Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Medical Sciences Department, University of Torino, Torino, Italy.
Sci Rep. 2017 Oct 5;7(1):12708. doi: 10.1038/s41598-017-12703-x.
Breast cancer (BC) is the leading cause of cancer death in women. Adipokines, and other inflammation molecules linked to adiposity, are suspected to be involved in breast carcinogenesis, however prospective findings are inconclusive. In a prospective nested case-control study within the EPIC-Varese cohort, we used conditional logistic regression to estimate rate ratios (RRs) for BC, with 95% confidence intervals (CI), in relation to plasma levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6, leptin, and adiponectin, controlling for BC risk factors. After a median 14.9 years, 351 BC cases were identified and matched to 351 controls. No marker was significantly associated with BC risk overall. Significant interactions between menopausal status and CRP, leptin, and adiponectin were found. Among postmenopausal women, high CRP was significantly associated with increased BC risk, and high adiponectin with significantly reduced risk. Among premenopausal women, high TNF-α was associated with significantly increased risk, and high leptin with reduced risk; interleukin-6 was associated with increased risk only in a continuous model. These findings constitute further evidence that inflammation plays a role in breast cancer. Interventions to lower CRP, TNF-α, and interleukin-6 and increase adiponectin levels may contribute to preventing BC.
乳腺癌（BC）是女性癌症死亡的主要原因。脂肪因子和其他与肥胖相关的炎症分子被怀疑参与乳腺癌的发生，但前瞻性研究结果尚无定论。在 EPIC-Varese 队列的一项前瞻性嵌套病例对照研究中，我们使用条件逻辑回归来估计与 C 反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6、瘦素和脂联素血浆水平相关的 BC 发生率比（RR），并控制了 BC 的危险因素。中位随访 14.9 年后，确定了 351 例 BC 病例，并与 351 例对照相匹配。没有标志物与总体 BC 风险显著相关。在绝经状态和 CRP、瘦素和脂联素之间发现了显著的相互作用。在绝经后妇女中，高 CRP 与 BC 风险增加显著相关，而高脂联素与风险降低显著相关。在绝经前妇女中，高 TNF-α与显著增加的风险相关，高瘦素与降低的风险相关；白细胞介素-6 仅在连续模型中与增加的风险相关。这些发现进一步证明了炎症在乳腺癌中的作用。降低 CRP、TNF-α 和白细胞介素-6 并增加脂联素水平的干预措施可能有助于预防 BC。
