Department of Vascular Medicine, UMCU, 3584 CX Utrecht, the Netherlands.
Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Avenue, Boston, MA 02115, USA.
Eur Heart J. 2019 Dec 21;40(48):3901-3909. doi: 10.1093/eurheartj/ehz587.
Low-grade inflammation, measured by elevated plasma concentrations of high-sensitive C-reactive protein (CRP), is a risk factor for cardiovascular disease (CVD). There is evidence that low-grade inflammation is also related to a higher risk of cancer. The present prospective cohort study evaluates the relation between low-grade systemic inflammation and risk of cancer in patients with stable CVD.
In total, 7178 patients with stable CVD and plasma CRP levels ≤10 mg/L were included. Data were linked to the Dutch national cancer registry. Cox regression models were fitted to study the relation between CRP and incident CVD and cancer. After a median follow-up time of 8.3 years (interquartile range 4.6-12.3) 1072 incident cancer diagnoses were observed. C-reactive protein concentration was related to total cancer [hazard ratio (HR) 1.35; 95% confidence interval (CI) 1.10-1.65] comparing last quintile to first quintile of CRP. Especially lung cancer, independent of histopathological subtype, was related to CRP (HR 3.39; 95% CI 2.02-5.69 comparing last to first quintile of CRP). Incidence of epithelial neoplasms and especially squamous cell neoplasms were related to CRP concentration, irrespective of anatomical location. Sensitivity analyses after excluding patients with a cancer diagnosis within 1, 2, and 5 years of follow-up showed similar results. No effect modification was observed by smoking status or time since smoking cessation (P-values for interaction > 0.05).
Chronic systemic low-grade inflammation, measured by CRP levels ≤10 mg/L, is a risk factor for incident cancer, markedly lung cancer, in patients with stable CVD. The relation between inflammation and incident cancer is seen in former and current smokers and is uncertain in never smokers.
通过检测高敏 C 反应蛋白（hs-CRP）的血浆浓度升高，可衡量低度炎症，该炎症是心血管疾病（CVD）的一个危险因素。有证据表明，低度炎症也与癌症风险增加有关。本前瞻性队列研究评估了稳定型 CVD 患者中低度全身性炎症与癌症风险之间的关系。
共纳入 7178 例稳定型 CVD 患者，其 CRP 水平≤10mg/L。将数据与荷兰国家癌症登记处相关联。采用 Cox 回归模型研究 CRP 与 CVD 和癌症事件之间的关系。中位随访时间为 8.3 年（四分位距为 4.6-12.3 年），共观察到 1072 例癌症发病。CRP 浓度与总癌症相关[危险比（HR）1.35；95%置信区间（CI）1.10-1.65]，将 CRP 的最后五分位数与第一五分位数相比。特别是肺癌，独立于组织病理学亚型，与 CRP 相关（HR 3.39；95%CI 2.02-5.69，CRP 最后五分位数与第一五分位数相比）。上皮性肿瘤的发病率，特别是鳞状细胞肿瘤，与 CRP 浓度相关，无论解剖位置如何。在排除随访 1、2 和 5 年内有癌症诊断的患者后进行敏感性分析，结果相似。未观察到吸烟状态或戒烟时间（交互作用 P 值>0.05）对 CRP 浓度与癌症事件之间关系的影响。
通过 CRP 水平≤10mg/L 检测到的慢性全身性低度炎症是稳定型 CVD 患者癌症事件的一个危险因素，尤其是肺癌。在现吸烟者和前吸烟者中观察到炎症与癌症之间的关系，而在从不吸烟者中则不确定。
Zotero 插件
