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Li L, Xu Y, Lai Z, Li D, Sun Q, Li Z, Zhou Y. Development and validation of a model and nomogram for breast cancer diagnosis based on quantitative analysis of serum disease-specific haptoglobin N-glycosylation. J Transl Med 2024; 22:331. [PMID: 38575942 PMCID: PMC10993522 DOI: 10.1186/s12967-024-05039-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 02/25/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND A better diagnostic marker is in need to distinguish breast cancer from suspicious breast lesions. The abnormal glycosylation of haptoglobin has been documented to assist cancer diagnosis. This study aims to evaluate disease-specific haptoglobin (DSHp)-β N-glycosylation as a potential biomarker for breast cancer diagnosis. METHODS DSHp-β chains of 497 patients with suspicious breast lesions who underwent breast surgery were separated from serum immunoinflammatory-related protein complexes. DSHp-β N-glycosylation was quantified by mass spectrometric analysis. After missing data imputation and propensity score matching, patients were randomly assigned to the training set (n = 269) and validation set (n = 113). Logistic regression analysis was employed in model and nomogram construction. The diagnostic performance was analyzed with receiver operating characteristic and calibration curves. RESULTS 95 N-glycopeptides at glycosylation sites N207/N211, N241, and N184 were identified in 235 patients with benign breast diseases and 262 patients with breast cancer. DSHp-β N-tetrafucosyl and hexafucosyl were significantly increased in breast cancer compared with benign diseases (p < 0.001 and p = 0.001, respectively). The new diagnostic model and nomogram included GN2F2, G6N3F6, GN2FS at N184, G-N&G2S2, G2&G3NFS, G2N3F, GN3 at N207/N211, CEA, CA153, and could reliably distinguish breast cancer from benign diseases. For the training set, validation set, and training and validation sets, the area under the curves (AUCs) were 0.80 (95% CI: 0.75-0.86, specificity: 87%, sensitivity: 62%), 0.77 (95% CI:0.69-0.86, specificity: 75%, sensitivity: 69%), and 0.80 (95% CI:0.76-0.84, specificity: 77%, sensitivity: 68%), respectively. CEA, CA153, and their combination yielded AUCs of 0.62 (95% CI: 0.56-0.67, specificity: 29%, sensitivity: 90%), 0.65 (95% CI: 0.60-0.71, specificity: 74%, sensitivity: 51%), and 0.67 (95% CI: 0.62-0.73, specificity: 60%, sensitivity: 68%), respectively. CONCLUSIONS The combination of DSHp-β N-glycopeptides, CEA, and CA153 might be a better serologic marker to differentiate between breast cancer and benign breast diseases. The dysregulated N-glycosylation of serum DSHp-β could provide insights into breast tumorigenesis.
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Affiliation(s)
- Linrong Li
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 41 Damucang Hutong, Xicheng District, Beijing, 100032, China
| | - Yali Xu
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 41 Damucang Hutong, Xicheng District, Beijing, 100032, China
| | - Zhizhen Lai
- Department of Biophysics and Structural Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, No. 5 Dongdan San Tiao, Beijing, 100005, China
| | - Dan Li
- Department of Biophysics and Structural Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, No. 5 Dongdan San Tiao, Beijing, 100005, China
| | - Qiang Sun
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 41 Damucang Hutong, Xicheng District, Beijing, 100032, China.
| | - Zhili Li
- Department of Biophysics and Structural Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, No. 5 Dongdan San Tiao, Beijing, 100005, China.
| | - Yidong Zhou
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 41 Damucang Hutong, Xicheng District, Beijing, 100032, China.
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2
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Yarmolinsky J, Robinson JW, Mariosa D, Karhunen V, Huang J, Dimou N, Murphy N, Burrows K, Bouras E, Smith-Byrne K, Lewis SJ, Galesloot TE, Kiemeney LA, Vermeulen S, Martin P, Albanes D, Hou L, Newcomb PA, White E, Wolk A, Wu AH, Le Marchand L, Phipps AI, Buchanan DD, Zhao SS, Gill D, Chanock SJ, Purdue MP, Davey Smith G, Brennan P, Herzig KH, Järvelin MR, Amos CI, Hung RJ, Dehghan A, Johansson M, Gunter MJ, Tsilidis KK, Martin RM. Association between circulating inflammatory markers and adult cancer risk: a Mendelian randomization analysis. EBioMedicine 2024; 100:104991. [PMID: 38301482 PMCID: PMC10844944 DOI: 10.1016/j.ebiom.2024.104991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Tumour-promoting inflammation is a "hallmark" of cancer and conventional epidemiological studies have reported links between various inflammatory markers and cancer risk. The causal nature of these relationships and, thus, the suitability of these markers as intervention targets for cancer prevention is unclear. METHODS We meta-analysed 6 genome-wide association studies of circulating inflammatory markers comprising 59,969 participants of European ancestry. We then used combined cis-Mendelian randomization and colocalisation analysis to evaluate the causal role of 66 circulating inflammatory markers in risk of 30 adult cancers in 338,294 cancer cases and up to 1,238,345 controls. Genetic instruments for inflammatory markers were constructed using genome-wide significant (P < 5.0 × 10-8) cis-acting SNPs (i.e., in or ±250 kb from the gene encoding the relevant protein) in weak linkage disequilibrium (LD, r2 < 0.10). Effect estimates were generated using inverse-variance weighted random-effects models and standard errors were inflated to account for weak LD between variants with reference to the 1000 Genomes Phase 3 CEU panel. A false discovery rate (FDR)-corrected P-value ("q-value") <0.05 was used as a threshold to define "strong evidence" to support associations and 0.05 ≤ q-value < 0.20 to define "suggestive evidence". A colocalisation posterior probability (PPH4) >70% was employed to indicate support for shared causal variants across inflammatory markers and cancer outcomes. Findings were replicated in the FinnGen study and then pooled using meta-analysis. FINDINGS We found strong evidence to support an association of genetically-proxied circulating pro-adrenomedullin concentrations with increased breast cancer risk (OR: 1.19, 95% CI: 1.10-1.29, q-value = 0.033, PPH4 = 84.3%) and suggestive evidence to support associations of interleukin-23 receptor concentrations with increased pancreatic cancer risk (OR: 1.42, 95% CI: 1.20-1.69, q-value = 0.055, PPH4 = 73.9%), prothrombin concentrations with decreased basal cell carcinoma risk (OR: 0.66, 95% CI: 0.53-0.81, q-value = 0.067, PPH4 = 81.8%), and interleukin-1 receptor-like 1 concentrations with decreased triple-negative breast cancer risk (OR: 0.92, 95% CI: 0.88-0.97, q-value = 0.15, PPH4 = 85.6%). These findings were replicated in pooled analyses with the FinnGen study. Though suggestive evidence was found to support an association of macrophage migration inhibitory factor concentrations with increased bladder cancer risk (OR: 2.46, 95% CI: 1.48-4.10, q-value = 0.072, PPH4 = 76.1%), this finding was not replicated when pooled with the FinnGen study. For 22 of 30 cancer outcomes examined, there was little evidence (q-value ≥0.20) that any of the 66 circulating inflammatory markers examined were associated with cancer risk. INTERPRETATION Our comprehensive joint Mendelian randomization and colocalisation analysis of the role of circulating inflammatory markers in cancer risk identified potential roles for 4 circulating inflammatory markers in risk of 4 site-specific cancers. Contrary to reports from some prior conventional epidemiological studies, we found little evidence of association of circulating inflammatory markers with the majority of site-specific cancers evaluated. FUNDING Cancer Research UK (C68933/A28534, C18281/A29019, PPRCPJT∖100005), World Cancer Research Fund (IIG_FULL_2020_022), National Institute for Health Research (NIHR202411, BRC-1215-20011), Medical Research Council (MC_UU_00011/1, MC_UU_00011/3, MC_UU_00011/6, and MC_UU_00011/4), Academy of Finland Project 326291, European Union's Horizon 2020 grant agreement no. 848158 (EarlyCause), French National Cancer Institute (INCa SHSESP20, 2020-076), Versus Arthritis (21173, 21754, 21755), National Institutes of Health (U19 CA203654), National Cancer Institute (U19CA203654).
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Affiliation(s)
- James Yarmolinsky
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK.
| | - Jamie W Robinson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Daniela Mariosa
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Ville Karhunen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland; Research Unit of Mathematical Sciences, University of Oulu, Oulu, Finland
| | - Jian Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | - Niki Dimou
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Neil Murphy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Kimberley Burrows
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emmanouil Bouras
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Karl Smith-Byrne
- The Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sarah J Lewis
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | - Sita Vermeulen
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul Martin
- School of Biochemistry, Biomedical Sciences Building, University of Bristol, University Walk, Bristol, UK
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Polly A Newcomb
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; School of Public Health, University of Washington, Seattle, WA, USA
| | - Emily White
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna H Wu
- University of Southern California, Preventative Medicine, Los Angeles, CA, USA
| | - Loïc Le Marchand
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA
| | - Amanda I Phipps
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Daniel D Buchanan
- Colorectal Oncogenomic Group, Department of Clinical Pathology, University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, University of Melbourne Centre for Cancer Research, Parkville, Victoria, Australia; Genetic Medicine and Family Clinic, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Sizheng Steven Zhao
- Centre for Epidemiology Versus Arthritis, Faculty of Biological Medicine and Health, University of Manchester, Manchester, UK
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Paul Brennan
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Karl-Heinz Herzig
- Institute of Biomedicine, Medical Research Center and Oulu University Hospital, University of Oulu, Oulu, Finland; Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Marjo-Riitta Järvelin
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France; Department of Epidemiology and Biostatistics, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; Unit of Primary Health Care, Oulu University Hospital, OYS, Oulu, Finland; Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK
| | - Chris I Amos
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
| | - Rayjean J Hung
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Abbas Dehghan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK; Dementia Research Institute, Imperial College London, London, UK
| | - Mattias Johansson
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Marc J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK; Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Kostas K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Richard M Martin
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; University Hospitals Bristol and Weston NHS Foundation Trust, National Institute for Health Research Bristol Biomedical Research Centre, University of Bristol, Bristol, UK
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Chen C, Xu Y, Lai Z, Li Z, Sun Q. Case Report: Exploration of changes in serum immunoinflammation-related protein complexes of patients with metastatic breast cancer. Front Oncol 2023; 13:1207991. [PMID: 37546392 PMCID: PMC10401826 DOI: 10.3389/fonc.2023.1207991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/26/2023] [Indexed: 08/08/2023] Open
Abstract
Patients with advanced breast cancer are difficult to treat and have poor prognosis. At present, the commonly used methods to monitor the disease progression of breast cancer are imaging examinations such as breast ultrasound, mammography and peripheral blood tumor markers such as carcinoembryonic antigen (CEA) and carbohydrate antigen 15-3 (CA15-3). However, none of them can detect tumor progression at an early stage. Serum immunoinflammation-related protein complexes (IIRPCs) showed potential to indicate cancer progression. Therefore, we attempted to monitor the level of IIRPCs in peripheral blood of patients with metastatic breast cancer and compare it with patients' treatment and disease progression, and here we performed case reports of two of them.
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Affiliation(s)
- Chang Chen
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yali Xu
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhizhen Lai
- Department of Biophysics and Structural Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Zhili Li
- Department of Biophysics and Structural Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Qiang Sun
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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4
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Zhu J, Lian J, Wang X, Wang R, Pang X, Xu B, Wang X, Li C, Ji S, Lu H. Role of endogenous and exogenous antioxidants in risk of six cancers: evidence from the Mendelian randomization study. Front Pharmacol 2023; 14:1185850. [PMID: 37441531 PMCID: PMC10333497 DOI: 10.3389/fphar.2023.1185850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
Background: Although oxidative stress is known to contribute to cancer, and endogenous and exogenous antioxidants are thought to prevent tumorigenesis by suppressing oxidative stress-induced DNA damage, antioxidants have also been reported to show negative effects on tumor formation, necessitating characterization of the causal associations between antioxidants and cancer risk. Methods: In this study, Mendelian randomization (MR) analysis, primarily inverse-variance weighted MR, was used to assess the causal effect of six endogenous and five exogenous diet-derived antioxidants on the risk of six cancers. MR-Egger intercept test and Cochran's Q statistic were utilized to assess pleiotropy and heterogeneity, respectively. Results: For endogenous antioxidants, a bidirectional two-sample MR analysis was conducted. Our findings suggested that serum albumin has a negative causal association with the risk of prostate cancer [odds ratio (OR) = 0.78, 95% confidence interval (CI): 0.68-0.91, p = 0.001]. The risks of the six cancers showed no significant associations with endogenous antioxidants in the converse MR analysis. For exogenous antioxidants, the unidirectional two-sample MR analysis exhibited a nominal relationship between the serum retinol level and non-small-cell lung cancer risk (OR = 0.29, 95% CI: 0.11-0.76, p = 0.011). Conclusions: Thus, our study revealed the protective effects of genetic susceptibility to high circulating albumin levels on prostate cancer, providing potential targeted interventions for prostate cancer prevention.
