C-Reactive Protein and Risk of Lung Cancer
C-Reactive Protein and Risk of Lung Cancer
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DOI：
10.1200/jco.2009.27.0454
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发表时间：
2010-06-01
影响因子：
45.3
通讯作者：
Engels, Eric A.
中科院分区：
文献类型：
--
作者：
Chaturvedi, Anil K.;Caporaso, Neil E.;Engels, Eric A.
目的慢性炎症可能在肺癌发生中发挥作用，强调了肺癌预防和筛查的潜力。我们研究了循环高敏C反应蛋白与患者和方法我们对592名肺癌患者和670名对照进行了巢式病例对照研究，这些患者和对照具有可用的诊断前血清，并且378名患者和447名对照具有前列腺、肺、结直肠癌和卵巢癌筛查试验（N = 77，464）。对照组与患者的年龄、性别、入组年份、随访时间和吸烟情况相匹配。我们测量了基线血清样本中的CRP水平，并对5种常见的CRP SNPs进行了基因分型。结果CRP水平升高与肺癌风险增加相关（比值比[OR]，1.98; 95%CI，1.35至2.89;第四个四分位数[Q4，>= 5.6 mg/L] v Q1 [< 1.0 mg/L] P趋势<0.001）。CRP的相关性在组织学、随访时间或吸烟状况方面没有显著差异，但在鳞状细胞癌中最为明显（OR，2.92; 95%CI，1.30 ~ 6.54），肺癌诊断前2 ~ 5年（OR，2.33; 95%CI，1.24至4.39），以及在既往吸烟者（OR，2.48; 95%CI，1.53至4.03）和当前吸烟者（OR，1.90; 95%CI，1.06至3.41）中。尽管CRP单核苷酸多态性和单倍型与CRP水平相关，但它们与肺癌风险无关。在既往吸烟者中，CRP水平升高的10年标准化肺癌绝对风险更高（Q4：2.55%; 95% CI，1.98%至3.27% v Q1：1.39%; 95% CI，1.07%至1.81%）和当前吸烟者（Q4：7.37%，95%CI，5.81%~ 9.33%vQ1：4.03%，95%CI，3.01%~ 5.40%）。结论CRP水平升高与肺癌发病风险增加相关，提示慢性肺部炎症在肺癌发生中的病因作用。J Clin Oncol 28：2719-2726.由美国临床肿瘤学会出版
PurposeChronic inflammation could play a role in lung carcinogenesis, underscoring the potential for lung cancer prevention and screening. We investigated the association of circulating high-sensitivity C-reactive protein (CRP, an inflammation biomarker) and CRP single nucleotide polymorphisms (SNPs) with prospective lung cancer risk.Patients and MethodsWe conducted a nested case-control study of 592 lung cancer patients and 670 controls with available prediagnostic serum and 378 patients and 447 controls with DNA within the screening arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (N = 77,464). Controls were matched to patients on age, sex, entry year, follow-up time, and smoking. We measured CRP levels in baseline serum samples and genotyped five common CRP SNPs.ResultsElevated CRP levels were associated with increased lung cancer risk ( odds ratio [OR], 1.98; 95% CI, 1.35 to 2.89; P-trend < .001 for fourth quartile [Q4, >= 5.6 mg/L] v Q1 [< 1.0 mg/L]). The CRP association did not differ significantly by histology, follow-up time, or smoking status, but was most apparent for squamous cell carcinomas (OR, 2.92; 95% CI, 1.30 to 6.54), 2 to 5 years before lung cancer diagnosis (OR, 2.33; 95% CI, 1.24 to 4.39), and among former smokers (OR, 2.48; 95% CI, 1.53 to 4.03) and current smokers (OR, 1.90; 95% CI, 1.06 to 3.41). Although CRP SNPs and haplotypes were associated with CRP levels, they were not associated with lung cancer risk. Ten-year standardized absolute risks of lung cancer were higher with elevated CRP levels among former smokers (Q4: 2.55%; 95% CI, 1.98% to 3.27% v Q1: 1.39%; 95% CI, 1.07% to 1.81%) and current smokers (Q4: 7.37%; 95% CI, 5.81% to 9.33% v Q1: 4.03%; 95% CI, 3.01% to 5.40%).ConclusionElevated CRP levels are associated with subsequently increased lung cancer risk, suggesting an etiologic role for chronic pulmonary inflammation in lung carcinogenesis. J Clin Oncol 28:2719-2726. Published by the American Society of Clinical Oncology