School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Oncology, Kailuan General Hospital, Tangshan, China.
Cancer Prev Res (Phila). 2022 Nov 1;15(11):747-754. doi: 10.1158/1940-6207.CAPR-21-0533.
C-reactive protein (CRP), a systemic marker of diagnosing chronic inflammation, has been associated with the incidence of multiple types of cancer. However, little is known about the impact of CRP on lung cancer incidence in Chinese population. A total of 97,950 participants without cancer at baseline (2006-2007) of the Kailuan Cohort Study were followed up. The concentration of plasma high-sensitivity CRP (hsCRP) was tested for all participants at baseline interview. Multivariable Cox proportional hazards regression models were used to assess the association between levels of hsCRP and incident lung cancer. During 8.7-year follow-up, 890 incident lung cancer cases occurred and were divided into three groups according to the level of hsCRP. The risk of incident lung cancer was significantly increased with elevated levels of hsCRP [HRMedium/Low, 1.21; 95% confidence interval (CI), 1.03-1.42; HRHigh/Low, 1.42, 95% CI, 1.20-1.68; Ptrend < 0.001], compared with the low group after adjusting confounders. Moreover, after stratifying by BMI, the significantly positive associations between the hsCRP level and the risk of lung cancer were found among those with BMI < 24 (HRHigh/Low, 1.51; 95% CI, 1.18-1.94; Ptrend = 0.001) and BMI = 24-28 (HRHigh/Low, 1.47; 95% CI, 1.13-1.92; Ptrend = 0.003), but not among those with BMI ≥ 28 (HRHigh/Low, 1.01; 95% CI, 0.64-1.57; Ptrend = 0.991). There was an antagonistic interaction between hsCRP levels and BMI that contributed to development of lung cancer (Pinteraction = 0.049). In conclusion, these findings indicate a dose-dependent relationship between hsCRP and lung cancer risk among Chinese population, especially in nonobese participants, suggesting that CRP could serve as a potential biomarker for prediction of lung cancer risk and identification of high-risk population.
In this prospective population-based cohort study, we found an association between higher plasma hsCRP and an increased risk of developing lung cancer, with stronger associations observed among nonobese participants.
探讨 C 反应蛋白（CRP）与中国人群肺癌发病风险的关系。
研究纳入了 97950 名无癌症的基线参与者（2006-2007 年），随访 8.7 年。采用多变量 Cox 比例风险回归模型评估 hsCRP 水平与肺癌发病风险的关系。
随访期间共发生 890 例肺癌病例。在校正混杂因素后，与低 hsCRP 组相比，hsCRP 水平较高的参与者发生肺癌的风险显著增加[中低 hsCRP，HR=1.21；95%CI，1.03-1.42；高低 hsCRP，HR=1.42；95%CI，1.20-1.68；Ptrend<0.001]。进一步按 BMI 分层后，仅在 BMI<24（HR=1.51；95%CI，1.18-1.94；Ptrend=0.001）和 BMI=24-28（HR=1.47；95%CI，1.13-1.92；Ptrend=0.003）的参与者中，hsCRP 水平与肺癌发病风险呈显著正相关，而在 BMI≥28 的参与者中无此相关性（HR=1.01；95%CI，0.64-1.57；Ptrend=0.991）。hsCRP 水平与 BMI 之间存在拮抗交互作用，对肺癌发病有影响（P 交互=0.049）。
hsCRP 与中国人群肺癌发病风险呈剂量依赖性关系，在非肥胖参与者中更为明显，提示 CRP 可能成为预测肺癌发病风险和识别高危人群的潜在生物标志物。
