炎性因子与乳腺癌发病风险的前瞻性队列研究
|
摘要
目的在大型前瞻性队列研究基础上,探讨高敏C-反应蛋白(high sensitivity C-reactive protein,hsCRP)和中性粒细胞(neutrophil,NE)与女性乳腺癌发病风险的关联性。方法收集2006-2007年开滦研究队列女性人群体检数据和hsCRP及NE检测结果等基线信息。采用多因素Cox风险模型分析基线hsCRP水平及NE水平与女性乳腺癌发病风险比(HR)和95%可信区间(95%CI)。结果队列共纳入18 866例女性,末次随访至2015年12月31日,随访期间共收集新发乳腺癌183例。其中,hsCRP<1 mg/L组、1～3 mg/L组和>3 mg/L组新发乳腺癌9年累积发病率分别为829/10万、1 211/10万和1 495/10万,差异有统计学意义(χ~2=12.08,P=0.002)。Cox分析显示:hsCRP>3 mg/L组乳腺癌发病风险是hsCRP<1 mg/L组的1.71(95%CI:1.18～2.47,P=0.005)倍,差异有统计学意义。NE水平(<3.70×10~9/L和≥3.70×10~9/L)差异与乳腺癌发病风险无统计学意义(P>0.05)。结论基线hsCRP水平升高可能增加乳腺癌发病风险。
Objective To investigate whether elevated baseline levels of high sensitivity C-Reactive Protein(hsCRP) and neutrophil(NE) are associated with an increased risk of breast cancer in Kailuan female cohort. Methods Females from Kailuan cohort(2006-2007) were included in this study. Information on check-up, hsCRP and NE were collected at baseline for all subjects. Multivariable Cox proportional hazards regression models were used to calculate hazard ratios(HR) and 95% confidence intervals(95%CI) of association between baseline hsCRP and NE values and breast cancer risk. Results By December 31, 2015, a total of 18 866 participants were enrolled in this study. During the follow-up, 183 new cases of breast cancer were observed. All participants were divided into three groups according to the level of hsCRP(<1 mg/L, 1-3 mg/L and >3 mg/L). The cumulative incidence of breast cancer were 829/10~5, 1 211/10~5 and 1 495/10~5 in these 3 groups, respectively(χ~2=12.08, P=0.002). Compared with participants with lower hsCRP levels(<1 mg/L), individuals with the highest hsCRP(>3 mg/L) levels had significantly increased risk of breast cancer(HR=1.71,95%CI: 1.18-2.47, P=0.005), howerver, we didn't find the statistically significant association between NE level(<3.70×10~9/Lvs. ≥3.70×10~9/L) and the risk of brease cancer(P>0.05). Conclusions Elevated levels of hsCRP at baseline might increase the risk of breast cancer in females.
Objective To investigate whether elevated baseline levels of high sensitivity C-Reactive Protein(hsCRP) and neutrophil(NE) are associated with an increased risk of breast cancer in Kailuan female cohort. Methods Females from Kailuan cohort(2006-2007) were included in this study. Information on check-up, hsCRP and NE were collected at baseline for all subjects. Multivariable Cox proportional hazards regression models were used to calculate hazard ratios(HR) and 95% confidence intervals(95%CI) of association between baseline hsCRP and NE values and breast cancer risk. Results By December 31, 2015, a total of 18 866 participants were enrolled in this study. During the follow-up, 183 new cases of breast cancer were observed. All participants were divided into three groups according to the level of hsCRP(<1 mg/L, 1-3 mg/L and >3 mg/L). The cumulative incidence of breast cancer were 829/10~5, 1 211/10~5 and 1 495/10~5 in these 3 groups, respectively(χ~2=12.08, P=0.002). Compared with participants with lower hsCRP levels(<1 mg/L), individuals with the highest hsCRP(>3 mg/L) levels had significantly increased risk of breast cancer(HR=1.71,95%CI: 1.18-2.47, P=0.005), howerver, we didn't find the statistically significant association between NE level(<3.70×10~9/Lvs. ≥3.70×10~9/L) and the risk of brease cancer(P>0.05). Conclusions Elevated levels of hsCRP at baseline might increase the risk of breast cancer in females.
