Inflammation and oxidative stress markers and esophageal adenocarcinoma incidence in a Barrett's esophagus cohort.

Abstract

BACKGROUND:

Persons with Barrett's esophagus experience increased risk of esophageal adenocarcinoma. Prediagnostic inflammation markers predict several cancers, but their role in predicting esophageal adenocarcinoma is unknown.

METHODS:

We investigated whether biomarkers of inflammation [C-reactive protein (CRP), interleukin-6 (IL6), soluble tumor necrosis factor (sTNF) receptors I and II], and of oxidative stress (F2-isoprostanes) predicted progression to esophageal adenocarcinoma in a prospective cohort of 397 patients with Barrett's esophagus, 45 of whom developed esophageal adenocarcinoma. Biomarkers were measured in stored plasma samples from two time points during follow-up, the mean of which served as the primary predictor. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression.

RESULTS:

CRP level above the median was associated with an 80% increased risk of esophageal adenocarcinoma. The HR and 95% CI adjusted for age, gender, and further adjusted for waist-hip ratio and smoking were 1.98 (1.05-3.73) and 1.77 (0.93-3.37), respectively, with Ptrend for continuous CRP = 0.04. Persons with IL6 levels above the median also had almost 2-fold increased risk [HR and 95% CI adjusted for age and gender, and further adjusted for waist-hip ratio and smoking were 1.95 (1.03-3.72) and 1.79 (0.93-3.43), respectively, but no evidence of a trend was observed]. Concentrations of TNF receptors and F2-isoprostanes were not associated with esophageal adenocarcinoma risk.

CONCLUSIONS:

Further research is needed to evaluate the role of inflammation and associated markers in esophageal adenocarcinoma development in persons with Barrett's esophagus.

IMPACT:

This prospective study suggests that inflammation markers, particularly CRP and IL6, may help identify persons at higher risk of progression to esophageal adenocarcinoma.

• Authors: Sheetal Hardikar, Lynn Onstad, Xiaoling Song, Angela M Wilson, Thomas J Montine, Mario Kratz, Garnet L Anderson, Patricia L Blount, Brian J Reid, Emily White, Thomas L Vaughan
• Journal: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology (Cancer Epidemiol Biomarkers Prev) Vol. 23 Issue 11 Pg. 2393-403 (Nov 2014) ISSN: 1538-7755 [Electronic] United States
• PMID: 25106775 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: ©2014 American Association for Cancer Research.

Chemical References

• Interleukin-6
• C-Reactive Protein

Topics

• Adenocarcinoma (immunology, pathology)
• Adult
• Aged
• Aged, 80 and over
• Barrett Esophagus (immunology, pathology)
• C-Reactive Protein (metabolism)
• Cohort Studies
• Esophageal Neoplasms (immunology, pathology)
• Female
• Humans
• Incidence
• Inflammation
• Interleukin-6 (metabolism)
• Male
• Middle Aged
• Oxidative Stress
• Prospective Studies