Cancer Epidemiology Group, Division of Cancer Studies, School of Medicine, King's College London, 3rd Floor, Bermondsey Wing, Guy's Hospital, London SE1 9RT, United Kingdom.
Cancer Epidemiol Biomarkers Prev. 2011 Mar;20(3):428-37. doi: 10.1158/1055-9965.EPI-10-1190. Epub 2011 Feb 4.
To study levels of C-reactive protein (CRP) and leukocytes, as inflammatory markers, in the context of cancer risk.
From the Apolipoprotein MOrtality RISk (AMORIS) study, we selected 102,749 persons with one measurement and 9,273 persons with three repeated measurements of CRP and leukocytes. Multivariate Cox proportional hazards regression was applied to categories of CRP (<10, 10-15, 15-25, 25-50, >50 g/L) and quartiles of leukocytes. An inflammation-based predictive score (IPS) indicated whether someone had CRP levels of more than 10 mg/L combined with leukocytes of more than 10×10(9)/L. Reverse causality was assessed by excluding those with less than 3, 5, or 7 years of follow-up. To analyze repeated measurements of CRP and leukocytes, the repeated IPS (IPSr) was calculated by adding the IPS of each measurement.
In the cohort with one measurement, there was a positive trend between CRP and risk of developing cancer, with the lowest category being the 0.99 (0.92-1.06), 1.28 (1.11-1.47), 1.27 (1.09-1.49), and 1.22 (1.01-1.48) for the second to fifth categories, respectively. This association disappeared when excluding those with follow-up of less than 3, 5, or 7 years. The association between leukocytes and cancer was slightly stronger. In the cohort with repeated measurements, the IPSr was strongly associated with cancer risk: 1.87 (1.33-2.63), 1.51 (0.56-4.06), and 4.46 (1.43-13.87) for IPSr=1, 2, and 3 compared with IPSr=0. The association remained after excluding those with follow-up of less than 1 year.
Our large, prospective cohort study adds evidence for a link between inflammatory markers and cancer risk by using repeated measurements and ascertaining reverse causality.
研究 C 反应蛋白（CRP）和白细胞等炎症标志物与癌症风险之间的关系。
我们从载脂蛋白 M 死亡率风险（AMORIS）研究中选择了 102749 名仅进行了一次 CRP 和白细胞测量的人员和 9273 名进行了三次重复测量的人员。应用多变量 Cox 比例风险回归分析 CRP（<10、10-15、15-25、25-50、>50 g/L）和白细胞四分位数的类别。炎症预测评分（IPS）表明某人是否同时具有 CRP 水平>10 mg/L 合并白细胞计数>10×10(9)/L。通过排除随访时间少于 3、5 或 7 年的人群来评估反向因果关系。为了分析 CRP 和白细胞的重复测量值，通过添加每次测量的 IPS 来计算重复 IPS（IPSr）。
在单次测量的队列中，CRP 与癌症发病风险呈正相关趋势，最低类别为第 0.99（0.92-1.06）、1.28（1.11-1.47）、1.27（1.09-1.49）和 1.22（1.01-1.48），分别为第二至第五类别。当排除随访时间少于 3、5 或 7 年的人群时，这种关联消失。白细胞与癌症的关联稍强。在重复测量的队列中，IPSr 与癌症风险密切相关：IPSr=1、2 和 3 时，分别为 1.87（1.33-2.63）、1.51（0.56-4.06）和 4.46（1.43-13.87），而 IPSr=0 时为 1.33（0.88-2.02）。在排除随访时间少于 1 年的人群后，这种关联仍然存在。
我们的大型前瞻性队列研究通过重复测量和确定反向因果关系，为炎症标志物与癌症风险之间的联系提供了更多证据。
