Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.
Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA.
J Natl Cancer Inst. 2021 Sep 4;113(9):1186-1193. doi: 10.1093/jnci/djab040.
Chronic inflammation may promote initiation and progression of pancreatic cancer, but no studies have examined the association between inflammation in the period before diagnosis and pancreatic cancer survival.
We prospectively examined the association of prediagnostic plasma levels of C-reactive protein, interleukin-6, and tumor necrosis factor-α receptor 2 with survival among 492 participants from 5 large US prospective cohort studies who developed pancreatic cancer. Using an empirical dietary inflammatory pattern (EDIP) score, we evaluated whether long-term proinflammatory diets were associated with survival among 1153 patients from 2 of the 5 cohorts. Cox proportional hazards regression was used to estimate hazard ratios for death with adjustment for potential confounders. All statistical tests were 2-sided.
Higher prediagnostic levels of C-reactive protein, interleukin-6, and tumor necrosis factor-α receptor 2 were individually associated with reduced survival (Ptrend = .03, .01, and .04, respectively). Compared with patients with a combined inflammatory biomarker score of 0 (all 3 marker levels below medians), those with a score of 3 (all 3 marker levels above medians) had a hazard ratio for death of 1.57 (95% confidence interval = 1.16 to 2.12; Ptrend = .003), corresponding to median overall survival times of 8 vs 5 months. Patients consuming the most proinflammatory diets (EDIP quartile 4) in the prediagnostic period had a hazard ratio for death of 1.34 (95% confidence interval = 1.13 to 1.59; Ptrend = .01), compared with those consuming the least proinflammatory diets (EDIP quartile 1).
Prediagnostic levels of inflammatory biomarkers and long-term proinflammatory diets were inversely associated with pancreatic cancer survival.
慢性炎症可能促进胰腺癌的发生和发展，但尚无研究探讨诊断前炎症与胰腺癌生存之间的关系。
我们前瞻性地研究了 5 项美国大型前瞻性队列研究中 492 名参与者的诊断前血浆 C 反应蛋白、白细胞介素-6 和肿瘤坏死因子-α受体 2 水平与生存之间的关系。我们使用经验性饮食炎症模式 (EDIP) 评分评估了来自其中 2 项队列研究的 1153 名患者的长期促炎饮食与生存之间的关系。使用 Cox 比例风险回归来估计死亡风险比，调整潜在混杂因素。所有统计检验均为双侧检验。
较高的诊断前 C 反应蛋白、白细胞介素-6 和肿瘤坏死因子-α受体 2 水平与生存降低相关（P 趋势分别为.03、.01 和.04）。与炎症生物标志物综合评分为 0（所有 3 个标志物水平均低于中位数）的患者相比，评分 3（所有 3 个标志物水平均高于中位数）的患者死亡风险比为 1.57（95%置信区间为 1.16 至 2.12；P 趋势 =.003），中位总生存时间分别为 8 个月和 5 个月。在诊断前期间摄入最促炎饮食（EDIP 四分位 4）的患者死亡风险比为 1.34（95%置信区间为 1.13 至 1.59；P 趋势 =.01），而摄入最不促炎饮食（EDIP 四分位 1）的患者为 1.34。
诊断前炎症生物标志物水平和长期促炎饮食与胰腺癌生存呈负相关。
