Department of Surgery, Taipei-Veterans General Hospital, Taipei, Taiwan.
Ann Surg Oncol. 2011 Jul;18(7):1907-15. doi: 10.1245/s10434-011-1575-9. Epub 2011 Feb 4.
An elevated plasma level of C-reactive protein (CRP) is a risk for, and prognostic factor of, colorectal cancer (CRC). In other reports of CRP concerning cardiovascular disease, CRP level correlated with its gene polymorphisms. We hypothesized that CRP polymorphisms associate risk and prognosis of CRC.
This study enrolled 421 patients with CRC and 218 healthy control subjects. After preliminary studies, we selected four single nucleotide polymorphisms (SNPs) in the CRP gene: +2147A > G (rs1205), +942G > C (rs1800947), -717A > G (rs2794521), and -757T > C (rs3093059). At first, analyzing distributions of four SNPs between CRC case and non-CRC control groups was performed. Subsequently, the impacts of these SNPs with other prognostic factors of disease-free interval (DFI) and cancer-specific survival (CSS) were analyzed using uni- and multivariate Cox regression analyses.
The case and control groups differed in the frequency of -757T > C (P = 0.002). The CRC case group had a higher percentage of the TT genotype (odds, 1.75). Regarding prognoses, multivariate analyses revealed that four factors, including stage (I, II, III), gross tumor type (polypoid, ulcerative, infiltrative), location (right, left, rectum), and -757T > C SNP (odds, 1.29; P = 0.048), correlated with DFI; two factors, including stage and +2147A > G SNP (odds, 0.71; P = 0.03), correlated with CSS.
The -757T > C SNP is a risk for and prognostic factor of DFI; the +2147A > G SNP is a prognostic factor of CSS. CRP polymorphisms associate the risk and survival of CRC.
C 反应蛋白(CRP)的血浆水平升高是结直肠癌(CRC)的风险因素和预后因素。在其他关于心血管疾病的 CRP 报告中,CRP 水平与基因多态性相关。我们假设 CRP 多态性与 CRC 的风险和预后相关。
本研究纳入了 421 例 CRC 患者和 218 例健康对照者。经过初步研究,我们选择了 CRP 基因中的四个单核苷酸多态性(SNP):+2147A>G(rs1205)、+942G>C(rs1800947)、-717A>G(rs2794521)和-757T>C(rs3093059)。首先,分析了 CRC 病例组和非 CRC 对照组之间四个 SNP 的分布情况。随后,采用单因素和多因素 Cox 回归分析,分析了这些 SNP 与无病间隔(DFS)和癌症特异性生存(CSS)的其他预后因素的关系。
病例组和对照组在-757T>C 频率上存在差异(P=0.002)。CRC 病例组 TT 基因型的比例较高(优势比,1.75)。关于预后,多因素分析显示,包括分期(I、II、III)、大体肿瘤类型(息肉样、溃疡性、浸润性)、部位(右、左、直肠)和-757T>C SNP(优势比,1.29;P=0.048)在内的四个因素与 DFI 相关;包括分期和+2147A>G SNP(优势比,0.71;P=0.03)在内的两个因素与 CSS 相关。
-757T>C SNP 是 DFI 的风险因素和预后因素;+2147A>G SNP 是 CSS 的预后因素。CRP 多态性与 CRC 的风险和生存相关。