Inflammatory biomarkers and risk of cancer in 84,000 individuals from the general population
Inflammatory biomarkers and risk of cancer in 84,000 individuals from the general population
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DOI：
10.1002/ijc.30194
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发表时间：
2016-10-01
影响因子：
6.4
通讯作者：
Nordestgaard, Borge G.
中科院分区：
文献类型：
--
作者：
Allin, Kristine H.;Bojesen, Stig E.;Nordestgaard, Borge G.
炎症和癌症是紧密相连的。本研究检验了基于血浆C反应蛋白（CRP）、纤维蛋白原和全血白细胞计数的炎症评分与结直肠癌、肺癌、乳腺癌和前列腺癌风险相关的假设。在来自丹麦一般人群的84，000名个体中构建了从零到三个升高的生物标志物的评分。在4.8年的中位随访时间内，发生了4，081例癌症事件。考克斯比例风险回归模型被用来估计风险比（HR）的事件癌症。与生物标志物未升高的个体相比，一种、两种和三种炎症生物标志物水平升高的个体的结直肠癌多因素校正HR分别为1.28（95% CI，1.01至1.62）、1.79（95% CI，1.41至2.27）和2.18（95% CI，1.67至2.86）。观察到肺癌和乳腺癌的风险呈类似的逐步增加趋势，三种生物标志物与无生物标志物升高的HR分别为3.03（95%CI，2.25至4.08）和1.42（95%CI，1.11至1.80）。HR在随访的第一年内最高。在有三种生物标志物升高的老年吸烟者中，肺癌的绝对5年风险为7.8%（95%CI，6.1至10），而在没有生物标志物升高的人群中为3.8%（95%CI，2.6至5.6）。总之，同时升高的CRP、纤维蛋白原和白细胞计数与结直肠癌、肺癌和乳腺癌的风险增加相关。癌症作为炎症的促进者可能比低度炎症促进癌症发展更能解释我们的发现。炎症和癌症是紧密相连的。在这项针对84，000名受试者的前瞻性研究中，作者检验了以下假设：基于C反应蛋白（CRP）和纤维蛋白原血浆水平以及全血白细胞计数的炎症评分与癌症风险相关。同时升高的CRP和纤维蛋白原水平以及白细胞计数与结直肠癌、肺癌和乳腺癌的风险增加相关：在三种生物标志物升高的患者中，风险分别增加2.2倍、3.0倍和1.4倍。这种关联在血液采样后的最初几年内最强，这表明隐性癌症引发炎症是一种解释。
Inflammation and cancer are tightly linked. This study tests the hypothesis that an inflammatory score based on plasma levels of C-reactive protein (CRP) and fibrinogen and whole blood leukocyte count is associated with risk of colorectal, lung, breast and prostate cancer. A score ranging from none through three elevated biomarkers was constructed in 84,000 individuals from the Danish general population. During a median follow-up time of 4.8 years, 4,081 incident cancers occurred. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) of incident cancer. Multifactor-adjusted HRs for colorectal cancer were 1.28 (95% CI, 1.01 to 1.62), 1.79 (95% CI, 1.41 to 2.27) and 2.18 (95% CI, 1.67 to 2.86) for individuals with elevated levels of one, two and three inflammatory biomarkers compared to individuals with none elevated biomarkers. A similar stepwise increasing risk was observed for lung and breast cancer with HRs of 3.03 (95% CI, 2.25 to 4.08) and 1.42 (95% CI, 1.11 to 1.80) for three versus none elevated biomarkers. HRs were highest within the first years of follow-up. Absolute 5-year risk of lung cancer was 7.8 (95% CI, 6.1 to 10)% among older smokers with three elevated biomarkers compared to 3.8 (95% CI, 2.6 to 5.6)% among those with none elevated biomarkers. In conclusion, simultaneously elevated CRP, fibrinogen and leukocyte count are associated with an increased risk of colorectal, lung and breast cancer. Cancer as a promoter of inflammation may be more likely to account for our findings than low-grade inflammation promoting cancer development.What's new? Inflammation and cancer are tightly linked. In this prospective study of 84,000 individuals, the authors tested the hypothesis that an inflammatory score based on plasma levels of C-reactive protein (CRP) and fibrinogen and whole blood leukocyte count is associated with cancer risk. Simultaneously elevated CRP and fibrinogen levels and leukocyte count were associated with an increased risk of colorectal, lung and breast cancer: among those with three versus none elevated biomarkers, the risk was increased 2.2-, 3.0- and 1.4-fold, respectively. The association was strongest within the first few years after blood sampling, suggesting occult cancer eliciting inflammation as an explanation.