Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, China.
Front Immunol. 2023 Oct 9;14:1265406. doi: 10.3389/fimmu.2023.1265406. eCollection 2023.
Inflammation is critically involved in the development of human cancer, and blood inflammatory biomarkers have been proposed to indicate the risk of different cancer types.
Using the Swedish Apolipoprotein-Related Mortality Risk (AMORIS) Cohort (N=812,073), we first performed a time-to-event analysis to evaluate the association of the baseline level of 12 blood inflammatory biomarkers measured during 1985-1996 with the subsequent risk of head and neck cancer (HNC) identified through the nationwide Swedish Cancer Register until end of 2020. A nested case-control study was further conducted to demonstrate the longitudinal trends of the studied biomarkers during the 30-year period prior to diagnosis of HNC.
In the time-to-event analysis, we identified a total of 2,510 newly diagnosed HNC cases. There was an increased risk of HNC per standard deviation (SD) increase of haptoglobin (hazard ratio [HR]: 1.25; 95% confidence interval [CI]: 1.21-1.30), leukocytes (HR: 1.22; 95%CI: 1.17-1.28), sedimentation rate (HR: 1.17; 95%CI: 1.07-1.29), and monocytes (HR: 1.34; 95%CI: 1.07-1.68) at baseline, after adjustment for age, sex, fasting status, occupational status, and country of birth. In contrast, there was a decreased risk of HNC per SD increase of lymphocytes in % (HR: 0.85; 95%CI: 0.73-0.99) and lymphocyte-to-monocyte ratio (LMR) (HR: 0.81; 95%CI: 0.69-0.95) at baseline. In the nested case-control study using repeatedly measured biomarker levels, we found that individuals with HNC had consistently higher levels of haptoglobin, leukocytes, sedimentation rate, and monocytes, as well as consistently lower levels of lymphocytes in % and LMR, during the 30-year period prior to diagnosis, compared to controls.
Based on a cohort of more than half a million participants with up to 35 years of follow-up, our findings provide solid evidence supporting the presence of alterations in blood inflammatory biomarkers during the decades before diagnosis of HNC.
炎症在人类癌症的发展中起着至关重要的作用，血液炎症生物标志物已被提出用于指示不同癌症类型的风险。
我们利用瑞典载脂蛋白相关死亡率风险（AMORIS）队列（N=812073），首先进行了一项时间事件分析，以评估在 1985 年至 1996 年期间测量的 12 种血液炎症生物标志物的基线水平与随后通过全国瑞典癌症登记处确定的头颈部癌症（HNC）风险之间的关联，直至 2020 年底。随后进行了一项嵌套病例对照研究，以证明在 HNC 诊断前的 30 年期间研究生物标志物的纵向趋势。
在时间事件分析中，我们共发现了 2510 例新诊断的 HNC 病例。与 haptoglobin（风险比[HR]：1.25；95%置信区间[CI]：1.21-1.30）、白细胞（HR：1.22；95%CI：1.17-1.28）、血沉（HR：1.17；95%CI：1.07-1.29）和单核细胞（HR：1.34；95%CI：1.07-1.68）的基线水平每增加一个标准差（SD），HNC 的风险增加，而淋巴细胞在%（HR：0.85；95%CI：0.73-0.99）和淋巴细胞与单核细胞比值（LMR）（HR：0.81；95%CI：0.69-0.95）的基线水平每增加一个 SD 则与 HNC 的风险降低相关。在使用重复测量生物标志物水平的嵌套病例对照研究中，我们发现与对照组相比，在诊断前 30 年期间，HNC 患者的 haptoglobin、白细胞、血沉和单核细胞水平一直较高，而淋巴细胞在%和 LMR 水平一直较低。
基于超过 50 万参与者的队列，随访时间长达 35 年，我们的研究结果提供了有力的证据，证明了在 HNC 诊断前数十年期间血液炎症生物标志物存在变化。
