Sin Don D, Man S F Paul, McWilliams Annette, Lam Stephen
Division of Respirology, Department of Medicine, University of British Columbia, Canada V5Z 1L3.
Am J Respir Crit Care Med. 2006 Mar 1;173(5):535-9. doi: 10.1164/rccm.200508-1305OC. Epub 2005 Dec 9.
Chronic inflammation has been implicated in the development of airway dysplasia and lung cancer. It is unclear whether circulating biomarkers of inflammation could be used to predict progression of airway dysplasia.
We determined whether circulating levels of C-reactive protein (CRP) or other inflammatory biomarkers could predict progression of bronchial dysplasia in smokers over 6 mo.
The plasma levels of CRP, interleukins 6 and 8, and monocyte chemoattractant protein 1 were measured at baseline in 65 ex- and current smokers who had at least one site of bronchial dysplasia > 1.2 mm in size. Additional bronchial biopsies were taken after 6 mo from the same sites where dysplastic lesions were discovered at baseline. Progressive dysplastic lesions were defined as worsening of the dysplastic lesion by at least two grades or development of new dysplastic lesions.
Half of the participants developed progressive dysplastic lesions after 6 mo. The baseline CRP levels in these participants were 64% higher than those without progressive disease (p = 0.027). Only one of eight (13%) participants with CRP < or = 0.5 mg/L developed progressive disease, whereas 31 of 57 (54%) participants with CRP > 0.5 mg/L developed progressive disease (p = 0.011). The odds of developing progressive disease were 9.6-fold higher in the latter than in the former group.
Plasma CRP, in concert with lung function and pack-years of smoking, appears to have excellent predictive powers in identifying participants with bronchial dyplastic lesions whose lesions progress to more advanced stages of dysplasia.
慢性炎症与气道发育异常和肺癌的发生有关。尚不清楚炎症的循环生物标志物是否可用于预测气道发育异常的进展。
我们确定循环中的C反应蛋白（CRP）水平或其他炎症生物标志物是否可预测吸烟者在6个月内支气管发育异常的进展。
对65名曾吸烟和正在吸烟的人进行基线时血浆CRP、白细胞介素6和8以及单核细胞趋化蛋白1水平的检测，这些人至少有一处支气管发育异常，大小超过1.2毫米。6个月后，在基线时发现发育异常病变的相同部位再次进行支气管活检。进展性发育异常病变的定义为发育异常病变至少恶化两个等级或出现新的发育异常病变。
6个月后，一半的参与者出现了进展性发育异常病变。这些参与者的基线CRP水平比没有进展性疾病的参与者高64%（p = 0.027）。CRP≤0.5 mg/L的8名参与者中只有1名（13%）出现了进展性疾病，而CRP>0.5 mg/L的57名参与者中有31名（54%）出现了进展性疾病（p = 0.011）。后一组发生进展性疾病的几率比前一组高9.6倍。
血浆CRP与肺功能和吸烟包年数相结合，在识别支气管发育异常病变进展到更高级别发育异常阶段的参与者方面似乎具有出色的预测能力。
