Chen Wen, Wang Jian-Bing, Abnet Christian C, Dawsey Sanford M, Fan Jin-Hu, Yin Liang-Yu, Yin Jian, Taylor Philip R, Qiao You-Lin, Freedman Neal D
Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland. Department of Epidemiology and Health Statistics, School of Public Health, Zhejiang University, Hangzhou, China.
Cancer Epidemiol Biomarkers Prev. 2015 Feb;24(2):386-92. doi: 10.1158/1055-9965.EPI-14-1038. Epub 2015 Jan 22.
C-reactive protein (CRP) is a marker of systemic inflammation that has been associated with the incidence and prognosis for a number of different cancers. Recent data suggest that CRP may be a prognostic factor for liver cancer and cirrhosis. However, few long-term studies are available.
We prospectively examined associations between serum CRP and subsequent risk of liver cancer incidence or chronic liver disease mortality in a nested case-control study performed in the Linxian Nutrition Intervention Trials cohort. Baseline serum CRP was measured for 220 incident liver cancer cases, 276 participants who died of chronic liver disease, and 1,018 age-, sex-, and trial-matched controls. Unconditional logistical regression models were used to estimate ORs and 95% confidence intervals (CI).
Compared with the lowest quartile, subjects in the fourth quartile of serum CRP had a higher risk of liver cancer incidence (OR, 1.63; 95% CI, 1.06-2.51), with a significant Ptrend across quartiles (P = 0.01). The association with liver cancer was only significant among men (Q4 vs. Q1; OR, 2.00; 1.10-3.62), but not among women (Q4 vs. Q1; OR, 1.15; 0.60-2.22). For chronic liver disease deaths, the corresponding risk estimate in men and women was 2.95 (1.90-4.57), with a monotonic trend (P < 0.001).
Higher serum CRP concentrations at baseline were associated with subsequent incidence of liver cancer and death from chronic liver disease.
Our findings suggest that levels of systemic inflammation may serve as a long-term marker of liver cancer and liver disease.
C反应蛋白（CRP）是全身炎症的标志物，与多种不同癌症的发病率和预后相关。近期数据表明，CRP可能是肝癌和肝硬化的一个预后因素。然而，长期研究较少。
在林县营养干预试验队列中进行的一项巢式病例对照研究中，我们前瞻性地研究了血清CRP与随后肝癌发病风险或慢性肝病死亡率之间的关联。对220例肝癌新发病例、276例死于慢性肝病的参与者以及1018例年龄、性别和试验匹配的对照者测量了基线血清CRP。采用无条件逻辑回归模型估计比值比（OR）和95%置信区间（CI）。
与最低四分位数相比，血清CRP处于第四四分位数的受试者肝癌发病风险更高（OR，1.63；95%CI，1.06 - 2.51），四分位数间Ptrend具有显著性（P = 0.01）。与肝癌的关联仅在男性中显著（Q4 vs. Q1；OR，2.00；1.10 - 3.62），而在女性中不显著（Q4 vs. Q1；OR，1.15；0.60 - 2.22）。对于慢性肝病死亡，男性和女性的相应风险估计值为2.95（1.90 - 4.57），呈单调趋势（P < 0.001）。
基线时较高的血清CRP浓度与随后的肝癌发病率和慢性肝病死亡相关。
我们的研究结果表明，全身炎症水平可能是肝癌和肝病的一个长期标志物。