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Affiliation(s)
- Jiahao Zhu
- Harbin Medical University Cancer Hospital, Department of Outpatient Chemotherapy, Harbin, China
| | - Jie Lian
- Harbin Medical University Cancer Hospital, Department of Outpatient Chemotherapy, Harbin, China
| | - Xin Wang
- Harbin Medical University Cancer Hospital, Department of Outpatient Chemotherapy, Harbin, China
| | - Ren Wang
- Harbin Medical University Cancer Hospital, Department of Outpatient Chemotherapy, Harbin, China
| | - Xiangyi Pang
- Harbin Medical University Cancer Hospital, Department of Outpatient Chemotherapy, Harbin, China
| | - Benjie Xu
- Harbin Medical University Cancer Hospital, Department of Outpatient Chemotherapy, Harbin, China
| | - Xing Wang
- Harbin Medical University Cancer Hospital, Department of Outpatient Chemotherapy, Harbin, China
| | - Chenyang Li
- Harbin Medical University Cancer Hospital, Department of Outpatient Chemotherapy, Harbin, China
| | - Shengjun Ji
- The Affiliated Suzhou Hospital of Nanjing Medical University, Department of Radiotherapy and Oncology, Suzhou, China
| | - Haibo Lu
- Harbin Medical University Cancer Hospital, Department of Outpatient Chemotherapy, Harbin, China
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Yarmolinsky J, Robinson JW, Mariosa D, Karhunen V, Huang J, Dimou N, Murphy N, Burrows K, Bouras E, Smith-Byrne K, Lewis SJ, Galesloot TE, Kiemeney LA, Vermeulen S, Martin P, Albanes D, Hou L, Newcomb PA, White E, Wolk A, Wu AH, Marchand LL, Phipps AI, Buchanan DD, Zhao SS, Gill D, Chanock SJ, Purdue MP, Smith GD, Brennan P, Herzig KH, Jarvelin MR, Dehghan A, Johansson M, Gunter MJ, Tsilidis KK, Martin RM. Association between circulating inflammatory markers and adult cancer risk: a Mendelian randomization analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.04.23289196. [PMID: 37205426 PMCID: PMC10187459 DOI: 10.1101/2023.05.04.23289196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Background Tumour-promoting inflammation is a "hallmark" of cancer and conventional epidemiological studies have reported links between various inflammatory markers and cancer risk. The causal nature of these relationships and, thus, the suitability of these markers as intervention targets for cancer prevention is unclear. Methods We meta-analysed 6 genome-wide association studies of circulating inflammatory markers comprising 59,969 participants of European ancestry. We then used combined cis-Mendelian randomization and colocalisation analysis to evaluate the causal role of 66 circulating inflammatory markers in risk of 30 adult cancers in 338,162 cancer cases and up to 824,556 controls. Genetic instruments for inflammatory markers were constructed using genome-wide significant (P < 5.0 x 10-8) cis-acting SNPs (i.e. in or ±250 kb from the gene encoding the relevant protein) in weak linkage disequilibrium (LD, r2 < 0.10). Effect estimates were generated using inverse-variance weighted random-effects models and standard errors were inflated to account for weak LD between variants with reference to the 1000 Genomes Phase 3 CEU panel. A false discovery rate (FDR)-corrected P-value ("q-value") < 0.05 was used as a threshold to define "strong evidence" to support associations and 0.05 ≤ q-value < 0.20 to define "suggestive evidence". A colocalisation posterior probability (PPH4) > 70% was employed to indicate support for shared causal variants across inflammatory markers and cancer outcomes. Results We found strong evidence to support an association of genetically-proxied circulating pro-adrenomedullin concentrations with increased breast cancer risk (OR 1.19, 95% CI 1.10-1.29, q-value=0.033, PPH4=84.3%) and suggestive evidence to support associations of interleukin-23 receptor concentrations with increased pancreatic cancer risk (OR 1.42, 95% CI 1.20-1.69, q-value=0.055, PPH4=73.9%), prothrombin concentrations with decreased basal cell carcinoma risk (OR 0.66, 95% CI 0.53-0.81, q-value=0.067, PPH4=81.8%), macrophage migration inhibitory factor concentrations with increased bladder cancer risk (OR 1.14, 95% CI 1.05-1.23, q-value=0.072, PPH4=76.1%), and interleukin-1 receptor-like 1 concentrations with decreased triple-negative breast cancer risk (OR 0.92, 95% CI 0.88-0.97, q-value=0.15), PPH4=85.6%). For 22 of 30 cancer outcomes examined, there was little evidence (q-value ≥ 0.20) that any of the 66 circulating inflammatory markers examined were associated with cancer risk. Conclusion Our comprehensive joint Mendelian randomization and colocalisation analysis of the role of circulating inflammatory markers in cancer risk identified potential roles for 5 circulating inflammatory markers in risk of 5 site-specific cancers. Contrary to reports from some prior conventional epidemiological studies, we found little evidence of association of circulating inflammatory markers with the majority of site-specific cancers evaluated.
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Affiliation(s)
- James Yarmolinsky
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jamie W Robinson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Daniela Mariosa
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Ville Karhunen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Research Unit of Mathematical Sciences, University of Oulu, Oulu, Finland
| | - Jian Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary’s Campus, London
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Niki Dimou
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Neil Murphy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Kimberley Burrows
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emmanouil Bouras
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Karl Smith-Byrne
- The Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Sarah J Lewis
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | - Sita Vermeulen
- Department for Health Evidence, Radboudumc, Nijmegen, The Netherlands
| | - Paul Martin
- School of Biochemistry, Biomedical Sciences Building, University of Bristol, University Walk, Bristol, UK
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Polly A Newcomb
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- School of Public Health, University of Washington, Seattle, Washington, USA
| | - Emily White
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna H Wu
- University of Southern California, Preventative Medicine, Los Angeles, California, USA
| | - Loïc Le Marchand
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA 22
| | - Amanda I Phipps
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
| | - Daniel D Buchanan
- Colorectal Oncogenomic Group, Department of Clinical Pathology, University of Melbourne, Parkville, Victoria, Australia
- Victorian Comprehensive Cancer Centre, University of Melbourne Centre for Cancer Research, Parkville, Victoria, Australia
- Genetic Medicine and Family Clinic, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | | | - Sizheng Steven Zhao
- Centre for Epidemiology Versus Arthritis, Faculty of Biological Medicine and Health, University of Manchester, Manchester, UK
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary’s Campus, London
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Paul Brennan
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Karl-Heinz Herzig
- Institute of Biomedicine, Medical Research Center and Oulu University Hospital, University of Oulu, Finland
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Marjo-Riitta Jarvelin
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Unit of Primary Health Care, Oulu University Hospital, OYS, Oulu, Finland
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, United Kingdom
| | - Abbas Dehghan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary’s Campus, London
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
- Dementia Research Institute, Imperial College London, London, UK
| | - Mattias Johansson
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Kostas K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary’s Campus, London
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Richard M Martin
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- University Hospitals Bristol and Weston NHS Foundation Trust, National Institute for Health Research Bristol Biomedical Research Centre, University of Bristol, Bristol, UK
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6
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Lou MW, Drummond AE, Swain CT, Milne RL, English DR, Brown KA, van Roekel EH, Skinner TL, Moore MM, Gaunt TR, Martin RM, Lewis SJ, Lynch BM. Linking Physical Activity to Breast Cancer via Inflammation, Part 2: The Effect of Inflammation on Breast Cancer Risk. Cancer Epidemiol Biomarkers Prev 2023; 32:597-605. [PMID: 36867866 PMCID: PMC10150245 DOI: 10.1158/1055-9965.epi-22-0929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/09/2022] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
This review synthesized and appraised the evidence for an effect of inflammation on breast cancer risk. Systematic searches identified prospective cohort and Mendelian randomization studies relevant to this review. Meta-analysis of 13 biomarkers of inflammation were conducted to appraise the evidence for an effect breast cancer risk; we examined the dose-response of these associations. Risk of bias was evaluated using the ROBINS-E tool and the quality of evidence was appraised with Grading of Recommendations Assessment, Development, and Evaluation. Thirty-four observational studies and three Mendelian randomization studies were included. Meta-analysis suggested that women with the highest levels of C-reactive protein (CRP) had a higher risk of developing breast cancer [risk ratio (RR) = 1.13; 95% confidence interval (CI), 1.01-1.26] compared with women with the lowest levels. Women with highest levels of adipokines, particularly adiponectin (RR = 0.76; 95% CI, 0.61-0.91) had a reduced breast cancer risk, although this finding was not supported by Mendelian randomization analysis. There was little evidence of an effect of cytokines, including TNFα and IL6, on breast cancer risk. The quality of evidence for each biomarker ranged from very low to moderate. Beyond CRP, the published data do not clearly support the role of inflammation in the development of breast cancer.
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Affiliation(s)
- Makayla W.C. Lou
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Ann E. Drummond
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
| | | | - Roger L. Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Dallas R. English
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Kristy A. Brown
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Eline H. van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Tina L. Skinner
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Melissa M. Moore
- Medical Oncology, St Vincent's Hospital, Melbourne, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Australia
| | - Tom R. Gaunt
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Richard M. Martin
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, United Kingdom
| | - Sarah J. Lewis
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Brigid M. Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
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7
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Savioli F, Morrow ES, Dolan RD, Romics L, Lannigan A, Edwards J, McMillan DC. Prognostic role of preoperative circulating systemic inflammatory response markers in primary breast cancer: meta-analysis. Br J Surg 2022; 109:1206-1215. [PMID: 36130112 DOI: 10.1093/bjs/znac319] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/27/2022] [Accepted: 08/17/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Circulating markers of the systemic inflammatory response are prognostic in several cancers, but their role in operable breast cancer is unclear. A systematic review and meta-analysis of the literature was carried out. METHODS A search of electronic databases up to August 2020 identified studies that examined the prognostic value of preoperative circulating markers of the systemic inflammatory response in primary operable breast cancer. A meta-analysis was carried out for each marker with more than three studies, reporting a HR and 95 per cent confidence interval for disease-free survival (DFS), breast cancer-specific survival (BCSS) or overall survival (OS). RESULTS In total, 57 studies were reviewed and 42 were suitable for meta-analysis. Higher neutrophil-to-lymphocyte ratio (NLR) was associated with worse overall survival (OS) (pooled HR 1.75, 95 per cent c.i. 1.52 to 2.00; P < 0.001), disease-free survival (DFS) (HR 1.67, 1.50 to 1.87; P < 0.001), and breast cancer-specific survival (BCSS) (HR 1.89, 1.35 to 2.63; P < 0.001). This effect was also seen with an arithmetically-derived NLR (dNLR). Higher platelet-to-lymphocyte ratio (PLR) was associated with worse OS (HR 1.29, 1.10 to 1.50; P = 0.001) and DFS (HR 1.58, 1.33 to 1.88; P < 0.001). Higher lymphocyte-to-monocyte ratio (LMR) was associated with improved DFS (HR 0.65, 0.51 to 0.82; P < 0.001), and higher C-reactive protein (CRP) level was associated with worse BCSS (HR 1.22, 1.07 to 1.39; P = 0.002) and OS (HR 1.24, 1.14 to 1.35; P = 0.002). CONCLUSION Current evidence suggests a role for preoperative NLR, dNLR, LMR, PLR, and CRP as prognostic markers in primary operable breast cancer. Further work should define their role in clinical practice, particularly reproducible thresholds and molecular subtypes for which these may be of most value.
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Affiliation(s)
- Francesca Savioli
- Academic Unit of Surgery, School of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Elizabeth S Morrow
- Academic Unit of Surgery, School of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Ross D Dolan
- Academic Unit of Surgery, School of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Laszlo Romics
- Academic Unit of Surgery, School of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Alison Lannigan
- Department of Breast Surgery, University Hospital Wishaw, Wishaw, UK
| | - Joanne Edwards
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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8
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Mikkelsen MK, Lindblom NAF, Dyhl-Polk A, Juhl CB, Johansen JS, Nielsen D. Systematic review and meta-analysis of C-reactive protein as a biomarker in breast cancer. Crit Rev Clin Lab Sci 2022; 59:480-500. [PMID: 35403550 DOI: 10.1080/10408363.2022.2050886] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Inflammation is an enabling characteristic of the hallmarks of cancer. There has therefore been increasing interest in the clinical value of circulating inflammatory biomarkers in cancer. In this review, we summarize results on C-reactive protein (CRP), alone or as part of the Glasgow Prognostic Score (GPS, composed of CRP and serum albumin), as a biomarker of prognosis or prediction and monitoring of therapeutic response in patients with breast cancer. A systematic literature search was performed in Medline and Embase from 1990 to August 2021. The association of serum CRP and overall survival and disease/progression-free survival was summarized in meta-analyses using a random effects model. The results from a total of 35 included studies (20,936 patients) were divided according to three identified patient settings (metastatic, non-metastatic, and general setting). Most of the studies examined prognostic utility. Several larger studies observed associations between high serum CRP and poor survival, but the meta-analyses suggested a limited value in a non-metastatic and general breast cancer setting (populations with unknown or varied disease stage). In metastatic patients, however, more consistent findings supported an association between serum CRP and prognosis (hazard ratio for overall survival: 1.87 (95% CI 1.31-2.67). Only five studies examined a role in prediction or monitoring of therapeutic response. One study reported a significant association between serum CRP levels and response to chemotherapy. Findings regarding serum CRP as a biomarker in breast cancer appear inconsistent, particularly in non-metastatic and general breast cancer, where the prognostic value could not be confirmed. In patients with metastatic breast cancer we suggest that high serum CRP is an indicator of poor prognosis. Too few studies assessed the role of serum CRP in prediction or monitoring of treatment response to allow conclusions.
