Evaluation of pro-inflammatory markers plasma C-reactive protein and urinary prostaglandin-E2 metabolite in colorectal adenoma risk.
C-reactive protein (CRP) is a pro-inflammatory protein with potential as a biomarker in predicting colon cancer risk. However, little is known regarding its association with risk of colorectal adenomas, particularly by subtypes. We conducted a colonoscopy-based matched case-control study to assess whether elevated plasma CRP levels may be associated with colorectal adenoma risk and further whether this association may be modified by urinary prostaglandin E2 metabolite (PGE-M), a biomarker of systemic prostaglandin E2 production. Included in the study were 226 cases with a single small tubular adenoma, 198 cases with multiple small tubular adenomas, 283 cases with at least one advanced adenoma, and 395 polyp-free controls. No apparent association between CRP level and risk of single small tubular adenomas was found (ptrend  = 0.59). A dose-response relationship with CRP level was observed for risk of either multiple small tubular adenomas (OR = 2.01, 95%CI = 1.10-3.68 for the highest versus lowest tertile comparison; ptrend   = 0.03) or advanced adenomas (OR = 1.81, 95%CI = 1.10-2.96 for the highest versus lowest tertile comparison; ptrend  = 0.02). In a joint analysis of CRP level and PGE-M, risk of multiple or advanced adenoma was greatest among those with highest levels of both CRP and PGE-M in comparison to those with low CRP and low PGE-M (OR = 3.72, 95%CI = 1.49-9.72). Our results suggest that elevated CRP, particularly in the context of concurrent elevated PGE-M, may be a biomarker of multiple or advanced adenoma risk in a screening age population. © 2015 Wiley Periodicals, Inc.
Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN, USA.|Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University School of Medicine, Nashville, TN, USA.
James R
JR
Davenport
Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN, USA.|Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
Qiuyin
Q
Cai
Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University School of Medicine, Nashville, TN, USA.|Gastroenterology Section, Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA.
Reid M
RM
Ness
Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN, USA.
Ginger
G
Milne
Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN, USA.|Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA.
Zhiguo
Z
Zhao
Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University School of Medicine, Nashville, TN, USA.|Gastroenterology Section, Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA.
Walter E
WE
Smalley
Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN, USA.|Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA.|Department of Veterans Affairs, Geriatric, Research, Education and Clinical Center (GRECC), Tennessee Valley Healthcare System, Nashville, TN, USA.
Wei
W
Zheng
Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN, USA.|Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA.|Department of Veterans Affairs, Geriatric, Research, Education and Clinical Center (GRECC), Tennessee Valley Healthcare System, Nashville, TN, USA.
Martha J
MJ
Shrubsole
D000236:Adenoma / Q000175:diagnosis* / Q000378:metabolism; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D015232:Dinoprostone / Q000652:urine*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors
D014408:Biomarkers, Tumor; D002097:C-Reactive Protein; D015232:Dinoprostone
C-reactive protein; biomarkers; colorectal adenoma risk; inflammation; prostaglandin-E2 Metabolite