Division of Medical Oncology and Hematology, Department of Medicine, Mount Sinai Hospital, 1284-600 University Avenue, Toronto, ON, M5G 1X5, Canada.
Breast Cancer Res Treat. 2013 Oct;141(3):485-93. doi: 10.1007/s10549-013-2694-8. Epub 2013 Sep 27.
Obesity, associated with inflammation, has been linked to poor prognosis in breast cancer. Research investigating the potential role of C-reactive protein (CRP), an obesity-associated systemic marker of inflammation, as a mediator of adverse prognostic effects of obesity has yielded inconsistent results. We examined the association of highly sensitive CRP (hsCRP) with obesity-related factors and breast cancer outcome. A cohort of 535 non-diabetic women diagnosed with T1-3, N0-1, M0 breast cancer, was assembled between 1989 and 1996 and followed prospectively. Circulating levels of hsCRP were analyzed on blood obtained postoperatively, prior to systemic therapy, in 501 women. Correlations and prognostic associations were analyzed using one-way analysis of variance, Spearman's rank correlation coefficients (r) and Cox models. hsCRP was significantly correlated with body mass index (r = 0.60), insulin (r = 0.44), leptin (r = 0.54), and lipids, but not T or N stage, grade or estrogen receptor/progesterone receptor. At a median follow-up of 12 years, hsCRP was not associated with distant disease-free survival or overall survival in univariable [Q4 vs. Q1 hazard ratio (HR) 1.03, 95 % confidence interval (CI) 0.69-1.52, P = 0.9 and HR 1.27, 95 % CI 0.86-1.86, P = 0.24, respectively] or multivariable [Q4 vs Q1 HR 1.02, 95 % CI 0.66-1.59, P = 0.93 and HR 1.17, 95 % CI 0.76-1.81, P = 0.48 respectively] analyses. hsCRP was associated with age, comorbidities, and the insulin resistance syndrome but not with breast cancer outcome.
肥胖与炎症有关，与乳腺癌的不良预后有关。研究调查了 C 反应蛋白（CRP）作为肥胖对预后不良影响的中介物的潜在作用，该蛋白是肥胖相关的全身性炎症标志物，但研究结果不一致。我们研究了高敏 C 反应蛋白（hsCRP）与肥胖相关因素和乳腺癌结局的关系。1989 年至 1996 年期间组建了一个由 535 名诊断为 T1-3、N0-1、M0 期乳腺癌的非糖尿病女性组成的队列，并进行了前瞻性随访。在 501 名女性中，在手术后、全身治疗前采集的血液中分析了 hsCRP 的循环水平。使用单向方差分析、Spearman 秩相关系数（r）和 Cox 模型分析相关性和预后相关性。hsCRP 与体重指数（r=0.60）、胰岛素（r=0.44）、瘦素（r=0.54）和脂质显著相关，但与 T 分期或 N 分期、分级或雌激素受体/孕激素受体无关。在中位随访 12 年后，hsCRP 与无远处疾病无复发生存或总生存在单变量分析中无相关性[Q4 与 Q1 危险比（HR）为 1.03，95%置信区间（CI）为 0.69-1.52，P=0.9 和 HR 为 1.27，95%CI 为 0.86-1.86，P=0.24]或多变量分析[Q4 与 Q1 HR 为 1.02，95%CI 为 0.66-1.59，P=0.93 和 HR 为 1.17，95%CI 为 0.76-1.81，P=0.48]。hsCRP 与年龄、合并症和胰岛素抵抗综合征相关，但与乳腺癌结局无关。
