Godos Justyna, Biondi Antonio, Galvano Fabio, Basile Francesco, Sciacca Salvatore, Giovannucci Edward L, Grosso Giuseppe
Justyna Godos, Salvatore Sciacca, Giuseppe Grosso, Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele, 95123 Catania, Italy.
World J Gastroenterol. 2017 Mar 14;23(10):1909-1919. doi: 10.3748/wjg.v23.i10.1909.
AIM: To perform a meta-analysis of observational studies on inflammatory markers levels and occurrence of colorectal adenoma. METHODS: PubMed and EMBASE databases were searched until March 2016 for the articles reporting on the circulating levels of inflammatory markers, including: C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) and risk of colorectal adenoma. Random-effects models were used to calculate summary odds ratios (ORs) with 95%CIs for the highest lowest category of exposure. Heterogeneity was assessed by using the test and statistic. Subgroup analyses were also performed to test for potential source of heterogeneity. RESULTS: A total of 14 case-control studies were included. Ten studies on CRP including a total of 3350 cases and 4168 controls showed non-significant summary (OR = 1.23, 95%CI: 0.98-1.54; = 54%, = 0.01) in the general analysis, but significant increased odds when considering only advanced adenoma (OR = 1.59, 95%CI: 1.09-2.32; = 44%, = 0.15). Subgroup and stratified analyses revealed a potential influence of smoking status and aspirin use on the association between CRP levels and colorectal adenoma. Five studies examined the association between circulating levels of TNF-α and colorectal adenoma risk, including a total of 1,568 cases and 2,832 controls. The summary OR for the highest the lowest category of exposure was 1.00 (95%CI: 0.77-1.29). The relationship between circulating IL-6 levels and colorectal adenoma risk was investigated in 7 studies including a total of 1936 cases and 3611 controls. The summary OR for the highest the lowest category of exposure was 1.19 (95%CI: 0.92-1.55). CONCLUSION: Summary of current evidence suggests a positive association of CRP levels and advanced colorectal adenoma risk. The role of potential confounding factors should be further evaluated.
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