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Affiliation(s)
- Marta Kramer Mikkelsen
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | | | - Anne Dyhl-Polk
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Carsten Bogh Juhl
- Department of Physiotherapy and Occupational Therapy, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - Julia Sidenius Johansen
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dorte Nielsen
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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9
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Circulating proteins as predictive and prognostic biomarkers in breast cancer. Clin Proteomics 2022; 19:25. [PMID: 35818030 PMCID: PMC9275040 DOI: 10.1186/s12014-022-09362-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 06/28/2022] [Indexed: 11/22/2022] Open
Abstract
Breast cancer (BC) is the most common cancer and among the leading causes of cancer death in women. It is a heterogeneous group of tumours with numerous morphological and molecular subtypes, making predictions of disease evolution and patient outcomes difficult. Therefore, biomarkers are needed to help clinicians choose the best treatment for each patient. For the last years, studies have increasingly focused on biomarkers obtainable by liquid biopsy. Circulating proteins (from serum or plasma) can be used for inexpensive and minimally invasive determination of disease risk, early diagnosis, treatment adjusting, prognostication and disease progression monitoring. We provide here a review of the main published studies on serum proteins in breast cancer and elaborate on the potential of circulating proteins to be predictive and/or prognostic biomarkers in breast cancer.
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10
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Guerville F, Bourdel-Marchasson I, Déchanet-Merville J, Pellegrin I, Soubeyran P, Appay V, Lemoine M. Does Inflammation Contribute to Cancer Incidence and Mortality during Aging? A Conceptual Review. Cancers (Basel) 2022; 14:cancers14071622. [PMID: 35406394 PMCID: PMC8996949 DOI: 10.3390/cancers14071622] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 03/11/2022] [Accepted: 03/19/2022] [Indexed: 11/16/2022] Open
Abstract
Aging is associated with chronic low-grade inflammation, cancer incidence and mortality. As inflammation contributes to cancer initiation and progression, one could hypothesize that age-associated chronic low-grade inflammation contributes to the increase in cancer incidence and/or mortality observed during aging. Here, we review the evidence supporting this hypothesis: (1) epidemiological associations between biomarkers of systemic inflammation and cancer incidence and mortality in older people, (2) therapeutic clues suggesting that targeting inflammation could reduce cancer incidence and mortality and (3) experimental evidence from animal models highlighting inflammation as a link between various mechanisms of aging and cancer initiation and progression. Despite a large body of literature linking aging, inflammation and cancer, convincing evidence for the clear implication of specific inflammatory pathways explaining cancer incidence or mortality during aging is still lacking. Further dedicated research is needed to fill these gaps in evidence and pave the way for the development of applications in clinical care.
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Affiliation(s)
- Florent Guerville
- ImmunoConcEpT, CNRS UMR5164, INSERM ERL1303, Université de Bordeaux, F-33076 Bordeaux, France; (J.D.-M.); (I.P.); (V.A.); (M.L.)
- Clinical Gerontology Department, Bordeaux University Hospital, F-33000 Bordeaux, France;
- Correspondence:
| | - Isabelle Bourdel-Marchasson
- Clinical Gerontology Department, Bordeaux University Hospital, F-33000 Bordeaux, France;
- CRMSB, CNRS UMR 5536, Université de Bordeaux, F-33000 Bordeaux, France
| | - Julie Déchanet-Merville
- ImmunoConcEpT, CNRS UMR5164, INSERM ERL1303, Université de Bordeaux, F-33076 Bordeaux, France; (J.D.-M.); (I.P.); (V.A.); (M.L.)
| | - Isabelle Pellegrin
- ImmunoConcEpT, CNRS UMR5164, INSERM ERL1303, Université de Bordeaux, F-33076 Bordeaux, France; (J.D.-M.); (I.P.); (V.A.); (M.L.)
- Laboratory of Immunology and Immunogenetics, Bordeaux University Hospital, F-33000 Bordeaux, France
| | - Pierre Soubeyran
- Department of Medical Oncology, Institut Bergonie, F-33076 Bordeaux, France;
| | - Victor Appay
- ImmunoConcEpT, CNRS UMR5164, INSERM ERL1303, Université de Bordeaux, F-33076 Bordeaux, France; (J.D.-M.); (I.P.); (V.A.); (M.L.)
| | - Maël Lemoine
- ImmunoConcEpT, CNRS UMR5164, INSERM ERL1303, Université de Bordeaux, F-33076 Bordeaux, France; (J.D.-M.); (I.P.); (V.A.); (M.L.)
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11
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Ma YY, Wang H, Zhao WD, Li YF, Wang JJ, Chen XY, Huang YQ, Wang WJ, Wang Y, Sun SC. Prognostic Value of Combined Lactate Dehydrogenase, C-Reactive Protein, Cancer Antigen 153 and Cancer Antigen 125 in Metastatic Breast Cancer. Cancer Control 2022; 29:10732748211053150. [PMID: 34989251 PMCID: PMC8743925 DOI: 10.1177/10732748211053150] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Breast cancer (BC), especially metastatic BC, is one of the most lethal diseases in women. CA 125 and CA 15-3 are commonly used indicators for diagnosis and prognosis of BC. Some serological indicators, such as lactate dehydrogenase (LDH) and C-reactive protein (CRP), can also be used to assess the prognosis and progression in BC. Methods Univariate Cox regression analysis and LASSO regression analysis were performed to identify prognostic factors and build prognostic models. We distributed the patients into 2 groups based on the median risk score, analyzed prognosis by Kaplan–Meier curve, and screened independent prognostic factors by multivariate Cox regression analysis. Result We identified 4 indicators-LDH, CRP, CA 15-3, and CA 125—related to the prognosis in BC and established a prognostic model. The high LDH group showed worse overall survival (OS) than low LDH group (P = .017; hazard ratio (HR), 1.528; 95% confidence interval (CI), 1.055-2.215). The high CRP group showed worse OS than low CRP group (P = .004; HR, 1.666; 95% CI, 1.143-2.429). The high CA153 group showed worse OS than low CA 15-3 group (P=.011; HR, 1.563; 95% CI, 1.075-2.274). The high CA 125 group showed worse OS than low CA 125 group (P = .021; HR, 1.499; 95% CI, 1.031-2.181). The area under the curve for risk score was .824, Ki-67 was .628, age was .511, and grade was .545. Risk score was found to be an independent prognostic factor using multivariate Cox regression analysis. Conclusion We successfully established an optimization model by combining 4 prognosis-related indicators to assess the prognosis in patients with metastatic BC.
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Affiliation(s)
- Yu-Yuan Ma
- Department of Thyroid and Breast Surgery, 117958Suzhou Municipal Hospital, Suzhou, P.R. China
| | - Han Wang
- Department of Oncology, Jining Cancer Hospital, Jining, P.R. China
| | - Wei-Dong Zhao
- Department of Oncology, 569222Yijishan Hospital of Wannan Medical College, Wuhu, P.R. China
| | - Yi-Fan Li
- Department of Oncology, Binzhou People's Hospital, Binzhou, P.R. China
| | - Jing-Jing Wang
- Department of Oncology, Taizhou Hospital of Traditional Chinese Medicine, Taizhou, P.R. China
| | - Xing-Yu Chen
- Department of General Surgery, Taizhou Fourth People's Hospital, Taizhou, P.R. China
| | - Yue-Qing Huang
- Department of General Medicine, Suzhou Municipal Hospital, Suzhou, P.R. China
| | - Wen-Jie Wang
- Department of Radio-Oncology, Suzhou Municipal Hospital, Suzhou, P.R. China
| | - Ying Wang
- Department of Oncology, Suzhou Municipal Hospital, Suzhou, P.R. China
| | - Shi-Chang Sun
- Department of Oncology, Jining Cancer Hospital, Jining, P.R. China
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12
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Dokunmu T, Obi P, Fatiregun O, Rotimi O, Agodirin S, Rotimi S. Haptoglobin genotypes and malaria comorbidity in breast cancer and healthy Nigerian women. Ann Afr Med 2022; 21:231-236. [DOI: 10.4103/1596-3519.356811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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13
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Ma Y, Shi L, Lu P, Yao S, Xu H, Hu J, Liang X, Liang X, Wei S. Creation of a Novel Nomogram Based on the Direct Bilirubin-To-Indirect Bilirubin Ratio and Lactate Dehydrogenase Levels in Resectable Colorectal Cancer. Front Mol Biosci 2021; 8:751506. [PMID: 34746234 PMCID: PMC8564357 DOI: 10.3389/fmolb.2021.751506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 10/04/2021] [Indexed: 01/03/2023] Open
Abstract
Background: Recently, many studies have suggested that bilirubin is associated with the prognosis of colorectal cancer (CRC). Conversely, there is substantial evidence that lactate dehydrogenase (LDH) levels are associated with the prognosis of cancer. Therefore, we sought to find a novel marker based on the above to predict prognosis in patients with resectable CRC. Methods: A total of 702 patients from Hubei Cancer Hospital were included. The whole population was randomly divided into training (n = 491) and testing (n = 211) cohorts. Next, we established a new index based on direct bilirubin, indirect bilirubin and LDH levels. Chi-square tests, Kaplan-Meier survival analyses, and Cox regression analyses were used to evaluate prognosis. The prediction accuracies of models for overall survival (OS) and disease-free survival (DFS) were estimated through Harrell’s concordance index (C-index) and the Brier score. Results: The median DFS duration was 32 months (range: 0–72.6 months), whereas the median OS duration was 35 months (range: 0 months–73.8 months). In addition, a new indicator, (DIR.LDH) (HR: 1.433; 95% CI, 1.069–1.920) could independently predict outcomes in CRC patients. Moreover, the module based on DIR. LDH was found to have exceptional performance for predicting OS and DFS. The C-index of the nomogram for OS was 0.802 (95% CI, 0.76–0.85) in the training cohort and 0.829 (95% CI, 0.77–0.89) in the testing cohort. The C-index of the nomogram for DFS was 0.774 (95% CI, 0.74–0.81) in the training cohort and 0.775 (95% CI, 0.71–0.84) in the testing cohort. Conclusion: We successfully established a novel module to guide clinical decision-making for CRC.
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Affiliation(s)
- Yifei Ma
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Wuhan, China.,Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Lulu Shi
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Ping Lu
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China.,Department of Abdominal Oncology, Hubei Cancer Hospital, Wuhan, China
| | - Shuang Yao
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Hongli Xu
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China.,Department of Abdominal Oncology, Hubei Cancer Hospital, Wuhan, China
| | - Junjie Hu
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Wuhan, China.,Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Xin Liang
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Wuhan, China.,Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Xinjun Liang
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China.,Department of Abdominal Oncology, Hubei Cancer Hospital, Wuhan, China
| | - Shaozhong Wei
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Wuhan, China.,Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
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14
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Yang Z, Zheng Y, Wu Z, Wen Y, Wang G, Chen S, Tan F, Li J, Wu S, Dai M, Li N, He J. Association between pre-diagnostic serum albumin and cancer risk: Results from a prospective population-based study. Cancer Med 2021; 10:4054-4065. [PMID: 34041866 PMCID: PMC8209558 DOI: 10.1002/cam4.3937] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/07/2021] [Accepted: 04/11/2021] [Indexed: 01/05/2023] Open
Abstract
Background Albumin is supposed to be associated with cancer risk. However, evidence on serum albumin and cancer risk among the Chinese population is sparse. This study was conducted to evaluate the association between pre‐diagnostic serum albumin and cancer risk among Chinese. Methods A total of 82,061 participants with baseline information on serum albumin concentration in the Kailuan cohort were recruited. Cox proportional hazards models and restricted cubic spline (RCS) analyses were used to evaluate the association between pre‐diagnostic serum albumin and cancer risk. Results Albumin levels were inversely associated with overall cancer risk (HR [95% CI]: Q2, Q3, Q4 vs. Q1: 0.91 [0.78–1.07], 0.80 [0.70–0.92], 0.73 [0.63–0.85]), and the risk of lung, colorectal, and liver cancer (HR [95% CI]: Q4 vs. Q1: lung: 0.70 [0.52–0.95], colorectal: 0.43 [0.26–0.72], liver: 0.59 [0.36–0.95]). After excluding new cancer cases within 2 years since enrollment, a more significant association was observed for liver cancer (HR [95% CI]: Q4 vs. Q1: 0.41 [0.21–0.78]), while associations converted to nonsignificant for lung and colorectal cancer. The RCS model suggested an inverse linear association between albumin and the risk of overall cancer (p‐overall < 0.0001, p‐nonlinear = 0.3716) and liver cancer (p‐overall = 0.0002, p‐nonlinear = 0.1807). Conclusions Our findings suggest that pre‐diagnostic serum albumin is inversely and linearly associated with cancer risk among the Chinese population. This study provides evidence that albumin may be valuable to the prediction and stratification of cancer risk in the general population. However, the biological mechanism and clinical significance remain to be elucidated. Population studies with longer follow‐up time as well as experimental studies are further required.
