Cancer Epidemiology Division, Cancer Council Victoria, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
Cancer Epidemiology Division, Cancer Council Victoria, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
Cancer Epidemiol. 2024 Dec;93:102662. doi: 10.1016/j.canep.2024.102662. Epub 2024 Sep 6.
Evidence suggests that inflammation may be associated with a higher risk of endometrial cancer, but previous reviews have typically examined a limited number of biomarkers. This study aimed to critically appraise the evidence on the effect of 13 circulating inflammatory biomarkers on endometrial cancer risk. MEDLINE and EMBASE databases were searched for prospective cohort, (nested) case-control and case-cohort studies, and Mendelian randomization (MR) studies published up to 31 March 2023. We performed a random-effects meta-analysis to estimate the pooled risk ratio and 95 % confidence interval (CI) for the association between each biomarker and endometrial cancer risk. Heterogeneity between studies was assessed using the I statistic. Eight studies were included in the meta-analysis. Comparing groups with the highest versus lowest concentration of biomarker, adiponectin levels were inversely associated with risk of endometrial cancer (risk ratio (RR) =0.75, 95 % CI: 0.57-0.99, I2: 9 %). Higher levels of CRP (RR=1.18, 95 % CI: 1.05-1.33, I: 2 %) and TNF-α (RR=1.58, 95 % CI: 1.13-2.21, I: 0 %) were positively associated with risk of endometrial cancer. There was suggestive evidence for a positive association was also found for IL-6 (RR=1.29, 95 % CI: 0.88-1.88, I: 0 %) and leptin (RR=1.50, 95 % CI: 0.83-2.71, I: 0 %). Our findings suggest that circulating inflammatory biomarkers are likely involved in the carcinogenesis of endometrial cancer. Future studies should consider prospective or MR design and measure a wider range of inflammatory markers.
有证据表明，炎症可能与子宫内膜癌风险增加有关，但之前的综述通常只检查了有限数量的生物标志物。本研究旨在批判性地评估 13 种循环炎症生物标志物对子宫内膜癌风险影响的证据。检索了 MEDLINE 和 EMBASE 数据库，以获取截至 2023 年 3 月 31 日发表的前瞻性队列研究、（嵌套）病例对照研究和病例对照研究以及孟德尔随机化（MR）研究。我们进行了随机效应荟萃分析，以估计每种生物标志物与子宫内膜癌风险之间的关联的汇总风险比和 95%置信区间（CI）。使用 I 统计量评估研究之间的异质性。Meta 分析纳入了 8 项研究。比较生物标志物浓度最高和最低的两组，脂联素水平与子宫内膜癌风险呈负相关（风险比（RR）=0.75，95%CI：0.57-0.99，I2：9%）。较高水平的 CRP（RR=1.18，95%CI：1.05-1.33，I：2%）和 TNF-α（RR=1.58，95%CI：1.13-2.21，I：0%）与子宫内膜癌风险呈正相关。IL-6（RR=1.29，95%CI：0.88-1.88，I：0%）和瘦素（RR=1.50，95%CI：0.83-2.71，I：0%）也有正相关的迹象。我们的研究结果表明，循环炎症生物标志物可能参与了子宫内膜癌的发生。未来的研究应考虑前瞻性或 MR 设计，并测量更广泛的炎症标志物。
