Prediagnostic Inflammation and Pancreatic Cancer Survival
Menée à partir de données portant sur 492 puis 1 153 patients ayant développé un cancer du pancréas, cette étude évalue l'association entre les niveaux plasmatiques de biomarqueurs de l'inflammation avant le diagnostic de la maladie et la survie des patients
Background : Chronic inflammation may promote initiation and progression of pancreatic cancer, but no studies have examined the association between inflammation in the period before diagnosis and pancreatic cancer survival.
Methods : We prospectively examined the association of prediagnostic plasma levels of C-reactive protein, interleukin-6, and tumor necrosis factor-
α receptor 2 with survival among 492 participants from 5 large US prospective cohort studies who developed pancreatic cancer. Using an empirical dietary inflammatory pattern (EDIP) score, we evaluated whether long-term proinflammatory diets were associated with survival among 1153 patients from 2 of the 5 cohorts. Cox proportional hazards regression was used to estimate hazard ratios for death with adjustment for potential confounders.
Results
:
Higher prediagnostic levels of C-reactive protein, interleukin-6, and tumor necrosis factor-α receptor 2 were individually associated with reduced survival (Ptrend = .03, .01, and .04, respectively). Compared to patients with a combined inflammatory biomarker score of 0 (all 3 markers levels below medians), those with a score of 3 (all 3 markers levels above medians) had a hazard ratio for death of 1.57 (95% confidence interval = 1.16 to 2.12; Ptrend = .003), corresponding to median overall survival times of 8 versus 5
months. Patients consuming the most proinflammatory diets (EDIP quartile 4) in the prediagnostic period had a hazard ratio for death of 1.34 (95% confidence interval = 1.13 to 1.59; Ptrend = .01), compared to those consuming the least proinflammatory diets (EDIP quartile 1).
Conclusion : Prediagnostic levels of inflammatory biomarkers and long-term proinflammatory diets were inversely associated with pancreatic cancer survival.
Journal of the National Cancer Institute , résumé, 2020