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Affiliation(s)
- Zhuoyu Yang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yadi Zheng
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zheng Wu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Wen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gang Wang
- Department of Oncology, Kailuan General Hospital, Tangshan, China
| | - Shuohua Chen
- Department of Health Care Center, Kailuan General Hospital, Tangshan, China
| | - Fengwei Tan
- Department of Thoracic surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiang Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shouling Wu
- Department of Health Care Center, Kailuan General Hospital, Tangshan, China
| | - Min Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ni Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Jie He
- Department of Thoracic surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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15
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Jung SY, Papp JC, Sobel EM, Pellegrini M, Yu H, Zhang ZF. Genetically Predicted C-Reactive Protein Associated With Postmenopausal Breast Cancer Risk: Interrelation With Estrogen and Cancer Molecular Subtypes Using Mendelian Randomization. Front Oncol 2021; 10:630994. [PMID: 33614510 PMCID: PMC7888276 DOI: 10.3389/fonc.2020.630994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/21/2020] [Indexed: 12/14/2022] Open
Abstract
Background Immune-related etiologic pathways that influence breast cancer risk are incompletely understood and may be confounded by lifestyles or reverse causality. Using a Mendelian randomization (MR) approach, we investigated the potential causal relationship between genetically elevated C-reactive protein (CRP) concentrations and primary invasive breast cancer risk in postmenopausal women. Methods We used individual-level data obtained from 10,179 women, including 537 who developed breast cancer, from the Women’s Health Initiative Database for Genotypes and Phenotypes Study, which consists of five genome-wide association (GWA) studies. We examined 61 GWA single-nucleotide polymorphisms (SNPs) previously associated with CRP. We employed weighted/penalized weighted–medians and MR gene–environment interactions that allow instruments’ invalidity to some extent and attenuate the heterogeneous estimates of outlying SNPs. Results In lifestyle-stratification analyses, genetically elevated CRP decreased risk for breast cancer in exogenous estrogen-only, estrogen + progestin, and past oral contraceptive (OC) users, but only among relatively short-term users (<5 years). Estrogen-only users for ≥5 years had more profound CRP-decreased breast cancer risk in dose–response fashion, whereas past OC users for ≥5 years had CRP-increased cancer risk. Also, genetically predicted CRP was strongly associated with increased risk for hormone-receptor positive or human epidermal growth factor receptor-2 negative breast cancer. Conclusions Our findings may provide novel evidence on the immune-related molecular pathways linking to breast cancer risk and suggest potential clinical use of CRP to predict the specific cancer subtypes. Our findings suggest potential interventions targeting CRP–inflammatory markers to reduce breast cancer risk.
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Affiliation(s)
- Su Yon Jung
- Translational Sciences Section, Jonsson Comprehensive Cancer Center, School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jeanette C Papp
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Eric M Sobel
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Computational Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Matteo Pellegrini
- Department of Molecular, Cell and Developmental Biology, Life Sciences Division, University of California, Los Angeles, Los Angeles, CA, United States
| | - Herbert Yu
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Zuo-Feng Zhang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States.,Center for Human Nutrition, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
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16
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Michels N, van Aart C, Morisse J, Mullee A, Huybrechts I. Chronic inflammation towards cancer incidence: A systematic review and meta-analysis of epidemiological studies. Crit Rev Oncol Hematol 2021; 157:103177. [PMID: 33264718 DOI: 10.1016/j.critrevonc.2020.103177] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/26/2020] [Accepted: 11/09/2020] [Indexed: 12/17/2022] Open
Abstract
This systematic review and meta-analysis provides epidemiological data on the relationship between chronic inflammation, as measured by inflammatory blood parameters, and cancer incidence. Two independent researchers searched PubMed, Web Of Science and Embase databases until October 2020. In vitro studies, animal studies, studies with chronically-ill subjects or cross-sectional studies were excluded. Quality was assessed with the Newcastle-Ottawa scale. The 59 nested case-control, 6 nested case-cohort and 42 prospective cohort studies considered 119 different inflammatory markers (top three: CRP, fibrinogen and IL6) and 26 cancer types (top five: colorectal, lung, breast, overall and prostate cancer). Nineteen meta-analyses resulted in ten significant positive associations: CRP-breast (OR = 1.23[1.05-1.43];HR = 1.14[1.01-1.28)), CRP-colorectal (OR = 1.34[1.11-1.60]), CRP-lung (HR = 2.03[1.59-2.60]), fibrinogen-lung (OR = 2.56[1.86-3.54]), IL6-lung (OR = 1.41[1.12-1.78]), CRP-ovarian (OR = 1.41[1.10-1.80]), CRP-prostate (HR = 1.09[1.03-1.15]), CRP-overall (HR = 1.35[1.16-1.57]) and fibrinogen-overall (OR = 1.22[1.07-1.39]). Study quality improvements can be done by better verification of inflammatory status (more than one baseline measurement of one parameter), adjusting for important confounders and ensuring long-term follow-up.
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Affiliation(s)
- Nathalie Michels
- Department of Public Health and Primary Care, Ghent University, Belgium.
| | - Carola van Aart
- Department of Public Health and Primary Care, Ghent University, Belgium
| | - Jens Morisse
- Department of Public Health and Primary Care, Ghent University, Belgium
| | - Amy Mullee
- UCD Institute of Food and Health, Dublin, Ireland
| | - Inge Huybrechts
- International Agency for Research on Cancer, Nutrition and Metabolism Section, Lyon, France
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17
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Bera A, Russ E, Manoharan MS, Eidelman O, Eklund M, Hueman M, Pollard HB, Hu H, Shriver CD, Srivastava M. Proteomic Analysis of Inflammatory Biomarkers Associated With Breast Cancer Recurrence. Mil Med 2020; 185:669-675. [PMID: 32074342 DOI: 10.1093/milmed/usz254] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Breast cancer is the most frequent cancer detected for women, and while our ability to treat breast cancer has improved substantially over the years, recurrence remains a major obstacle. Standard screening for new and recurrent breast cancer involves clinical breast imaging. However, there is no clinically approved noninvasive body fluid test for the early detection of recurrent breast cancer. Materials and Method: In this study, we analyzed serum samples from both recurrent and nonrecurrent breast cancer patients by different proteomics methods to identify biomarkers in patients with recurrence of disease. RESULTS Comparative data analysis identified several histone deacetylase (HDAC) proteins, which were found at significantly higher levels in the serum of recurrent breast cancer patients: HDAC9 (C-term) (P = 0.0035), HDAC5 (C-term) (P = 0.013), small ubiquitin-like modifier 1 (N-term) (P = 0.017), embryonic stem cell-expressed Ras (inter) (P = 0.018), and HDAC7 (C-term) (P = 0.020). Chronic inflammation plays a critical role in the development of the breast cancer recurrence, and we identified several proinflammatory cytokines that were present at elevated levels only in recurrent breast cancer patient serum. CONCLUSIONS Our data indicated that the epigenetic regulation of inflammatory processes plays a critical role in breast cancer recurrence. The identified proteins could lay the groundwork for the development of a serum-based breast cancer recurrence assay.
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Affiliation(s)
- Alakesh Bera
- Department of Anatomy, Physiology, and Genetics, Uniformed Services University Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
| | - Eric Russ
- Department of Anatomy, Physiology, and Genetics, Uniformed Services University Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
| | - Muthu Saravanan Manoharan
- Department of Medicine/Infectious Diseases, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229
| | - Ofer Eidelman
- Department of Anatomy, Physiology, and Genetics, Uniformed Services University Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
| | - Michael Eklund
- Department of Anatomy, Physiology, and Genetics, Uniformed Services University Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
| | - Matthew Hueman
- Murtha Cancer Center, Uniformed Services University/Walter Reed National Military Medical Center, 4494 North Palmer Road, Bethesda, MD 20889
| | - Harvey B Pollard
- Department of Anatomy, Physiology, and Genetics, Uniformed Services University Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
| | - Hai Hu
- Chan Soon-Shiong Institute of Molecular Medicine at Windber, 620 7th Street, Windber, PA 15963
| | - Craig D Shriver
- Murtha Cancer Center, Uniformed Services University/Walter Reed National Military Medical Center, 4494 North Palmer Road, Bethesda, MD 20889
| | - Meera Srivastava
- Department of Anatomy, Physiology, and Genetics, Uniformed Services University Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
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18
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Xiao L, Lyu J, Liu X, Li K, Wang Y, Zhang R, Chen T, Li T. Clinical Application Value of the Prognostic Nutritional Index for Predicting Survival in Patients with Esophageal Squamous Cell Carcinoma Undergoing Chemoradiotherapy or Radiotherapy. Nutr Cancer 2020; 73:1933-1940. [PMID: 33044092 DOI: 10.1080/01635581.2020.1817511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The prognostic nutrition index (PNI) has been shown to have prognostic value for several common cancers. The study aim was to explore the clinical application value of the PNI for prognosis of patients with esophageal squamous cell carcinoma (ESCC) treated with radical chemoradiotherapy (CRT) or radiotherapy (RT). METHODS Overall, 193 patients with ESCC who received radiotherapy with or without chemotherapy at Sichuan Cancer Hospital from March 20, 2012 to December 25, 2017 were retrospectively analyzed. Based on serum measurements before treatment, the PNI at ESCC recurrence was calculated as albumin (g/L) + 5 × total lymphocyte count. The Kaplan-Meier method and Cox proportional regression model were used to analyze the relationship between PNI and overall survival (OS). RESULTS The average PNI of 193 ESCC patients was 49.01 ± 4.68. The optimal cutoff value of PNI was 47.975, and the patients were divided into a low-PNI group (<47.975) and a high-PNI group (≥47.975). PNI was related to tumor length, T-stage and synchronous chemotherapy in ESCC patients (P < 0.05). The median OS for the entire group was 22.37 mo,. The median OS of patients in the high-PNI group and low-PNI group were 32.63 mo, and 15.4 mo, respectively, the 3-year survival rates were 47.5% and 32.2% and the 5-year survival rates were 37.7% and 16.8%, respectively, (all P = 0.001). Univariate analysis showed that PNI, tumor length, T-stage and synchronous chemotherapy were related to the prognosis of ESCC patients (P < 0.05). Multivariate analysis showed that tumor length (P = 0.019), synchronous chemotherapy (P = 0.009) and PNI (P = 0.003) were independent prognostic factors affecting the prognosis of patients in ESCC treated with RT or CRT. CONCLUSIONS The calculation of PNI value is simple, reliable and repeatable and can improve the accuracy of a patient's prognosis. Confirmation of these results by a large-sample prospective study is desirable.
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Affiliation(s)
- Ling Xiao
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.,Department of Radiotherapy Centre, Sichuan Cancer Hospital & Institute, Chengdu, China
| | - Jiahua Lyu
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.,Department of Radiotherapy Centre, Sichuan Cancer Hospital & Institute, Chengdu, China
| | - Xiao Liu
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
| | - Ke Li
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
| | - Yuan Wang
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Rongke Zhang
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
| | - Taiyu Chen
- Clinical Medical College of Chengdu Medical College, Chengdu, China
| | - Tao Li
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.,Department of Radiotherapy Centre, Sichuan Cancer Hospital & Institute, Chengdu, China
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19
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Kehm RD, McDonald JA, Fenton SE, Kavanaugh-Lynch M, Leung KA, McKenzie KE, Mandelblatt JS, Terry MB. Inflammatory Biomarkers and Breast Cancer Risk: A Systematic Review of the Evidence and Future Potential for Intervention Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155445. [PMID: 32731638 PMCID: PMC7432395 DOI: 10.3390/ijerph17155445] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/16/2020] [Accepted: 07/24/2020] [Indexed: 12/18/2022]
Abstract
Measuring systemic chronic inflammatory markers in the blood may be one way of understanding the role of inflammation in breast cancer risk, and might provide an intermediate outcome marker in prevention studies. Here, we present the results of a systematic review of prospective epidemiologic studies that examined associations between systemic inflammatory biomarkers measured in blood and breast cancer risk. From 1 January 2014 to 20 April 2020, we identified 18 unique studies (from 16 publications) that examined the association of systemic inflammatory biomarkers measured in blood with breast cancer risk using prospectively collected epidemiologic data. Only one marker, C-reactive protein, was studied extensively (measured in 13 of the 16 publications), and had some evidence of a positive association with breast cancer risk. Evidence associating other inflammatory biomarkers and more comprehensive panels of markers with the development of breast cancer is limited. Future prospective evidence from expanded panels of systemic blood inflammatory biomarkers is needed to establish strong and independent links with breast cancer risk, along with mechanistic studies to understand inflammatory pathways and demonstrate how breast tissue responds to chronic inflammation. This knowledge could ultimately support the development and evaluation of mechanistically driven interventions to reduce inflammation and prevent breast cancer.
