Akinyemiju Tomi, Moore Justin X, Pisu Maria, Goodman Michael, Howard Virginia J, Safford Monika, Gilchrist Susan C, Cushman Mary, Long LeAnn, Judd Suzanne E
Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
Division of Public Health Sciences and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.
Oncotarget. 2019 Aug 6;10(47):4857-4867. doi: 10.18632/oncotarget.27108.
This study examines the association between inflammatory biomarkers and risk of cancer mortality by race. Data were obtained from 1,856 participants in the prospective REGARDS cohort who were cancer-free at baseline, and analyzed in relation to cancer mortality prospectively. Biomarkers were log-transformed and categorized into tertiles due to non-normal distributions, and Cox proportional hazard regression models were utilized to compute hazard ratios with 95% confidence intervals using robust sandwich methods. Individuals in the highest tertile of IL-6 had over a 12-fold increased risk of cancer mortality (HR: 12.97, 95% CI: 3.46-48.63); those in the highest tertile of IL-8 had over a 2-fold increased risk of cancer mortality (HR: 2.21, 95% CI: 0.86-5.71), while those in the highest tertile of IL-10 had over a 3-fold increased risk of cancer mortality (HR: 3.06, 95% CI: 1.35-6.89). In race-stratified analysis, each unit increase in IL-6 was associated with increased risk of cancer mortality among African-Americans (HR: 3.88, 95% CI: 1.17-12.88) and Whites (5.25, 95% CI: 1.24-22.31). If replicated in larger, racially diverse prospective cohorts, these results suggest that cancer patients may benefit from clinical or lifestyle approaches to regulate systemic inflammation as a cancer prevention strategy.
本研究考察了炎症生物标志物与不同种族癌症死亡风险之间的关联。数据来自前瞻性REGARDS队列中的1856名参与者,这些参与者在基线时无癌症,并对其癌症死亡情况进行了前瞻性分析。由于生物标志物的分布呈非正态,因此对其进行对数转换并分为三分位数,使用稳健三明治方法,利用Cox比例风险回归模型计算风险比及95%置信区间。白细胞介素-6(IL-6)最高三分位数的个体癌症死亡风险增加了12倍以上(风险比:12.97,95%置信区间:3.46 - 48.63);白细胞介素-8(IL-8)最高三分位数的个体癌症死亡风险增加了2倍以上(风险比:2.21,95%置信区间:0.86 - 5.71),而白细胞介素-10(IL-10)最高三分位数的个体癌症死亡风险增加了3倍以上(风险比:3.06,95%置信区间:1.35 - 6.89)。在种族分层分析中,IL-6每增加一个单位,非裔美国人(风险比:3.88,95%置信区间:1.17 - 12.88)和白人(风险比:5.25,95%置信区间:1.24 - 22.31)的癌症死亡风险均增加。如果在更大规模、种族多样的前瞻性队列中得到验证,这些结果表明,癌症患者可能会从调节全身炎症的临床或生活方式方法中受益,将其作为一种癌症预防策略。