Organophosphate Flame Retardants Exposure Predicts Epidermal Growth Factor Receptor Expression in Lung Cancer Patients: A Prospective Cohort Study

Abstract

Abstract Background: Organophosphate flame retardants (OPFRs) have been widely distributed in our environment, and potential health hazards, including lung injuries from OPFR exposure, have been raised. Methods: The aim of the study was to investigate the distribution of OPFR exposure among lung cancer patients and its effects on epidermal growth factor (EGFR) expression. The current study enrolled 97 lung cancer patients, and their exposure to 10 OPFR compounds was evaluated using urine samples. Demographic and clinical features, along with urinary OPFR concentration, were compared based on the expression of EGFR gene. Spearman correlation was conducted to examine the relationship between OPFRs, while logistic regression was used to identify OPFR compounds that were independently associated with EGFR mutation. Results: OPFR exposure was found to be widespread in lung cancer patients, with an overall detection frequency of 98.81%. The urinary concentration of tris(2-butoxyethyl) phosphate (TBEP) was significantly lower in the group with EGFR mutation. TBEP showed an inverse relationship with mutant EGFR, particularly in the highest quartile when comparing to the lowest quartile (odds ratio 0.13, 95% confidence interval 0.03–0.65, p = 0.013). Conclusions: Exposure to OPFRs was prevalent in lung cancer patients. Among these pollutants, TBEP was identified as an independent inverse factor for the expression of EGFR mutation. Our study provides a reference for OPFR exposure in patients diagnosed with lung cancer and highlights the role of TBEP in evaluating EGFR mutation in this population.