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. 2021 Sep 4;113(9):1186-1193.
doi: 10.1093/jnci/djab040.

Prediagnostic Inflammation and Pancreatic Cancer Survival

Chen Yuan  1 , Vicente Morales-Oyarvide  1 , Natalia Khalaf  2 , Kimberly Perez  1 , Fred K Tabung  3   4   5 , Gloria Y F Ho  6 , Charles Kooperberg  7 , Aladdin H Shadyab  8 , Lihong Qi  9 , Peter Kraft  10   11 , Howard D Sesso  10   12   13 , Edward L Giovannucci  5   10   13 , JoAnn E Manson  10   12 , Meir J Stampfer  5   10   13 , Kimmie Ng  1 , Charles S Fuchs  14 , Brian M Wolpin  1 , Ana Babic  1
Affiliations

Prediagnostic Inflammation and Pancreatic Cancer Survival

Chen Yuan et al. J Natl Cancer Inst. .

Abstract

Background: Chronic inflammation may promote initiation and progression of pancreatic cancer, but no studies have examined the association between inflammation in the period before diagnosis and pancreatic cancer survival.

Methods: We prospectively examined the association of prediagnostic plasma levels of C-reactive protein, interleukin-6, and tumor necrosis factor-α receptor 2 with survival among 492 participants from 5 large US prospective cohort studies who developed pancreatic cancer. Using an empirical dietary inflammatory pattern (EDIP) score, we evaluated whether long-term proinflammatory diets were associated with survival among 1153 patients from 2 of the 5 cohorts. Cox proportional hazards regression was used to estimate hazard ratios for death with adjustment for potential confounders. All statistical tests were 2-sided.

Results: Higher prediagnostic levels of C-reactive protein, interleukin-6, and tumor necrosis factor-α receptor 2 were individually associated with reduced survival (Ptrend = .03, .01, and .04, respectively). Compared with patients with a combined inflammatory biomarker score of 0 (all 3 marker levels below medians), those with a score of 3 (all 3 marker levels above medians) had a hazard ratio for death of 1.57 (95% confidence interval = 1.16 to 2.12; Ptrend = .003), corresponding to median overall survival times of 8 vs 5 months. Patients consuming the most proinflammatory diets (EDIP quartile 4) in the prediagnostic period had a hazard ratio for death of 1.34 (95% confidence interval = 1.13 to 1.59; Ptrend = .01), compared with those consuming the least proinflammatory diets (EDIP quartile 1).

Conclusion: Prediagnostic levels of inflammatory biomarkers and long-term proinflammatory diets were inversely associated with pancreatic cancer survival.

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