Circulating C-reactive protein and colorectal cancer risk: a report from the Shanghai Men’s Health Study
Menée sur 288 patients atteints d'un cancer colorectal et sur 576 témoins, cette étude chinoise évalue l'association entre les niveaux plasmatiques de la protéine C réactive avant diagnostic et le risque de développer la maladie
Chronic inflammation has been implicated in the pathogenesis of colorectal cancer. The objective of this study was to evaluate the association of pre-diagnostic circulating levels of C-reactive protein (CRP), a biomarker of systemic inflammation, with subsequent development of colorectal cancer. Pre-diagnostic plasma CRP levels were examined among 288 colorectal cancer cases and 576 frequency-matched controls nested within the Shanghai Men’s Health Study (2002-2006), a population-based cohort study of 61 491 Chinese men. The association between CRP levels and colorectal cancer risk was investigated. Baseline plasma CRP levels were 53% higher among men who subsequently developed colorectal cancer than among those who remained free of the disease (1.15 µg/ml vs. 0.75 µg/ml; P<0.001). Multivariate analyses showed a dose-dependent relationship between CRP and colorectal cancer risk (P-trend=0.003); men in the highest tertile (CRP >1.19 µg/ml) had 1.88-fold (95%CI: 1.24-2.86) increased odds of developing colorectal cancer compared with men in the lowest tertile (CRP <0.45 µg/ml). The association was only significant for colon cancer, when cancer site was considered, and was predominantly seen for cases diagnosed within 4 years of blood collection; adjusted ORs for the highest vs. the lowest tertiles were 3.28 (95%CI: 1.28-8.37), 3.68 (95%CI: 1.62-8.38), and 1.05 (95%CI: 0.56-1.97), respectively for cases diagnosed <2, 2-4, and >4 years after blood collection. The findings from our study suggest that circulating CRP level is positively associated with colorectal cancer risk in Chinese men, and this association, at least in part, is explained by inflammation-related, cancerous, or precancerous processes.
Carcinogenesis , résumé, 2013