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. 2020 Nov 30;20(1):1168.
doi: 10.1186/s12885-020-07665-9.

A prospective follow-up study of the relationship between high-sensitivity C-reactive protein and primary liver cancer

Sarah Tan Siyin  1 , Tong Liu  1 , Wenqiang Li  1 , Nan Yao  1 , Guoshuai Xu  1 , Jun Qu  2 , Yajun Chen  3
Affiliations

A prospective follow-up study of the relationship between high-sensitivity C-reactive protein and primary liver cancer

Sarah Tan Siyin et al. BMC Cancer. .

Abstract

Background: Competing risk method has not been used in a large-scale prospective study to investigate whether increased levels of high-sensitivity C-reactive protein (hs-CRP) elevate the risk of primary liver cancer (PLC). Our study aims to prospectively investigate the relationship between hs-CRP and new-onset PLC.

Methods and results: Ninety-five thousand seven hundred fifty-nine participants without the diagnosis of PLC, and who had their demographic characteristics and biochemical parameters recorded, were analyzed from the Kailuan Cohort study. Cox proportional hazards regression models and competing risk regression models were used to evaluate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of PLC. During a median follow-up of 11.07 years, 357 incidental PLC cases were identified over a total of 1,035,039 person-years. The multivariable HRs (95%CI) for the association of hs-CRP of 1-3 mg/L group and hs-CRP>3 mg/L with PLC were 1.07(0.82 ~ 1.38), 1.51(1.15 ~ 1.98) in a Cox proportional hazard regression analysis adjusted for other potential confounders. In the cause-specific hazard model, the multivariable HRs (95%CI) for the association of hs-CRP of 1-3 mg/L group and hs-CRP>3 mg/L with PLC were 1.06(0.81 ~ 1.40), 1.50(1.14 ~ 1.99). Similar results were also observed in the sub-distribution hazard function model with corresponding multivariate HRs (95%CI) of 1.05(0.80 ~ 1.40), 1.49(1.13 ~ 1.98) in hs-CRP of 1-3 mg/L group and hs-CRP>3 mg/L group, respectively.

Conclusions: This prospective study found a significant association of higher levels of hs-CRP with new-onset PLC. The main clinical implications would be an increased awareness of hs-CRP and its correlation to the risk of PLC. This study should be a steppingstone to further research on chronic inflammation and PLC.

Trial registration: Registration number: ChiCTR-TNRC-11001489 .

Keywords: Cohort; Competing risk models; High-sensitivity C-reactive protein; Incidence; Primary liver cancer.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The procedure of participants screening
Fig. 2
Fig. 2
Cumulative incidence of PLC stratified by hs-CRP
Fig. 3
Fig. 3
Association between PLC and hs-CRP using RCS with 3 knots. Cubic spline graph of the adjusted HR (represented by solid line) and 95%CI (represented by the dotted lines)
See this image and copyright information in PMC

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