1. Associations of C-Reactive Protein, Granulocytes and Granulocyte-to-Lymphocyte Ratio with Mortality from Breast Cancer in Non-Institutionalized American Women
- Author
-
Wulaningsih, Wahyu, Holmberg, Lars, Abeler-Doner, Lucie, Ng, Tony, Rohrmann, Sabine, Van Hemelrijck, Mieke, and University of Zurich
- Subjects
Physiology ,Neutrophils ,Immune Cells ,Inflammatory Diseases ,Immunology ,lcsh:Medicine ,610 Medicine & health ,1100 General Agricultural and Biological Sciences ,Cardiovascular Medicine ,Pathology and Laboratory Medicine ,Body Mass Index ,White Blood Cells ,Signs and Symptoms ,Diagnostic Medicine ,Animal Cells ,1300 General Biochemistry, Genetics and Molecular Biology ,Breast Tumors ,Breast Cancer ,Medicine and Health Sciences ,Obesity ,skin and connective tissue diseases ,lcsh:Science ,Immune Response ,Inflammation ,1000 Multidisciplinary ,Cancer och onkologi ,Blood Cells ,Body Weight ,lcsh:R ,Biology and Life Sciences ,Cancers and Neoplasms ,Cell Biology ,10060 Epidemiology, Biostatistics and Prevention Institute (EBPI) ,Physiological Parameters ,Oncology ,Cardiovascular Diseases ,Cancer and Oncology ,lcsh:Q ,Cellular Types ,Research Article ,Granulocytes - Abstract
Inflammation may play a role in breast cancer, but evidence in the general population is lacking. We investigated the association between serum inflammatory markers (C-reactive protein (CRP), absolute granulocyte count (AGC) and granulocyte-to-lymphocyte (G/L) ratio) and breast cancer (BCa) mortality in American women while accounting for adiposity. From the Third National Health and Nutrition Examination Survey (NHANES III) we selected all women aged 20+ without any known history of cancer (n = 7,780). Multivariable Cox regression models were used to assess CRP, AGC and G/L ratio in relation to mortality from BCa, all cancer, cardiovascular disease and all causes. Stratification analyses by body mass index (BMI) and waist circumference were performed to investigate the effect of adiposity on this association. During a mean follow-up of 167 months, 44 women died from BCa. After adjustments for BMI and waist circumference, only G/L ratio was associated to risk of BCa death (e.g. HR: 2.35, 95% CI: 1.36-4.06 for the 3rd compared to the 1st tertile, P-trend = 0.01). Except for a borderline interaction between CRP categories and obesity by BMI, no statistically significant interaction between markers and categories of BMI or waist circumference was observed. All three markers were associated with mortality from cardiovascular disease and all causes. Our findings support a role of inflammation in BCa mortality which may involve mechanisms apart from obesity, and potential usefulness of GLR as a marker in assessing inflammation and cancer.
- Published
- 2016