Am J Epidemiol. 2013 Oct 15;178(8):1256-64. doi: 10.1093/aje/kwt098. Epub 2013 Aug 21.
Chronic inflammation may play a role in ovarian carcinogenesis. We examined associations between 3 plasma biomarkers of inflammation-C-reactive protein (CRP), interleukin 6, and tumor necrosis factor α receptor 2-and risk of invasive epithelial ovarian cancer in prospectively collected samples from the Nurses' Health Study (NHS; 1989-2010), Nurses' Health Study II (NHS II; 1996-2009), and the Women's Health Study (WHS; 1992-2011) and performed a meta-analysis including data from previous publications. Associations with ovarian cancer risk were calculated using logistic regression (NHS/NHS II; n = 217 cases) or Cox proportional hazards regression (WHS; n = 159 cases). Study-specific results were combined using random-effects meta-analysis. In the NHS/NHS II and WHS, we observed a 53% increased risk of invasive ovarian cancer when comparing women in the fourth quartile of CRP with women in the first quartile (95% confidence interval (CI): 1.05, 2.23). A CRP level of >10 mg/L versus a level of ≤1 mg/L was associated with a 2.16-fold increased risk (95% CI: 1.23, 3.78). In a meta-analysis of published studies, women in the third tertile of CRP had a 35% increased risk (95% CI: 1.10, 1.67) compared with women in the first tertile. There were no significant associations between interleukin 6 or tumor necrosis factor α receptor 2 and risk in the NHS/NHS II. Our results support the hypothesis that higher levels of circulating CRP are associated with increased risk of ovarian cancer, indicating that the role of inflammation in ovarian cancer requires further elucidation.
慢性炎症可能在卵巢癌的发生中起作用。我们研究了 3 种血浆炎症生物标志物-C 反应蛋白（CRP）、白细胞介素 6 和肿瘤坏死因子α受体 2-与前瞻性收集的护士健康研究（NHS；1989-2010 年）、护士健康研究 II（NHS II；1996-2009 年）和妇女健康研究（WHS；1992-2011 年）样本中侵袭性上皮性卵巢癌风险之间的关联，并对以前发表的研究数据进行了荟萃分析。使用逻辑回归（NHS/NHS II；n=217 例病例）或 Cox 比例风险回归（WHS；n=159 例病例）计算与卵巢癌风险的关联。使用随机效应荟萃分析合并研究特异性结果。在 NHS/NHS II 和 WHS 中，我们发现 CRP 四分位间距第四组女性与第一组女性相比，侵袭性卵巢癌风险增加 53%（95%置信区间（CI）：1.05，2.23）。CRP 水平>10mg/L 与水平≤1mg/L 相比，风险增加 2.16 倍（95%CI：1.23，3.78）。在对已发表研究的荟萃分析中，CRP 三分位间距第三组女性与第一组女性相比，风险增加 35%（95%CI：1.10，1.67）。在 NHS/NHS II 中，白细胞介素 6 或肿瘤坏死因子α受体 2 与风险之间没有显著关联。我们的研究结果支持循环 CRP 水平升高与卵巢癌风险增加相关的假说，表明炎症在卵巢癌中的作用需要进一步阐明。
