Platz Elizabeth A, De Marzo Angelo M, Erlinger Thomas P, Rifai Nader, Visvanathan Kala, Hoffman Sandra C, Helzlsouer Kathy J
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Prostate. 2004 Jun 1;59(4):393-400. doi: 10.1002/pros.10368.
We evaluated the association of pre-diagnostic plasma concentration of C-reactive protein, a sensitive, but non-specific indicator of inflammation, with subsequent risk of prostate cancer.
Included were 264 histologically confirmed prostate cancer cases and 264 age-matched controls who were participants in the CLUE II cohort of Washington County, MD. C-reactive protein was measured using a high-sensitivity immunoturbidimetric assay. Odds ratios (ORs) and 95% confidence intervals (CI) were estimated from conditional logistic regression models by fourth of the C-reactive protein distribution with cutpoints based on the controls. The median concentrations from the lowest to highest fourth were 0.41, 1.03, 1.90, and 4.53 mg/L.
Geometric mean plasma concentrations did not differ between the cases (1.24 +/- 2.94 mg/L) and controls (1.41 +/- 2.97 mg/L; P = 0.16). Compared to the bottom fourth, the ORs (95% CI) of prostate cancer were 1.29 (0.80-2.08), 0.98 (0.61-1.58), and 0.95 (0.57-1.58) for the second, third, and highest fourths (P trend = 0.66). These findings were unchanged after adjusting for body mass index (BMI) and cigarette smoking status or after excluding men with markedly elevated C-reactive protein, cases diagnosed during the first 2 years of follow-up, or controls who never had a PSA test. These findings did not differ by stage or grade of prostate cancer.
Pre-diagnostic plasma concentration of C-reactive protein was not associated with subsequent risk of prostate cancer.
我们评估了炎症的敏感但非特异性指标——诊断前血浆C反应蛋白浓度与后续前列腺癌风险之间的关联。
纳入了264例经组织学确诊的前列腺癌病例和264例年龄匹配的对照，他们均为马里兰州华盛顿县CLUE II队列的参与者。使用高敏免疫比浊法测量C反应蛋白。通过条件逻辑回归模型，根据对照组的C反应蛋白分布四分位数及切点估计比值比（OR）和95%置信区间（CI）。从最低到最高四分位数的中位数浓度分别为0.41、1.03、1.90和4.53mg/L。
病例组（1.24±2.94mg/L）和对照组（1.41±2.97mg/L；P = 0.16）的几何平均血浆浓度无差异。与最低四分位数相比，前列腺癌的OR（95%CI）在第二、第三和最高四分位数分别为1.29（0.80 - 2.08）、0.98（0.61 - 1.58）和0.95（0.57 - 1.58）（P趋势 = 0.66）。在调整体重指数（BMI）和吸烟状况后，或排除C反应蛋白明显升高的男性、随访前2年内诊断的病例或从未进行过前列腺特异性抗原（PSA）检测的对照后，这些结果未改变。这些结果在前列腺癌的不同分期或分级中无差异。
诊断前血浆C反应蛋白浓度与后续前列腺癌风险无关。
