HRQoL scores were calculated using the QoLR package, and TTD events were determined (minimum clinically significant difference = 5 points). Cox regression analysis was used to evaluate the effect of Cpn IgG and IgA on HRQoL.

Results: We investigated the relationship between Cpn IgG and IgA and quality of life in patients with primary lung cancer. The study was found that 75.61% of cases were Cpn IgG + and 45.12% were Cpn IgA + . Cpn IgA + IgG + was 41.46%. For EORTC QLQ-C30, Physical function (PF) and Pain (PA) TTD events on the functional scale and Symptom scale were the most common during follow-up. After adjusting for gender and smoking status, Pre-treatment Cpn IgA + was found to signifcantly delay TTD of Physical functioning(HR = 0.539, 95% CI: 0.291-0.996, P = 0.048). In addition, Cpn IgG + before treatment significantly delayed TTD in Emotional functioning (HR = 0.310, 95% CI: 0.115-0.836, P = 0.021). For EORTC QLQ-LC13, deterioration of dyspnea (LC-DY) was the most common event. However, Cpn IgG and IgA before treatment had no effect on the TTD of EORTC QLQ-LC13 items.

Conclusions: According to EORTC QLQ-C30 and EORTC QLQ-LC13, Cpn IgA delayed TTD in Physical functioning and Cpn IgG delayed TTD in Emotional functioning.

Keywords: Chlamydia pneumonia; Health-related quality of life; Primary lung cancer; Time to deterioration.

MeSH terms

Chlamydophila Infections* / complications
Humans
Immunoglobulin A
Immunoglobulin G
Lung Neoplasms* / therapy
Prospective Studies
Quality of Life / psychology
Surveys and Questionnaires

Substances

Immunoglobulin A
Immunoglobulin G

Abstract

MeSH terms

Substances

Grants and funding