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Affiliation(s)
- Rebecca D. Kehm
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA; (R.D.K.); (J.A.M.)
| | - Jasmine A. McDonald
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA; (R.D.K.); (J.A.M.)
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY 10032, USA
| | - Suzanne E. Fenton
- National Toxicology Program Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, 111 TW Alexander Drive, Durham, NC 27709, USA;
| | - Marion Kavanaugh-Lynch
- California Breast Cancer Research Program, University of California, 300 Lakeside Drive, Oakland, CA 94612, USA; (M.K.-L.); (K.E.M.)
| | | | - Katherine E. McKenzie
- California Breast Cancer Research Program, University of California, 300 Lakeside Drive, Oakland, CA 94612, USA; (M.K.-L.); (K.E.M.)
| | - Jeanne S. Mandelblatt
- Department of Oncology, Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University, 3800 Reservoir Rd. NW, Washington, DC 20057, USA
- Correspondence: (J.S.M.); (M.B.T.)
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA; (R.D.K.); (J.A.M.)
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY 10032, USA
- Correspondence: (J.S.M.); (M.B.T.)
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20
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DuPré NC, Heng YJ, Raby BA, Glass K, Hart JE, Chu JH, Askew C, Eliassen AH, Hankinson SE, Kraft P, Laden F, Tamimi RM. Involvement of fine particulate matter exposure with gene expression pathways in breast tumor and adjacent-normal breast tissue. ENVIRONMENTAL RESEARCH 2020; 186:109535. [PMID: 32668536 PMCID: PMC7368092 DOI: 10.1016/j.envres.2020.109535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/18/2020] [Accepted: 04/12/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Fine particulate matter (PM2.5) has been associated with breast cancer specific mortality, particularly for women with Stage I cancer. We examined the biological pathways that are perturbed by PM2.5 exposures by analyzing gene expression measurements from breast tissue specimens. METHODS The Nurses' Health Studies (NHS and NHSII) are prospective cohorts with archival breast tissue specimens from breast cancer cases. Global gene expression data were ascertained with the Affymetrix Glue Human Transcriptome Array 3.0. PM2.5 was estimated using spatio-temporal models linked to participants' home addresses. All analyses were performed separately in tumor (n = 591) and adjacent-normal (n = 497) samples, and stratified by estrogen receptor (ER) status and stage. We used multivariable linear regression, gene-set enrichment analyses (GSEA), and the least squares kernel machine (LSKM) to assess whether 3-year cumulative average pre-diagnosis PM2.5 exposure was associated with breast-tissue gene expression pathways among predominately Stage I and II women (90.7%) and postmenopausal (81.2%) women. Replication samples (tumor, n = 245; adjacent-normal, n = 165) were measured on Affymetrix Human Transcriptome Array (HTA 2.0). RESULTS Overall, no pathways in the tumor area were significantly associated with PM2.5 exposure. Among 272 adjacent-normal samples from Stage I ER-positive women, PM2.5 was associated with perturbations in the oxidative phosphorylation, protein secretion, and mTORC1 signaling pathways (GSEA and LSKM p-values <0.05); however, results were not replicated in a small set of replication samples (n = 80). CONCLUSIONS PM2.5 was generally not associated with breast tissue gene expression though was suggested to perturb oxidative phosphorylation and regulation of proteins and cellular signaling in adjacent-normal breast tissue. More research is needed on the biological role of PM2.5 that influences breast tumor progression.
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Affiliation(s)
- Natalie C DuPré
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology and Population Health, University of Louisville School of Public Health and Information Sciences, Louisville, KY, USA.
| | - Yujing J Heng
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Cancer Research Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Benjamin A Raby
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kimberly Glass
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, 02215, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02215, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jen-Hwa Chu
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Catherine Askew
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - A Heather Eliassen
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Susan E Hankinson
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02215, USA
| | - Francine Laden
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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21
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Maskarinec G, Ju D, Shvetsov YB, Horio D, Chan O, Loo LWM, Hernandez BY. Breast tumor tissue inflammation but not lobular involution is associated with survival among breast cancer patients in the Multiethnic Cohort. Cancer Epidemiol 2020; 65:101685. [PMID: 32058311 DOI: 10.1016/j.canep.2020.101685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/29/2020] [Accepted: 02/02/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND This study investigated the association of breast lobular involution status and three inflammatory markers as predictors of survival among breast cancer patients in the Multiethnic Cohort. METHODS Lobular involution was evaluated in tissue sections of normal breast tissue and COX-2, TNF-α, and TGF-β proteins were assessed by immunohistochemistry in tumor microarrays. A summary score added the expression levels of the three markers. Cox regression was applied to estimate hazard ratios (HRs) and 95 % confidence intervals (CI) with age as the time metric and adjustment for factors known to affect mortality. RESULTS Among 254 women (mean age = 61.7 ± 8.7 years) with pathologic blocks and follow-up information, 54 all-cause and 10 breast cancer-specific deaths were identified after a mean follow-up time of 16.0 ± 3.1 years. For 214 participants, an inflammatory score was available and 157 women had information on lobular involution. Lobular involution was not significantly associated with survival. Expression of both COX-2 and TNF-α were significant predictors of lower survival (p = 0.02 and 0.04), while the association for TGF-β was weaker (p = 0.09). When combined into one overall inflammation score, both intermediate (HR = 2.72; 95 % CI 0.90-8.28) and high (HR = 4.21; 95 % CI 1.51-11.8) scores were associated with higher mortality but only the latter was statistically significant. No significant association with breast cancer-specific mortality was detected. CONCLUSIONS These results suggest that strong expression of inflammatory markers in breast tissue predicts a poorer prognosis possibly due to a system-wide state of chronic inflammation.
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Affiliation(s)
| | - Dan Ju
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | | | - David Horio
- University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Owen Chan
- University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Lenora W M Loo
- University of Hawaii Cancer Center, Honolulu, HI, United States
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22
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Sollie S, Michaud DS, Sarker D, Karagiannis SN, Josephs DH, Hammar N, Santaolalla A, Walldius G, Garmo H, Holmberg L, Jungner I, Van Hemelrijck M. Chronic inflammation markers are associated with risk of pancreatic cancer in the Swedish AMORIS cohort study. BMC Cancer 2019; 19:858. [PMID: 31464604 PMCID: PMC6716919 DOI: 10.1186/s12885-019-6082-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 08/23/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Nested case-control studies examining the association between serum markers of chronic inflammation, focused on three specific biomarkers (CRP, IL-8 and TNF-α), and risk of pancreatic cancer have reported no associations. In this study, we evaluated associations between standard pre-diagnostic serum markers of chronic inflammation (CRP, albumin, haptoglobin and leukocytes) and pancreatic cancer risk in the Swedish Apolipoprotein-related MORtality RISk (AMORIS) prospective cohort study. METHODS We selected all participants (≥20 years old) with baseline measurements of CRP, albumin, haptoglobin and leukocytes between 1985 and 1996 (n = 61,597). Participants were excluded if they had a history of chronic pancreatitis and all individuals were free from pancreatic cancer at baseline. Cox proportional multivariable hazards regression analysis was carried out for medical cut-offs of CRP, albumin, haptoglobin and leukocytes. RESULTS We observed an increased risk of pancreatic cancer for those individuals with higher levels of serum haptoglobin (≥1.4 g/L), CRP (≥10 mg/L) and leukocytes (≥10 × 109 cells/L) compared to those with haptoglobin levels < 1.4 g/L, CRP levels < 10 mg/L and Leukocyte levels < 10 × 109 cells/L [haptoglobin HR: 2.23 (95% CI 1.72-2.88), CRP HR: 1.32 (95% CI 1.00-1.74), leukocytes HR: 2.20 (95% CI 1.52-3.18)]. No associations were noted for serum albumin. CONCLUSIONS We found an increased risk of pancreatic cancer associated with pre-diagnostic serum levels of haptoglobin, CRP and leukocytes. Our finding suggests a possible role of chronic inflammation in the aetiology of pancreatic cancer and highlight the need to further investigate this association.
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Affiliation(s)
- Sam Sollie
- King’s College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research (TOUR), 3rd Floor, Bermondsey Wing, Guy’s Hospital London, London, SE1 9RT UK
| | - Dominique S. Michaud
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA USA
- Department of Epidemiology, Brown University School of Public Health, Providence, RI USA
| | - Debashis Sarker
- King’s College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research (TOUR), 3rd Floor, Bermondsey Wing, Guy’s Hospital London, London, SE1 9RT UK
- Department of Medical Oncology, Guy’s and St Thomas’ NHS Trust, London, UK
| | - Sophia N. Karagiannis
- St John’s Institute of Dermatology, School of Basics and Medical Biosciences, King’s College London, Guy’s Hospital, London, UK
| | - Debra H. Josephs
- King’s College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research (TOUR), 3rd Floor, Bermondsey Wing, Guy’s Hospital London, London, SE1 9RT UK
- Department of Medical Oncology, Guy’s and St Thomas’ NHS Trust, London, UK
| | - Niklas Hammar
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Aida Santaolalla
- King’s College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research (TOUR), 3rd Floor, Bermondsey Wing, Guy’s Hospital London, London, SE1 9RT UK
| | - Goran Walldius
- Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Hans Garmo
- King’s College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research (TOUR), 3rd Floor, Bermondsey Wing, Guy’s Hospital London, London, SE1 9RT UK
| | - Lars Holmberg
- King’s College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research (TOUR), 3rd Floor, Bermondsey Wing, Guy’s Hospital London, London, SE1 9RT UK
| | - Ingmar Jungner
- Department of Medicine, Clinical Epidemiological Unit, Karolinska Institutet and CALAB Research, Stockholm, Sweden
| | - Mieke Van Hemelrijck
- King’s College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research (TOUR), 3rd Floor, Bermondsey Wing, Guy’s Hospital London, London, SE1 9RT UK
- Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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23
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Can Systemic Inflammatory Markers Be Used to Predict the Pathological Grade of Meningioma Before Surgery? World Neurosurg 2019; 127:e677-e684. [DOI: 10.1016/j.wneu.2019.03.241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 03/22/2019] [Accepted: 03/23/2019] [Indexed: 11/17/2022]
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24
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Nakamura M, Bax HJ, Scotto D, Souri EA, Sollie S, Harris RJ, Hammar N, Walldius G, Winship A, Ghosh S, Montes A, Spicer JF, Van Hemelrijck M, Josephs DH, Lacy KE, Tsoka S, Karagiannis SN. Immune mediator expression signatures are associated with improved outcome in ovarian carcinoma. Oncoimmunology 2019; 8:e1593811. [PMID: 31069161 PMCID: PMC6492968 DOI: 10.1080/2162402x.2019.1593811] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/17/2019] [Accepted: 03/02/2019] [Indexed: 01/04/2023] Open
Abstract
Immune and inflammatory cascades may play multiple roles in ovarian cancer. We aimed to identify relationships between expression of immune and inflammatory mediators and patient outcomes. We interrogated differential gene expression of 44 markers and marker combinations (n = 1,978) in 1,656 ovarian carcinoma patient tumors, alongside matched 5-year overall survival (OS) data in silico. Using machine learning methods, we investigated whether genomic expression of these 44 mediators can discriminate between malignant and non-malignant tissues in 839 ovarian cancer and 115 non-malignant ovary samples. We furthermore assessed inflammation markers in 289 ovarian cancer patients’ sera in the Swedish Apolipoprotein MOrtality-related RISk (AMORIS) cohort. Expression of the 44 mediators could discriminate between malignant and non-malignant tissues with at least 96% accuracy. Higher expression of classical Th1, Th2, Th17, anti-parasitic/infection and M1 macrophage mediator signatures were associated with better OS. Contrastingly, inflammatory and angiogenic mediators, CXCL-12, C-reactive protein (CRP) and platelet-derived growth factor subunit A (PDGFA) were negatively associated with OS. Of the serum inflammatory markers in the AMORIS cohort, women with ovarian cancer who had elevated levels of haptoglobin (≥1.4 g/L) had a higher risk of dying from ovarian cancer compared to those with haptoglobin levels <1.4 g/L (HR = 2.09, 95% CI:1.38–3.16). Our findings indicate that elevated “classical” immune mediators, associated with response to pathogen antigen challenge, may confer immunological advantage in ovarian cancer, while inflammatory markers appear to have negative prognostic value. These highlight associations between immune protection, inflammation and clinical outcomes, and offer opportunities for patient stratification based on secretome markers.
