Abstract
BackgroundNested 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.MethodsWe 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.ResultsWe 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.ConclusionsWe 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.
Highlights
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 addition to these biomarker studies, it is worth noting that chronic pancreatitis (CP), a progressive inflammatory process that results in the permanent damage of the organ structure, is associated with a 13.3-fold risk of pancreatic cancer and up to 33-fold risk in patients who suffer from both diabetes and CP [13, 14]
Few serum markers of chronic inflammation have been investigated in relation to CP and pancreatic cancer diagnosis (mainly C-reactive protein (CRP) and cytokines such as Interleukin-6 (IL-6) and Tumour Necrosis Factors (TNF-α)), partially because CP may elevate pancreatic enzymes instead [5, 15,16,17]
Summary
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. A small study at the Royal Infirmary of Edinburgh, including 42 pancreatic cancer patients and 12 controls, observed a statistically significant lower serum albumin levels in pancreatic cancer patients compared to controls [8]. In addition to these biomarker studies, it is worth noting that chronic pancreatitis (CP), a progressive inflammatory process that results in the permanent damage of the organ structure, is associated with a 13.3-fold risk of pancreatic cancer and up to 33-fold risk in patients who suffer from both diabetes and CP [13, 14]. Few serum markers of chronic inflammation have been investigated in relation to CP and pancreatic cancer diagnosis (mainly CRP and cytokines such as Interleukin-6 (IL-6) and Tumour Necrosis Factors (TNF-α)), partially because CP may elevate pancreatic enzymes instead [5, 15,16,17]
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