Objective: To investigate whether elevated levels of high sensitivity C-Reactive Protein (hsCRP) and neutrophil (NE) at baseline are associated with an increased risk of colorectal cancer in Kailuan male cohort. Methods: Since May 2006, males from Kailuan cohort were included in this study. Information on demographics, medical history, anthropometry, hsCRP and NE were collectedat baseline for all subjects. Multivariable Cox proportional hazards regression models were used to calculate hazard ratios (HR) of association between baseline hsCRP and NE and colorectal cancer risk. Results: By December 31, 2015, a total of 73 869 participants were enrolled in this study. During the follow-up, 336 incident colorectal cancer cases were identified. All participants were divided into three groups according to the level of hsCRP (<1 mg/L, 1-3 mg/L and >3 mg/L). The cumulative incidence of colorectal cancer were 456/10(5,) 510/10(5) and 746/10(5) in these 3 groups, respectively (χ(2)=10.79, P=0.005). Compared with participants with lower hsCRP levels (<1 mg/L), individuals with the highest hsCRP (>3 mg/L) levels had significant increased risks of colorectal cancer (HR=1.38, 95%CI: 1.05-1.81, P=0.020)after adjusting for age, gender, smoking, drinking, BMI, diabetes and income. Furthermore, subjects were divided into two groups according to the level of NE (≤ 4.08×10(9)/L and > 4.08×10(9)/L). Multivariable Cox proportional hazards regression models indicated that there is no statistical significance of association between NE and colorectal cancer. Conclusions: Elevated levels of hsCRP at baseline might increase the risk of colorectal cancer in males.
目的： 在大型前瞻性队列研究基础上，探讨高敏C－反应蛋白(hsCRP)和中性粒细胞(NE)与大肠癌发病风险的关联性。 方法： 利用2006—2007年开滦男性队列，收集社会人口学、疾病史、身体测量指标和hsCRP及NE检测结果等基线信息。采用多因素Cox比例风险回归模型分析基线hsCRP水平及NE水平与男性人群大肠癌发病风险比(HR)。 结果： 至2015年12月31日，共计纳入73 869例男性，随访期间共收集新发大肠癌336例。依hsCRP检测水平，将研究对象分为三组：<1 mg/L、1～3 mg/L和>3 mg/L组。三组中新发大肠癌9年累积发病率分别为456/10万、510/10万和746/10万，经Log－rank检验，差异有统计学意义(χ(2)＝10.79，P＝0.005)。调整年龄、吸烟、饮酒、体质指数(BMI)、糖尿病史和人均收入后，结果显示，hsCRP水平最高组(>3 mg/L)大肠癌发病风险是hsCRP水平最低组(<1 mg/L)的1.38倍(95%CI: 1.05～1.81, P＝0.020)。依NE检测平均水平，将其分为二组(≤4.08×10(9)/L和> 4.08×10(9)/L)，多因素Cox比例风险回归模型显示，NE水平较高组(>4.08×10(9)/L)大肠癌发病风险是NE水平较低组(≤4.08×10(9)/L)的1.11倍(95%CI: 0.90～1.39, P＝0.331)，但差异无统计学意义。 结论： 基线hsCRP水平升高可能增加男性大肠癌发病风险。.
Keywords: C-reactive protein; Cohort studies; Colorectal neoplasms; Neutrophils.