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Affiliation(s)
- Mano Nakamura
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Heather J Bax
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK.,School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Daniele Scotto
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Elmira Amiri Souri
- Department of Informatics, Faculty of Natural and Mathematical Sciences, King's College London, London, UK
| | - Sam Sollie
- King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research (TOUR), London, UK
| | - Robert J Harris
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Niklas Hammar
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Goran Walldius
- Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Winship
- Departments of Medical Oncology and Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sharmistha Ghosh
- Departments of Medical Oncology and Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ana Montes
- Departments of Medical Oncology and Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - James F Spicer
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Mieke Van Hemelrijck
- King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology & Urology Research (TOUR), London, UK.,Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Debra H Josephs
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK.,School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Katie E Lacy
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Sophia Tsoka
- Department of Informatics, Faculty of Natural and Mathematical Sciences, King's College London, London, UK
| | - Sophia N Karagiannis
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
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25
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Berger E, Delpierre C, Hosnijeh FS, Kelly-Irving M, Portengen L, Bergdahl IA, Johansson AS, Krogh V, Palli D, Panico S, Sacerdote C, Tumino R, Kyrtopoulos SA, Vineis P, Chadeau-Hyam M, Vermeulen R, Castagné R. Association between low-grade inflammation and Breast cancer and B-cell Myeloma and Non-Hodgkin Lymphoma: findings from two prospective cohorts. Sci Rep 2018; 8:10805. [PMID: 30018397 PMCID: PMC6050323 DOI: 10.1038/s41598-018-29041-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 07/04/2018] [Indexed: 12/15/2022] Open
Abstract
Chronic inflammation may be involved in cancer development and progression. Using 28 inflammatory-related proteins collected from prospective blood samples from two case-control studies nested in the Italian component of the European Prospective Investigation into Cancer and nutrition (n = 261) and in the Northern Sweden Health and Disease Study (n = 402), we tested the hypothesis that an inflammatory score is associated with breast cancer (BC) and Β-cell Non-Hodgkin Lymphoma (B-cell NHL, including 68 multiple myeloma cases) onset. We modelled the relationship between this inflammatory score and the two cancers studied: (BC and B-cell NHL) using generalised linear models, and assessed, through adjustments the role of behaviours and lifestyle factors. Analyses were performed by cancer types pooling both populations, and stratified by cohorts, and time to diagnosis. Our results suggested a lower inflammatory score in B-cell NHL cases (β = -1.28, p = 0.012), and, to lesser, extent with BC (β = -0.96, p = 0.33) compared to controls, mainly driven by cancer cases diagnosed less than 6 years after enrolment. These associations were not affected by subsequent adjustments for potential intermediate confounders, notably behaviours. Sensitivity analyses indicated that our findings were not affected by the way the inflammatory score was calculated. These observations call for further studies involving larger populations, larger variety of cancer types and repeated measures of larger panel of inflammatory markers.
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Affiliation(s)
- Eloise Berger
- LEASP, UMR 1027, Inserm-Université Toulouse III Paul Sabatier, Toulouse, France
| | - Cyrille Delpierre
- LEASP, UMR 1027, Inserm-Université Toulouse III Paul Sabatier, Toulouse, France
| | - Fatemeh Saberi Hosnijeh
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands.,Immunology Department, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Lutzen Portengen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands
| | | | | | - Vittorio Krogh
- Fondazione IRCCS- Instituto Nazionale dei Tumori, Milan, Italy
| | - Domenico Palli
- Istituto per lo Studio e la Prevenzione Oncologica (ISPO Toscana), Florence, Italy
| | - Salvatore Panico
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Carlotta Sacerdote
- Piedmont Reference Centre for Epidemiology and Cancer Prevention (CPO Piemonte), Turin, Italy
| | - Rosario Tumino
- Cancer registry and Histopathology Unit, Azienda Ospedaliera 'Civile -M.P.Arezzo', Ragusa, Italy
| | - Soterios A Kyrtopoulos
- National Hellenic Research Foundation, Institute of Biology, Medicinal Chemistry and Biotechnology, Athens, Greece
| | - Paolo Vineis
- HuGeF, Human Genetics Foundation, Torino, Italy.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,MRC-PHE Centre for Environment and Health, Imperial College, London, London, UK
| | - Marc Chadeau-Hyam
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,MRC-PHE Centre for Environment and Health, Imperial College, London, London, UK
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Raphaële Castagné
- LEASP, UMR 1027, Inserm-Université Toulouse III Paul Sabatier, Toulouse, France. .,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. .,MRC-PHE Centre for Environment and Health, Imperial College, London, London, UK.
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26
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Sylman JL, Mitrugno A, Atallah M, Tormoen GW, Shatzel JJ, Tassi Yunga S, Wagner TH, Leppert JT, Mallick P, McCarty OJT. The Predictive Value of Inflammation-Related Peripheral Blood Measurements in Cancer Staging and Prognosis. Front Oncol 2018; 8:78. [PMID: 29619344 PMCID: PMC5871812 DOI: 10.3389/fonc.2018.00078] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/07/2018] [Indexed: 12/23/2022] Open
Abstract
In this review, we discuss the interaction between cancer and markers of inflammation (such as levels of inflammatory cells and proteins) in the circulation, and the potential benefits of routinely monitoring these markers in peripheral blood measurement assays. Next, we discuss the prognostic value and limitations of using inflammatory markers such as neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios and C-reactive protein measurements. Furthermore, the review discusses the benefits of combining multiple types of measurements and longitudinal tracking to improve staging and prognosis prediction of patients with cancer, and the ability of novel in silico frameworks to leverage this high-dimensional data.
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Affiliation(s)
- Joanna L Sylman
- VA Palo Alto Health Care System, Palo Alto, CA, United States.,Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR, United States.,Canary Center at Stanford, Department of Radiology, Stanford University School of Medicine, Stanford, CA, United States
| | - Annachiara Mitrugno
- Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Michelle Atallah
- Canary Center at Stanford, Department of Radiology, Stanford University School of Medicine, Stanford, CA, United States
| | - Garth W Tormoen
- Department of Radiation Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Joseph J Shatzel
- Division of Hematology and Medical Oncology, Oregon Health & Science University, Portland, OR, United States.,Cancer Early Detection & Advanced Research Center, Oregon Health & Science University, Portland, OR, United States
| | - Samuel Tassi Yunga
- Cancer Early Detection & Advanced Research Center, Oregon Health & Science University, Portland, OR, United States.,Knight Cancer Institute, Oregon Health & Science University, Portland, OR, United States
| | - Todd H Wagner
- VA Palo Alto Health Care System, Palo Alto, CA, United States.,Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - John T Leppert
- VA Palo Alto Health Care System, Palo Alto, CA, United States.,Department of Urology, Stanford University School of Medicine, Stanford, CA, United States
| | - Parag Mallick
- Canary Center at Stanford, Department of Radiology, Stanford University School of Medicine, Stanford, CA, United States
| | - Owen J T McCarty
- Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR, United States
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27
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Arthur R, Williams R, Garmo H, Holmberg L, Stattin P, Malmström H, Lambe M, Hammar N, Walldius G, Robinsson D, Jungner I, Van Hemelrijck M. Serum inflammatory markers in relation to prostate cancer severity and death in the Swedish AMORIS study. Int J Cancer 2018; 142:2254-2262. [PMID: 29322512 DOI: 10.1002/ijc.31256] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 10/29/2017] [Accepted: 11/29/2017] [Indexed: 12/11/2022]
Abstract
Inflammation is a well-documented driver of cancer development and progression. However, little is known about its role in prostate carcinogenesis. Thus, we examined the association of C-reactive protein (CRP), haptoglobin, albumin and white blood cells (WBC) with prostate cancer (PCa) severity (defined by PCa risk category and clinicopathological characteristics) and progression (defined by PCa death). We selected 8,471 Swedish men with newly diagnosed PCa who had exposure measurements taken approximately 14 years prior to diagnosis. We calculated odds ratio (OR) and 95% confidence interval (CI) for the associations between the inflammatory markers and PCa severity using logistic regression, while Cox proportional hazard regression was used for the associations with overall and PCa death. Serum CRP levels were associated with increased odds of high risk and metastatic PCa, and high PSA levels (≥20 µg/L) (OR: 1.29; 95% CI: 1.06-1.56, 1.32; 1.05-1.65 and 1.51; 1.26-1.81, respectively). Similarly, higher haptoglobin levels were associated with increased odds of metastatic PCa, high PSA level and possibly high grade PCa (1.38; 1.10-1.74, 1.50; 1.17-1.93 and 1.25; 1.00-1.56, respectively). Albumin was positively associated with Gleason 4 + 3 tumour (1.38; 1.02-1.86) and overall death (HRunit increase in log : 1.60; 95% CI: 1.11-2.30), but inversely associated with high risk PCa and high PSA levels (≥20 µg/L) (0.71; 0.56-0.89 and 0.72; 0.5 9-0.90). WBC was associated with increased odds of T3-T4 PCa. Except for albumin, none of these markers were associated with PCa death or overall death. Systemic inflammation as early as 14 years prior to diagnosis may influence prostate cancer severity.
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Affiliation(s)
- R Arthur
- Division of Cancer Studies, Faculty of Life Sciences and Medicine, King's College London, Translational Oncology & Urology Research (TOUR), London, United Kingdom.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - R Williams
- Division of Cancer Studies, Faculty of Life Sciences and Medicine, King's College London, Translational Oncology & Urology Research (TOUR), London, United Kingdom
| | - H Garmo
- Division of Cancer Studies, Faculty of Life Sciences and Medicine, King's College London, Translational Oncology & Urology Research (TOUR), London, United Kingdom.,Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - L Holmberg
- Division of Cancer Studies, Faculty of Life Sciences and Medicine, King's College London, Translational Oncology & Urology Research (TOUR), London, United Kingdom
| | - P Stattin
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden.,Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - H Malmström
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Swedish Orphan Biovitrum, Stockholm, Sweden
| | - M Lambe
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - N Hammar
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Global Medicines Development, Medical Evidence & Observational Research, AstraZeneca, Stockholm, Sweden
| | - G Walldius
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - D Robinsson
- Department of Urology, Ryhov Hospital, Jönköping, Sweden
| | - I Jungner
- Department of Clinical Epidemiology, Karolinska Institutet and CALAB Research, Stockholm, Sweden
| | - M Van Hemelrijck
- Division of Cancer Studies, Faculty of Life Sciences and Medicine, King's College London, Translational Oncology & Urology Research (TOUR), London, United Kingdom.,Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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28
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Kühn T, Sookthai D, Graf ME, Schübel R, Freisling H, Johnson T, Katzke V, Kaaks R. Albumin, bilirubin, uric acid and cancer risk: results from a prospective population-based study. Br J Cancer 2017; 117:1572-1579. [PMID: 28898231 PMCID: PMC5680462 DOI: 10.1038/bjc.2017.313] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/05/2017] [Accepted: 08/11/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND It has long been proposed that albumin, bilirubin and uric acid may inhibit cancer development due to their anti-oxidative properties. However, there is a lack of population-based studies on blood levels of these molecules and cancer risk. METHODS Associations between pre-diagnostic serum albumin, bilirubin and uric acid and the risks of common cancers as well as cancer death in the EPIC-Heidelberg cohort were evaluated by multivariable Cox regression analyses. A case-cohort sample including a random subcohort (n=2739) and all incident cases of breast (n=627), prostate (n=554), colorectal (n=256), and lung cancer (n=195) as well as cancer death (n=761) that occurred between baseline (1994-1998) and 2009 was used. RESULTS Albumin levels were inversely associated with breast cancer risk (hazard ratioQuartile 4 vs Quartile 1 (95% CI): 0.71 (0.51, 0.99), Plinear trend=0.004) and overall cancer mortality (HRQ4 vs Q1 (95% CI): 0.64 (0.48, 0.86), Plinear trend<0.001) after multivariable adjustment. Uric acid levels were also inversely associated with breast cancer risk (HRQ4 vs Q1 (95% CI): 0.72 (0.53, 0.99), Plinear trend=0.043) and cancer mortality (HRQ4 vs Q1 (95% CI): 0.75 (0.58, 0.98), Plinear trend=0.09). There were no significant associations between albumin or uric acid and prostate, lung and colorectal cancer. Serum bilirubin was not associated with any cancer end point. CONCLUSIONS The present findings indicate that higher levels of albumin and uric acid are related to lower risks of breast cancer and cancer mortality. Further studies are needed to assess whether the observed associations are causal.
