title: 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.
  
  
  CONCLUSIONS
  This prospective study suggests that inflammation markers, particularly CRP and IL6, may help identify persons at higher risk of progression to esophageal adenocarcinoma.
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. Department of Epidemiology, University of Washington, Seattle, Washington. shardika@fhcrc.org.
authors.forename: Sheetal
authors.initials: S
authors.lastname: Hardikar
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Lynn
authors.initials: L
authors.lastname: Onstad
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Song
authors.affiliation: Department of Pathology, University of Washington, Seattle, Washington.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Wilson
authors.affiliation: Department of Pathology, University of Washington, Seattle, Washington.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Montine
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. Department of Epidemiology, University of Washington, Seattle, Washington. Department of Medicine, University of Washington, Seattle, Washington.
authors.forename: Mario
authors.initials: M
authors.lastname: Kratz
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. Department of Biostatistics, University of Washington, Seattle, Washington.
authors.forename: Garnet L
authors.initials: GL
authors.lastname: Anderson
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. Department of Medicine, University of Washington, Seattle, Washington. Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Blount
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. Department of Medicine, University of Washington, Seattle, Washington. Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. Department of Genome Sciences, University of Washington, Seattle, Washington.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Reid
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. Department of Epidemiology, University of Washington, Seattle, Washington.
authors.forename: Emily
authors.initials: E
authors.lastname: White
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. Department of Epidemiology, University of Washington, Seattle, Washington.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Vaughan
mesh_terms: D000230:Adenocarcinoma / Q000276:immunology* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000276:immunology* / Q000473:pathology; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D007249:Inflammation; D015850:Interleukin-6 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D011446:Prospective Studies
chemical_list: D015850:Interleukin-6; D002097:C-Reactive Protein
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