Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, United States; Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, United States.
Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States.
Cancer Epidemiol. 2021 Dec;75:102043. doi: 10.1016/j.canep.2021.102043. Epub 2021 Sep 24.
The role of growth factors and inflammation in the onset of glioma is poorly understood, and conflicting reports of associations of circulating IGF-1 and inflammatory biomarkers with glioma risk exist in the literature. We examined associations between C-reactive protein (CRP), white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), and insulin-like growth factor-1 (IGF-1) and glioma risk in the UK Biobank cohort.
Hazard ratios (HR) and 95% confidence intervals (CI) for glioma according to circulating biomarkers concentrations were calculated using Cox proportional hazards regression, adjusted for age, sex, race, and education. Analyses were conducted separately for glioma overall and by glioma subtype.
We identified 417 incident glioma cases among 428,537 participants with 3,255,815 person-years of follow up. Weak, non-significant associations were observed with increasing levels of these biomarkers for risk of glioma overall or by glioma subtype. Among women only, IGF-1 in the highest quartile was positively associated with glioma risk compared to the lowest quartile (HR=1.64, 95%CI: 1.03-2.60, p-trend=0.08), as was NLR (HR=1.54, 95%CI: 1.00-2.39, p-trend=0.05).
In this prospective cohort, we found no significant associations between the inflammatory biomarkers CRP and WBC and the development of glioma. NLR and IGF-1 were associated with risk in women, but not men. When considered with previous studies, further investigation of NLR and IGF-1 as markers of glioma risk appears warranted, particularly in women.
生长因子和炎症在神经胶质瘤发病中的作用尚未完全阐明，关于循环 IGF-1 和炎症生物标志物与神经胶质瘤风险之间的关联，文献中存在相互矛盾的报道。我们研究了 C 反应蛋白（CRP）、白细胞计数（WBC）、中性粒细胞与淋巴细胞比值（NLR）和胰岛素样生长因子-1（IGF-1）与英国生物库队列中神经胶质瘤风险之间的关联。
使用 Cox 比例风险回归分析，根据循环生物标志物浓度计算神经胶质瘤的风险比（HR）和 95%置信区间（CI），调整了年龄、性别、种族和教育因素。对整体神经胶质瘤和神经胶质瘤亚型分别进行了分析。
在 428537 名参与者中，有 417 名参与者患有神经胶质瘤，随访时间为 3255815 人年。我们发现这些生物标志物水平升高与整体神经胶质瘤或神经胶质瘤亚型的风险呈微弱、无统计学意义的关联。仅在女性中，与最低四分位相比，最高四分位的 IGF-1 与神经胶质瘤风险呈正相关（HR=1.64，95%CI：1.03-2.60，p 趋势=0.08），NLR（HR=1.54，95%CI：1.00-2.39，p 趋势=0.05）也是如此。
在这项前瞻性队列研究中，我们没有发现 CRP 和 WBC 等炎症生物标志物与神经胶质瘤的发展之间存在显著关联。NLR 和 IGF-1 与女性的风险相关，但与男性无关。考虑到之前的研究，进一步研究 NLR 和 IGF-1 作为神经胶质瘤风险的标志物似乎是必要的，尤其是在女性中。