引文
[1] 陈万青,孙可欣,郑荣寿,等.2014年中国分地区恶性肿瘤发病和死亡分析 [J].中国肿瘤,2018,27(1):1-14.DOI:10.11735/j.issn.1004-0242.2018.01.A001.Chen WQ,Sun KX,Zheng RS,et al.Report of cancer incidence and mortality in different areas of China,2014.[J].China Cancer,2018,27(1):1-14.DOI:10.11735/j.issn.1004-0242.2018.01.A001.
[2] Ollberding NJ,Kim Y,Shvetsov YB,et al.Prediagnostic leptin,adiponectin,C-Reactive protein,and the risk of postmenopausal breast cancer [J].Cancer Prev Res(Phila),2013,6(3):188-195.DOI:10.1158/1940-6207.
[3] Guo YZ,Pan L,Du CJ,et al.Association between C-reactive protein and risk of cancer:a meta-analysis of prospective cohort studies [J].Asian Pac J Cancer Prev,2013,14(1):243-248.
[4] Gang W,Ni L,Sheng C,et al.A prospective follow-up study of the relationship between C-reactiveprotein and human cancer risk in the Chinese Kailuan female cohort [J].Cancer Epidemiol Biomarkers Prev,2015,24(2):459-465.DOI:10.1158/1055-9965.
[5] 王刚,吕章艳,冯小双,等.基线高敏C-反应蛋白与吸烟人群上消化道癌发病风险的前瞻性队列研究 [J].中华疾病控制杂志,2018,22(2):109-112.DOI:10.16462/j.cnki.zhjbkz.2018.02.002.Wang G,lv ZY,Feng XS,et al.The relationship between high sensitivity C-reactive protein and the risk of upper gastrointestinal cancer among smokers in Kailuan cohort [J].Chin J Dis Control Prev,2018,22(2):109-112.DOI:10.16462/j.cnki.zhjbkz.2018.02.002.
[6] Allin KH,Bojesen SE,Nordestgaard BG.Baseline C-reactive protein is associated with incident cancer and survival in patients with cancer [J].J Clin Oncol,2009,27(13):2217-2224.DOI:10.1200/JCO.2008.19.8440.
[7] Mahmoud FA,Rivera NI.The role of C-reactive protein as aprognostic indicator in advanced cancer [J].Curr Oncol Rep,2002,4(3):250-255.
[8] Pasceri V,Cammarota G.C-reactive protein and risk of colon cancer [J].JAMA,2004,291(23):2818-2819.DOI:10.1001/jama.291.23.2819-a.
[9] Harris RE,Chlebowski RT,Jackson RD,et al.Breast cancer and nonsteroidal anti-inflammatory drugs:prospective results from the women’s health initiative [J].Cancer Res,2003,63(18):6096-6101.
[10] Kim ES,Kim SY,Koh M,et al.C-reactive protein binds to integrin α2 and Fcγ receptor I,leading to breast celladhesion and breast cancer progression [J].Oncogene,2017.DOI:10.1038/onc.2017.298.
[11] Allin KH,Bojesen SE,Nordestgaard BG.Inflammatory biomarkers and risk of cancer in 84,000 individuals from the general population [J].Int J Cancer,2016,139(7):1493-1500.DOI:10.1002/ijc.30194.
[12] Frydenberg H,Thune I,Lofter?d T,et al.Pre-diagnostic high-sensitive C-reactive protein and breast cancer risk,recurrence,and survival [J].Breast Cancer Res Treat,2016,155(2):345-354.DOI:10.1007/s10549-015-3671-1.
[13] Chan DS,Bandera EV,Greenwood DC,et al.Circulating C-reactive protein and breast cancer risk-systematic literature review and meta-analysis of prospective cohort studies [J].Cancer Epidemiol Biomarkers Prev,2015,24(10):1439-1449.DOI:10.1158/1055-9965.
[14] Wulaningsih W,Holmberg L,Garmo H,et al.Prediagnostic serum inflammatory markers in relation to breast cancer risk,severity at diagnosis and survival in breast cancer patients [J].Carcinogenesis,2015,36(10):1121-1128.DOI:10.1093/carcin/bgv096.
[15] Nelson SH,Brasky TM,Patterson RE,et at.The association of the C-reactive protein inflammatory biomarker with breast cancer incidence and mortality in the women's health initiative [J].Cancer Epidemiol Biomarkers Prev,2017,26(7):1100-1106.DOI:10.1158/1055-9965.
