基线高敏C-反应蛋白水平与男性吸烟人群肺癌发病风险队列研究

The relationship between high sensitivity C-reactive protein and the risk of lung cancer among smoking males in Kailuan group

目的探讨高敏C-反应蛋白(high sensitivity C-reactive protein,hs CRP)与男性吸烟人群肺癌发病的关联性。方法以参加2006年7月开滦集团体检的男性吸烟人群建立队列,收集基线调查资料和hs CRP实验室检测结果。通过每2年1次的体检和每年1次的目标人群健康状况相关信息数据库检索,收集肺癌发病和死亡等结局信息。采用多因素Cox比例风险回归模型分析男性吸烟人群基线hs CRP水平与肺癌发病风险,调整变量包括年龄、吸烟程度、饮酒、体质指数和糖尿病史情况。结果至2014年12月31日,纳入队列38 099人,随访期内共收集新发肺癌333例。hsCRP<1 mg/L组、hsCRP 1~3 mg/L组和hsCRP>3 mg/L组中新发肺癌8年累积发病率分别为727/10万、995/10万和1 344/10万,组间差异具有统计学意义(X^2=23.79,P<0.001)。调整年龄、吸烟程度、饮酒、体质指数和糖尿病史后,hsCRP 1~3 mg/L组和hsCRP>3 mg/L组患者肺癌发病风险分别是hsCRP<1 mg/L组的1.37倍和1.69倍,差异均有统计学意义(95%CI:1.06~1.77,P=0.017;95%CI:1.29~2.23,P<0.001)。结论基线hs CRP水平升高增加了男性吸烟人群肺癌发病风险。

Objective To investigate whether elevated levels of hsCRP （high sensitivity C-reactive protein）at baseline are associated with an increased risk of lung cancer among smoking males in Kailuan group.Methods 38 099 males from the Chinese Kailuan cohort were enrolled in the study in July 2006.All of the subjects were followed-up through Dec 31,2014.Levels of high-sensitivity CRP （hsCRP） were tested and demographic information and risk factor data were collected at baseline for all subjects.Multivariable Cox proportional hazards regression models were used to calculate hazard ratios （HR） and 95% confidence intervals （95% CI） for baseline levels of hsCRP after adjusting for age,smoking,drinking,BMI,and diabetes,and risk of lung cancer.Results By Dee 31,2014,a total of 333 incident lung cancer cases accrued.Three groups were divided according to the level of hsCRP （〈 1 mg/L,1-3 mg/L and 〉 3 mg/L）.The 8-year cumulative incidence of lung cancer were 727/100 000,995/100 000 and 1 344/100 000 in these 3 groups,respectively （x2 =23.79,P 〈0.001）.Compared to nales with lower hsCRP levels （〈 1 mg/L）,males with higher hsCRP （1-3 mg/L and 〉3 mg/L） levels had significant increased risks of lung cancer （HR =1.37,95% CI =1.06-1.77,P =0.017 and HR =1.69,95% CI =1.29-2.23,P 〈0.001 respectively） after adjusting for age,smoking,drinking,BMI and diabetes.Conclusions Elevated levels of hsCRP at baseline might increase the risk of lung cancer in smoking males.