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Affiliation(s)
- Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 280, Heidelberg D-69120, Germany
| | - Disorn Sookthai
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 280, Heidelberg D-69120, Germany
| | - Mirja E Graf
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 280, Heidelberg D-69120, Germany
| | - Ruth Schübel
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 280, Heidelberg D-69120, Germany
| | - Heinz Freisling
- International Agency for Research on Cancer, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, Lyon 69008, France
| | - Theron Johnson
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 280, Heidelberg D-69120, Germany
| | - Verena Katzke
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 280, Heidelberg D-69120, Germany
| | - Rudolf Kaaks
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 280, Heidelberg D-69120, Germany
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29
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Liu X, Qu JK, Zhang J, Yan Y, Zhao XX, Wang JZ, Qu HY, Liu L, Wang JS, Duan XY. Prognostic role of pretreatment neutrophil to lymphocyte ratio in breast cancer patients: A meta-analysis. Medicine (Baltimore) 2017; 96:e8101. [PMID: 29137007 PMCID: PMC5690700 DOI: 10.1097/md.0000000000008101] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Inflammation and cancer are closely related to each other. As a parameter that can reflect inflammation and host immune reaction, elevated blood neutrophil to lymphocyte ratio (NLR) has been confirmed to be correlated with poor prognosis in a variety of cancers. However, this remains controversial in breast cancer. Thus, we performed this updated meta-analysis to further clarify whether high NLR could be a predictor of survival in breast cancer patients. METHODS We searched on PubMed Database and Cochrane Library. Overall survival (OS), disease-free survival (DFS), and cancer-specific survival were used as outcome events, and hazard ratio (HR) was chosen as the parameter to evaluate the correlation. RESULT Eighteen eligible studies were involved in this meta-analysis. The synthesized analysis demonstrated that elevated NLR was associated with poor DFS [HR = 1.72, 95% confidence interval (95% CI) = 1.30-2.27], OS (HR = 1.87, 95% CI = 1.41-2.48), and cancer-specific survival (HR = 2.09, 95% CI = 1.04-4.21). The correlation was stronger in triple-negative breast cancer (TNBC) (OS: HR = 2.58, 95% CI = 1.63-4.06; DFS: HR = 3.51, 95% CI = 1.97-6.24). CONCLUSION Higher NLR was correlated to poor prognosis of breast cancer patients. As a clinical parameter that we can easily obtain, NLR might be a potential predictor in patients' survival to assist with physicians' treatment decisions.
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Affiliation(s)
- Xu Liu
- The Second Department of Thoracic Surgery, the First Affiliated Hospital of Xi’an Jiaotong University
| | - Jing-Kun Qu
- The Second Department of Thoracic Surgery, the First Affiliated Hospital of Xi’an Jiaotong University
| | - Jia Zhang
- The Second Department of Thoracic Surgery, the First Affiliated Hospital of Xi’an Jiaotong University
| | - Yan Yan
- The Second Department of Thoracic Surgery, the First Affiliated Hospital of Xi’an Jiaotong University
| | - Xi-Xi Zhao
- Department of Oncology, the Second Affiliated Hospital of Xi’an Jiaotong University
| | - Ji-Zhao Wang
- The Second Department of Thoracic Surgery, the First Affiliated Hospital of Xi’an Jiaotong University
| | - Hang-Ying Qu
- The Department of Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P.R. China
| | - Lin Liu
- The Second Department of Thoracic Surgery, the First Affiliated Hospital of Xi’an Jiaotong University
| | - Jian-Sheng Wang
- The Second Department of Thoracic Surgery, the First Affiliated Hospital of Xi’an Jiaotong University
| | - Xiao-Yi Duan
- The Department of Oncological Surgery, Shaanxi University of Chinese Medicine
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30
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Biomarkers of inflammation and breast cancer risk: a case-control study nested in the EPIC-Varese cohort. Sci Rep 2017; 7:12708. [PMID: 28983080 PMCID: PMC5629213 DOI: 10.1038/s41598-017-12703-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 09/18/2017] [Indexed: 12/21/2022] Open
Abstract
Breast cancer (BC) is the leading cause of cancer death in women. Adipokines, and other inflammation molecules linked to adiposity, are suspected to be involved in breast carcinogenesis, however prospective findings are inconclusive. In a prospective nested case-control study within the EPIC-Varese cohort, we used conditional logistic regression to estimate rate ratios (RRs) for BC, with 95% confidence intervals (CI), in relation to plasma levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6, leptin, and adiponectin, controlling for BC risk factors. After a median 14.9 years, 351 BC cases were identified and matched to 351 controls. No marker was significantly associated with BC risk overall. Significant interactions between menopausal status and CRP, leptin, and adiponectin were found. Among postmenopausal women, high CRP was significantly associated with increased BC risk, and high adiponectin with significantly reduced risk. Among premenopausal women, high TNF-α was associated with significantly increased risk, and high leptin with reduced risk; interleukin-6 was associated with increased risk only in a continuous model. These findings constitute further evidence that inflammation plays a role in breast cancer. Interventions to lower CRP, TNF-α, and interleukin-6 and increase adiponectin levels may contribute to preventing BC.
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31
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Serum inflammatory markers and colorectal cancer risk and survival. Br J Cancer 2017; 116:1358-1365. [PMID: 28376082 PMCID: PMC5482738 DOI: 10.1038/bjc.2017.96] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/31/2017] [Accepted: 03/17/2017] [Indexed: 12/26/2022] Open
Abstract
Background: Inflammation has been linked with development of some cancers. We investigated systemic inflammation in relation to colorectal cancer incidence and subsequent survival using common serum inflammatory markers Design: A cohort of men and women aged 20 years and older in greater Stockholm area with serum C-reactive protein (CRP) and albumin measured between 1986 and 1999 were included (n=325 599). A subset of these had baseline measurements of haptoglobin and leukocytes. Multivariable Cox regression was performed to assess risk of colorectal cancer by levels of inflammatory markers, adjusting for potential confounders. Analyses were stratified by circulating glucose, total cholesterol and triglycerides. Overall and CRC-specific death following diagnosis were assessed as secondary outcomes. Results: A total of 4764 individuals were diagnosed with colorectal cancer. A positive association between haptoglobin and colorectal cancer incidence was found (hazard ratio (HR): 1.17; 95% CI: 1.06–1.28). A positive association was also observed with leukocytes (HR: 1.21; 95% CI: 1.03–1.42). No evidence of association was noted between CRP and colorectal cancer risk. Higher risks of all-cause death were seen with haptoglobin and leukocytes levels. Higher haptoglobin levels were linked with an increased risk of colorectal cancer death (HR: 1.19; 95% CI: 1.01–1.41). Conclusions: Prediagnostic systemic inflammation may impact colorectal cancer incidence and survival; therefore, prompting investigations linking inflammatory pathways preceding colorectal cancer with disease severity and progression.
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32
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Shackshaft L, Van Hemelrijck M, Garmo H, Malmström H, Lambe M, Hammar N, Walldius G, Jungner I, Wulaningsih W. Circulating gamma-glutamyl transferase and development of specific breast cancer subtypes: findings from the Apolipoprotein Mortality Risk (AMORIS) cohort. Breast Cancer Res 2017; 19:22. [PMID: 28264697 PMCID: PMC5339947 DOI: 10.1186/s13058-017-0816-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Different etiological pathways may precede development of specific breast cancer subtypes and impact prevention or treatment strategies. We investigated the association between gamma-glutamyl transferase (GGT) and development of specific breast cancer subtypes based on oestrogen receptor (ER), progesterone receptor (PR) and HER2 status. METHODS We included 231,283 cancer-free women in a Swedish cohort. Associations between GGT and breast cancer subtypes were investigated with nested case-control and case-case analyses. We used logistic regression models to assess serum GGT in relation to breast cancer subtype, based on individual and combined receptor status. RESULTS Positive associations were found between serum GGT and development of ER+, ER- and PR+ breast cancers compared to controls (odds ratio (OR) 1.14 (95% confidence interval (CI) 1.08-1.19), 1.11 (1.01-1.23) and 1.18 (1.12-1.24), respectively) and of ER+/PR+ tumours. We found inverse associations between GGT levels and PR- breast cancers compared to PR+ (OR 0.87 (0.80-0.95)), between ER+/PR- tumours compared to ER+/PR+ tumours and between ER-/PR-/HER+ compared to ER+/HER2 or PR+/HER2 tumours (OR 0.55 (95% CI 0.34-0.90). CONCLUSION The observed associations between pre-diagnostic serum GGT and different breast cancer subtypes may indicate distinct underlying pathways and require further investigations to tease out their clinical implications.
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Affiliation(s)
- Lydia Shackshaft
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, Faculty of Life Sciences & Medicine, Guy's Hospital, 3rd Floor, Bermondsey Wing, London, SE1 9RT, UK
| | - Mieke Van Hemelrijck
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, Faculty of Life Sciences & Medicine, Guy's Hospital, 3rd Floor, Bermondsey Wing, London, SE1 9RT, UK.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Hans Garmo
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, Faculty of Life Sciences & Medicine, Guy's Hospital, 3rd Floor, Bermondsey Wing, London, SE1 9RT, UK.,Regional Cancer Centre, Uppsala, Sweden
| | - Håkan Malmström
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mats Lambe
- Regional Cancer Centre, Uppsala, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Hammar
- AstraZeneca R&D, Mölndal, Sweden.,Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Göran Walldius
- Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ingmar Jungner
- Department of Medicine, Clinical Epidemiological Unit, Karolinska Institutet and CALAB Research, Stockholm, Sweden
| | - Wahyu Wulaningsih
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, Faculty of Life Sciences & Medicine, Guy's Hospital, 3rd Floor, Bermondsey Wing, London, SE1 9RT, UK. .,MRC Unit for Lifelong Health and Ageing at University College London, London, UK.
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33
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Walldius G, Malmström H, Jungner I, de Faire U, Lambe M, Van Hemelrijck M, Hammar N. Cohort Profile: The AMORIS cohort. Int J Epidemiol 2017; 46:1103-1103i. [DOI: 10.1093/ije/dyw333] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2016] [Indexed: 01/22/2023] Open
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34
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Wulaningsih W, Astuti Y, Matsuguchi T, Anggrandariyanny P, Watkins J. Circulating Prostate-Specific Antigen and Telomere Length in a Nationally Representative Sample of Men Without History of Prostate Cancer. Prostate 2017; 77:22-32. [PMID: 27566127 DOI: 10.1002/pros.23245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 07/27/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND We investigated the association of prostate-specific antigen (PSA) with leukocyte telomere length, which may be altered in preclinical prostate malignancies. METHODS This study was based on the 2001-2002 U.S. National Health and Nutrition Examination Survey (NHANES). A subsample of 1,127 men aged 40-85 years without prior history of prostate cancer who provided informed consent and blood samples were selected. Leukocyte telomere length (LTL) relative to standard DNA reference (T/S ratio) was quantified by polymerase chain reaction (PCR). Survey-weighted multivariable linear regression was performed to examine T/S ratio across quintiles of total and free PSA and free-to-total PSA ratio (%fPSA). A sensitivity analysis was performed by excluding men dying from prostate cancer during follow-up through to December 31, 2006. Stratification analyses were carried out to assess any effect modification by age group, race, body mass index (BMI), and levels of C-reactive protein (CRP), a marker of inflammation. RESULTS Higher total PSA levels were associated to longer LTL, with approximately 8% increase in log-transformed T/S ratio (95% confidence interval [CI]: 2-13%) among men in the highest quintile of total PSA compared to the lowest in the fully adjusted model (Ptrend = 0.01). No significant association was found for free PSA or %fPSA, although nonlinearity between all PSA measures and T/S ratio was indicated. Similar results were found after excluding men who died from prostate cancer during follow-up. We also found the associations between total PSA and T/S ratio to be strongest among non-Hispanic blacks, non-obese men (BMI <30 kg/m2 ), and those with low CRP. However, a significant interaction was only found between total PSA and race/ethnicity (Pinteraction = 0.01). CONCLUSION Total PSA levels were strongly associated to LTL, particularly among non-Hispanic blacks. Our findings support a potential link between PSA and specific mechanisms contributing to prostate cancer development. Prostate 77:22-32, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Wahyu Wulaningsih
- MRC Unit for Lifelong Health and Ageing, University College London, London, United Kingdom
- Division of Haematology/Oncology, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
- PILAR Research and Education, Cambridge, United Kingdom
| | - Yuliana Astuti
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Department of Obstetrics/Gynaecology, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | - Tetsuya Matsuguchi
- Department of Biochemistry and Biophysics, University of California, Driver Group, L.L.C., San Francisco, California
| | - Putri Anggrandariyanny
- Division of Haematology/Oncology, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | - Johnathan Watkins
- PILAR Research and Education, Cambridge, United Kingdom
- Institute for Mathematical and Molecular Biomedicine, King's College London, London, United Kingdom
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Xu Z, Xu W, Cheng H, Shen W, Ying J, Cheng F, Xu W. The Prognostic Role of the Platelet-Lymphocytes Ratio in Gastric Cancer: A Meta-Analysis. PLoS One 2016; 11:e0163719. [PMID: 27684077 PMCID: PMC5042439 DOI: 10.1371/journal.pone.0163719] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 09/13/2016] [Indexed: 12/26/2022] Open
Abstract
Background Systemic inflammatory parameters, such as the elevator PLR (platelet-lymphocyte ratio), the NLR (neutrophil-lymphocyte ratio) and the platelet count (PLT), have been found to be associated with the prognosis in gastric cancer; however, these results, especially those relating to the PLR, remain inconsistent. So we aimed to evaluate the prognostic role of the PLR in gastric cancer by conducting and presenting the findings of this meta-analysis. Methods We conducted a systematic literature search in PubMed, Embase and the Cochrane Library to evaluate the prognostic value of the PLR in gastric cancer. The quality of the included studies was evaluated using the Newcastle Ottawa Quality Assessment Scale (NOS). The hazard ratio (HR) /Odds Ratio (OR) and its 95% confidence were pooled using a random effects model. A funnel plot based on overall survival was used to evaluate the publication bias. Results It total, 8 studies comprising 4513 patients with gastric cancer met the pre-setting inclusion criteria. In comparison to the normal PLR, an elevated PLR was correlated with a higher risk of lymph node metastasis with an OR of 1.50 (95% Cl:1.24–1.82; I2 = 17%) and serosal invasion (T3 +T4) risk with an OR of 2.01 (95% Cl: 1.49–2.73; I2 = 55%), and an elevated PLR also increased the advanced stage (III +IV) risk with an OR of 1.99 (95% Cl: 1.60–2.46; I2 = 28%). An elevated PLR was not a reliable predictor for OS with an HR of 0.99 (95% CI: 0.9–1.1; I2 = 12%). Conclusions An elevated PLR was correlated with a higher risk of lymph node metastasis, serosal invasion and advanced stage (III +IV) risk in gastric cancer; however, the PLR may not act as a negative predictor for the overall survival of gastric cancer.