[16] Zhang SM,Lin J,Cook NR,et al.C-reactive protein and risk of breast cancer [J].J Natl Cancer Inst,2007,99(11):890-894.
[2] Ollberding NJ,Kim Y,Shvetsov YB,et al.Prediagnostic leptin,adiponectin,C-Reactive protein,and the risk of postmenopausal breast cancer [J].Cancer Prev Res(Phila),2013,6(3):188-195.DOI:10.1158/1940-6207.
[3] Guo YZ,Pan L,Du CJ,et al.Association between C-reactive protein and risk of cancer:a meta-analysis of prospective cohort studies [J].Asian Pac J Cancer Prev,2013,14(1):243-248.
[4] Gang W,Ni L,Sheng C,et al.A prospective follow-up study of the relationship between C-reactiveprotein and human cancer risk in the Chinese Kailuan female cohort [J].Cancer Epidemiol Biomarkers Prev,2015,24(2):459-465.DOI:10.1158/1055-9965.
[5] 王刚,吕章艳,冯小双,等.基线高敏C-反应蛋白与吸烟人群上消化道癌发病风险的前瞻性队列研究 [J].中华疾病控制杂志,2018,22(2):109-112.DOI:10.16462/j.cnki.zhjbkz.2018.02.002.Wang G,lv ZY,Feng XS,et al.The relationship between high sensitivity C-reactive protein and the risk of upper gastrointestinal cancer among smokers in Kailuan cohort [J].Chin J Dis Control Prev,2018,22(2):109-112.DOI:10.16462/j.cnki.zhjbkz.2018.02.002.
[6] Allin KH,Bojesen SE,Nordestgaard BG.Baseline C-reactive protein is associated with incident cancer and survival in patients with cancer [J].J Clin Oncol,2009,27(13):2217-2224.DOI:10.1200/JCO.2008.19.8440.
[7] Mahmoud FA,Rivera NI.The role of C-reactive protein as aprognostic indicator in advanced cancer [J].Curr Oncol Rep,2002,4(3):250-255.
[8] Pasceri V,Cammarota G.C-reactive protein and risk of colon cancer [J].JAMA,2004,291(23):2818-2819.DOI:10.1001/jama.291.23.2819-a.
[9] Harris RE,Chlebowski RT,Jackson RD,et al.Breast cancer and nonsteroidal anti-inflammatory drugs:prospective results from the women’s health initiative [J].Cancer Res,2003,63(18):6096-6101.
[10] Kim ES,Kim SY,Koh M,et al.C-reactive protein binds to integrin α2 and Fcγ receptor I,leading to breast celladhesion and breast cancer progression [J].Oncogene,2017.DOI:10.1038/onc.2017.298.
[11] Allin KH,Bojesen SE,Nordestgaard BG.Inflammatory biomarkers and risk of cancer in 84,000 individuals from the general population [J].Int J Cancer,2016,139(7):1493-1500.DOI:10.1002/ijc.30194.
[12] Frydenberg H,Thune I,Lofter?d T,et al.Pre-diagnostic high-sensitive C-reactive protein and breast cancer risk,recurrence,and survival [J].Breast Cancer Res Treat,2016,155(2):345-354.DOI:10.1007/s10549-015-3671-1.
[13] Chan DS,Bandera EV,Greenwood DC,et al.Circulating C-reactive protein and breast cancer risk-systematic literature review and meta-analysis of prospective cohort studies [J].Cancer Epidemiol Biomarkers Prev,2015,24(10):1439-1449.DOI:10.1158/1055-9965.
[14] Wulaningsih W,Holmberg L,Garmo H,et al.Prediagnostic serum inflammatory markers in relation to breast cancer risk,severity at diagnosis and survival in breast cancer patients [J].Carcinogenesis,2015,36(10):1121-1128.DOI:10.1093/carcin/bgv096.
[15] Nelson SH,Brasky TM,Patterson RE,et at.The association of the C-reactive protein inflammatory biomarker with breast cancer incidence and mortality in the women's health initiative [J].Cancer Epidemiol Biomarkers Prev,2017,26(7):1100-1106.DOI:10.1158/1055-9965.
[16] Zhang SM,Lin J,Cook NR,et al.C-reactive protein and risk of breast cancer [J].J Natl Cancer Inst,2007,99(11):890-894.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |