Plasma C-reactive protein and risk of breast cancer in two prospective studies and a meta-analysis.
Plasma C-reactive protein and risk of breast cancer in two prospective studies and a meta-analysis.
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在两项前瞻性研究和一项荟萃分析中，血浆C反应蛋白和乳腺癌的风险。
DOI：
10.1158/1055-9965.epi-15-0187
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发表时间：
2015-08
期刊：
影响因子：
--
通讯作者：
Hankinson SE
中科院分区：
文献类型：
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作者：
Wang J;Lee IM;Tworoger SS;Buring JE;Ridker PM;Rosner B;Hankinson SE
流行病学研究已将C反应蛋白评估为乳腺癌的危险因素。然而，前瞻性研究的结果并不一致。我们在护士健康研究（NHS）和妇女健康研究（WHS）的整个队列中进行的病例对照研究中使用诊断前血液样本评估了这种关联。NHS中的943例病例和WHS中的1919例病例有助于分析。在NHS和WHS中分别使用条件Logistic回归和考克斯比例风险模型。我们使用随机效应荟萃分析将我们的结果与先前的前瞻性研究进行了汇总。在NHS中，较高的CRP水平与乳腺癌风险的持续增加相关（五分位数5 vs. 1：相对风险[RR] = 1.27，95%置信区间[CI] = 0.93，1.73; Ptrend = 0.02）;结果在肿瘤侵袭性或激素受体状态方面没有显著差异。然而，在WHS中未观察到与总体风险（五分位数5 vs. 1：RR = 0.89，95%CI = 0.76，1.06; Ptrend = 0.38）或肿瘤侵袭性或激素受体状态的相关性。荟萃分析（包括来自11项研究的5371例病例）显示CRP最高与最低类别的女性风险适度增加（RR = 1.26，95%CI = 1.07，1.49）。来自前瞻性研究的现有数据表明，CRP（一种非特异性炎症标志物）与乳腺癌风险呈中度正相关。我们的研究结果为炎症可以影响乳腺癌发展的概念提供了支持。
C-reactive protein has been evaluated as a risk factor for breast cancer in epidemiologic studies. However, results from prospective studies are inconsistent. We evaluated the association using pre-diagnostic blood samples in a case-control study nested within the Nurses' Health Study (NHS) and the full cohort of the Women's Health Study (WHS). 943 cases in the NHS and 1919 cases in the WHS contributed to the analysis. Conditional logistic regression and Cox proportional hazards model were used in the NHS and WHS, respectively. We pooled our results with prior prospective studies using random effect meta-analysis. In the NHS, higher CRP levels were associated with a suggestively increased risk of breast cancer (quintile 5 vs. 1: relative risk [RR] = 1.27, 95% confidence interval [CI] = 0.93, 1.73; Ptrend = 0.02); results did not vary significantly by tumor invasiveness or hormone receptor status. However, no association was observed in the WHS for overall risk (quintile 5 vs. 1: RR = 0.89, 95%CI = 0.76, 1.06; Ptrend = 0.38) or by tumor invasiveness or hormone receptor status. The meta-analysis (including 5371 cases from 11 studies) showed a modestly increased risk among women in the highest vs. lowest categories of CRP (RR = 1.26, 95%CI = 1.07, 1.49). Existing data from prospective studies suggest that CRP, a non-specific marker of inflammation, is modestly positively associated with breast cancer risk. Our findings provide support to the concept that inflammation can influence breast cancer development.