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Affiliation(s)
- Zhengshui Xu
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Wei Xu
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- * E-mail:
| | - Hua Cheng
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Wei Shen
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jiaqi Ying
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Fei Cheng
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Wenji Xu
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Wulaningsih W, Serrano FEC, Utarini A, Matsuguchi T, Watkins J. Smoking, second-hand smoke exposure and smoking cessation in relation to leukocyte telomere length and mortality. Oncotarget 2016; 7:60419-60431. [PMID: 27509177 PMCID: PMC5312393 DOI: 10.18632/oncotarget.11051] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 07/19/2016] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To investigate the link between smoking exposure, telomere length and mortality, with emphasis on second-hand smoke (SHS) exposure and the duration of smoking cessation. RESULTS A total of 1,018 participants died during follow-up (mean: 10.3 years). A 50 base-pair decrease in LTL was shown among cotinine-confirmed current versus never smokers. The 90th quantile of LTL decreased with increasing cotinine among never smokers, indicating a role of SHS. Longer telomeres with smoking cessation were indicated but limited to a 3-16 year period of abstaining smoking. When assessing mortality, we observed a lower risk of all-cause death for the second quintile compared to the first among never smokers (HR: 0.67, 95% CI: 0.52-0.87), and a higher risk was found among current smokers (HR: 1.89, 1.19-2.92). MATERIALS AND METHODS We studied 6,456 nationally representative U.S. respondents with mortality follow-up through to 31 December 2011. Smoking status was assessed by interviews and cotinine levels. Relative leukocyte telomere length (LTL) was quantified by polymerase chain reaction (PCR). Multivariable linear regression was performed to examine LTL by smoking exposure, adjusted for age, sex, race/ethnicity, socioeconomic status, education, body mass index, alcohol consumption, and physical activity. We further estimated the association of LTL with cotinine levels using quantile regression, and with smoking cessation dynamics. Cox regression was used to estimate mortality by smoking status and LTL. CONCLUSION Our findings indicated a complex association between smoking, telomere length, and mortality. LTL alterations with SHS and smoking cessation warrant further investigation for translation to public health measures.
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Affiliation(s)
- Wahyu Wulaningsih
- Division of Cancer Studies, King's College London, London, UK
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
- Division of Haematology/Oncology, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
- PILAR Research and Education, Cambridge, UK
| | - Fidel Emmanuel C. Serrano
- National Institute of Molecular Biology and Biotechnology, University of The Philippines Diliman, Diliman, Quezon City, Metro Manila, The Philippines
| | - Adi Utarini
- Department of Health Policy and Management, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Tetsuya Matsuguchi
- Department of Biochemistry and Biophysics, University of California, San Francisco, CA, USA
- Driver Group, L.L.C., San Francisco, CA, USA
| | - Johnathan Watkins
- PILAR Research and Education, Cambridge, UK
- Institute for Mathematical and Molecular Biomedicine, King's College London, London, UK
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Wulaningsih W, Sagoo HK, Hamza M, Melvin J, Holmberg L, Garmo H, Malmström H, Lambe M, Hammar N, Walldius G, Jungner I, Van Hemelrijck M. Serum Calcium and the Risk of Breast Cancer: Findings from the Swedish AMORIS Study and a Meta-Analysis of Prospective Studies. Int J Mol Sci 2016; 17:ijms17091487. [PMID: 27608013 PMCID: PMC5037765 DOI: 10.3390/ijms17091487] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/30/2016] [Accepted: 08/30/2016] [Indexed: 11/16/2022] Open
Abstract
To investigate the association between serum calcium and risk of breast cancer using a large cohort and a systematic review with meta-analysis. From the Swedish Apolipoprotein Mortality Risk (AMORIS) Study we included 229,674 women who had baseline measurements of serum total calcium and albumin. Multivariable Cox regression was used to assess the association between total and albumin-corrected calcium and breast cancer risk. For the systematic review, an electronic search of MEDLINE and EMBASE databases was performed to identify other prospective cohorts assessing the relationship between serum calcium and breast cancer risk. We pooled the results of our AMORIS cohort with other eligible studies in a meta-analysis using a random effects model. I2 test was used to assess heterogeneity. In the AMORIS study, 10,863 women were diagnosed with breast cancer (mean follow-up: 19 years). We found an inverse association between total serum calcium and breast cancer when comparing the fourth quartile to the first quartile (HR: 0.94, 95% CI: 0.88–0.99, p value for trend 0.04) and similar results using albumin-corrected calcium. In the systematic review, we identified another two prospective cohorts evaluating pre-diagnostic serum total calcium and breast cancer. Combining these studies and our findings in AMORIS in a meta-analysis showed a protective effect of serum calcium against breast cancer, with a summary RR of 0.80 (95% CI: 0.66–0.97). No substantial heterogeneity was observed. Our findings in AMORIS and the meta-analysis support an inverse association between serum calcium and breast cancer risk, which warrants mechanistic investigations.
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Affiliation(s)
- Wahyu Wulaningsih
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London SE1 9RT, UK.
| | - Harkiran K Sagoo
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London SE1 9RT, UK.
| | - Mustafa Hamza
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London SE1 9RT, UK.
| | - Jennifer Melvin
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London SE1 9RT, UK.
| | - Lars Holmberg
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London SE1 9RT, UK.
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala 751 85, Sweden.
- Regional Cancer Centre, Uppsala 751 83, Sweden.
| | - Hans Garmo
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London SE1 9RT, UK.
- Regional Cancer Centre, Uppsala 751 83, Sweden.
| | - Håkan Malmström
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden.
| | - Mats Lambe
- Regional Cancer Centre, Uppsala 751 83, Sweden.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 171 77, Sweden.
| | - Niklas Hammar
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden.
- AstraZeneca R&D, Mölndal 431 50, Sweden.
| | - Göran Walldius
- Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden.
| | - Ingmar Jungner
- Department of Medicine, Clinical Epidemiological Unit, Karolinska Institutet and CALAB Research, Stockholm 171 77, Sweden.
| | - Mieke Van Hemelrijck
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London SE1 9RT, UK.
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden.
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Associations of C-Reactive Protein, Granulocytes and Granulocyte-to-Lymphocyte Ratio with Mortality from Breast Cancer in Non-Institutionalized American Women. PLoS One 2016; 11:e0157482. [PMID: 27294662 PMCID: PMC4905698 DOI: 10.1371/journal.pone.0157482] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 05/31/2016] [Indexed: 12/16/2022] Open
Abstract
Inflammation may play a role in breast cancer, but evidence in the general population is lacking. We investigated the association between serum inflammatory markers (C-reactive protein (CRP), absolute granulocyte count (AGC) and granulocyte-to-lymphocyte (G/L) ratio) and breast cancer (BCa) mortality in American women while accounting for adiposity. From the Third National Health and Nutrition Examination Survey (NHANES III) we selected all women aged 20+ without any known history of cancer (n = 7,780). Multivariable Cox regression models were used to assess CRP, AGC and G/L ratio in relation to mortality from BCa, all cancer, cardiovascular disease and all causes. Stratification analyses by body mass index (BMI) and waist circumference were performed to investigate the effect of adiposity on this association. During a mean follow-up of 167 months, 44 women died from BCa. After adjustments for BMI and waist circumference, only G/L ratio was associated to risk of BCa death (e.g. HR: 2.35, 95% CI: 1.36–4.06 for the 3rd compared to the 1st tertile, Ptrend = 0.01). Except for a borderline interaction between CRP categories and obesity by BMI, no statistically significant interaction between markers and categories of BMI or waist circumference was observed. All three markers were associated with mortality from cardiovascular disease and all causes. Our findings support a role of inflammation in BCa mortality which may involve mechanisms apart from obesity, and potential usefulness of GLR as a marker in assessing inflammation and cancer.
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Wulaningsih W, Holmberg L, Garmo H, Karagiannis SN, Ahlstedt S, Malmstrom H, Lambe M, Hammar N, Walldius G, Jungner I, Ng T, Van Hemelrijck M. Investigating the association between allergen-specific immunoglobulin E, cancer risk and survival. Oncoimmunology 2016; 5:e1154250. [PMID: 27471625 PMCID: PMC4938379 DOI: 10.1080/2162402x.2016.1154250] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 01/29/2016] [Accepted: 02/09/2016] [Indexed: 11/17/2022] Open
Abstract
Prior findings linking allergy and cancer have been inconsistent, which may be driven by diverse assessment methods. We used serum specific immunoglobulin E (IgE) against common inhalant allergens that was assessed prior to cancer diagnosis in studying this association. We selected 8,727 Swedish men and women who had measurements of serum allergen-specific IgE and total IgE between 1992 and 1996. Multivariable Cox regression using age as a timescale was performed to assess the associations of IgE sensitization, defined by any levels of serum specific IgE ≥35 kU/L, with risk of overall and specific cancers. A test for trend was performed by assigning scores derived from allergen-specific IgE levels at baseline as an ordinal scale. Kaplan-Meier curves and log-rank test were used to assess cancer survival by IgE sensitization status. During a mean follow-up of 16 year, 689 persons were diagnosed with cancer. We found an inverse association between IgE sensitization and cancer risk, with a hazard ratio (HR) of 0.83 and 95% confidence intervals (CI) of 0.70-0.99. A similar trend was seen with specific IgE scores overall (Ptrend = 0.007) and in women (Ptrend = 0.01). Although IgE sensitization was not associated with risk of common site-specific cancers, serum specific IgE scores were inversely associated with melanoma risk in men and women combined, and with risk of female breast and gynecological cancers combined. No association with survival was observed. The association between circulating IgE levels and incident cancer may point toward a role of T-helper 2 (TH2)-biased response in development of some cancers.
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Affiliation(s)
- Wahyu Wulaningsih
- Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK
- Division of Hematology/Oncology, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | - Lars Holmberg
- Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
- Regional Cancer Centre, Uppsala, Sweden
| | - Hans Garmo
- Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK
- St. John's Institute of Dermatology, Division of Genetics and Molecular Medicine, Faculty of Life Sciences and Medicine, King's College London, NIHR Biomedical Research Centre at Guy's and St. Thomas's Hospitals and King's College London, London, UK
| | - Sophia N. Karagiannis
- St. John's Institute of Dermatology, Division of Genetics and Molecular Medicine, Faculty of Life Sciences and Medicine, King's College London, NIHR Biomedical Research Centre at Guy's and St. Thomas's Hospitals and King's College London, London, UK
| | - Staffan Ahlstedt
- Center of Allergy Research, Institute of Environmental Medicine, Karolinska Insitutet, Stockholm, Sweden
| | - Håkan Malmstrom
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mats Lambe
- Regional Cancer Centre, Uppsala, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Hammar
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- AstraZeneca R&D, Mölndal, Sweden
| | - Göran Walldius
- Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ingmar Jungner
- Department of Medicine, Clinical Epidemiological Unit, Karolinska Institutet and CALAB Research, Stockholm, Sweden
| | - Tony Ng
- Richard Dimbleby Department of Cancer Research, Randall Division and Division of Cancer Studies, King's College London, London, UK
| | - Mieke Van Hemelrijck
- Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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