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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 1/2009

01-03-2009 | Epidemiology

Correlates of circulating C-reactive protein and serum amyloid A concentrations in breast cancer survivors

Authors: Brandon L. Pierce, Marian L. Neuhouser, Mark H. Wener, Leslie Bernstein, Richard N. Baumgartner, Rachel Ballard-Barbash, Frank D. Gilliland, Kathy B. Baumgartner, Bess Sorensen, Anne McTiernan, Cornelia M. Ulrich

Published in: Breast Cancer Research and Treatment | Issue 1/2009

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Abstract

Introduction Inflammatory status may be an important prognostic factor for breast cancer. Correlates of markers of inflammation in breast cancer survivors have not been thoroughly evaluated. Methods Using data from, the Health, Eating, Activity, and Lifestyle (HEAL) Study (a population-based, multiethnic prospective cohort study of female breast cancer patients) we evaluated the associations between circulating markers of inflammation (C-reactive protein [CRP] and serum amyloid A [SAA], measured ∼31 months after diagnosis) and several demographic, lifestyle, and clinical characteristics in 741 disease-free breast cancer survivors. Analysis of variance and regression methods were used for statistical analyses of log-transformed values of CRP and SAA. Results After adjusting for age, BMI, ethnicity, and study site, higher concentrations of CRP were associated with increasing concentration of SAA (P-trend < 0.0001), increasing age (P-trend < 0.0001), increasing BMI (P-trend < 0.0001), increasing waist circumference (P-trend < 0.0001), positive history of heart failure (P = 0.0007), decreasing physical activity (P-trend = 0.005), Hispanic ethnicity (P = 0.05 vs. non-Hispanic white), and current smoking (P = 0.03 vs. never smoking). Vitamin E supplementation (P = 0.0005), tamoxifen use (P = 0.008), and radiation treatment (compared to no chemotherapy or radiation; P = 0.04) were associated with reduced CRP. Associations of CRP with clinical characteristics were not significant in the adjusted models. In a multivariate analysis, CRP showed significant associations with waist circumference, BMI, age, history of heart failure, tamoxifen use, and vitamin E supplementation (R2 = 0.35). Similar, yet fewer, associations were observed for SAA (R2 = 0.19). Conclusions This study highlights important correlates of inflammatory status in breast cancer patients. Our results are consistent with those from similar studies of healthy women.
Literature
1.
Kuller LH, Tracy RP, Shaten J et al (1996) Relation of C-reactive protein and coronary heart disease in the MRFIT nested case-control study. Multiple risk factor intervention trial. Am J Epidemiol 144(6):537–547PubMed
2.
3.
Thun MJ, Henley SJ, Patrono C (2002) Nonsteroidal anti-inflammatory drugs as anticancer agents: mechanistic, pharmacologic, and clinical issues. J Natl Cancer Inst 94(4):252–266PubMed
4.
Sandler RS, Halabi S, Baron JA et al (2003) A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer. New Engl J Med 348(10):883–890PubMedCrossRef
5.
Baron JA, Cole BF, Sandler RS et al (2003) A randomized trial of aspirin to prevent colorectal adenomas. New Engl J Med 348(10):891–899PubMedCrossRef
6.
Harris RE, Chlebowski RT, Jackson RD et al (2003) Breast cancer and nonsteroidal anti-inflammatory drugs: prospective results from the Women’s Health Initiative. Cancer Res 63(18):6096–6101PubMed
7.
Ulrich CM, Bigler J, Potter JD (2006) Non-steroidal anti-inflammatory drugs for cancer prevention: promise, perils, and pharmacogenetics. Nat Rev Cancer 6(2):130–140PubMedCrossRef
8.
Schultz DR, Arnold PI (1990) Properties of four acute phase proteins: C-reactive protein, serum amyloid A protein, alpha 1-acid glycoprotein, and fibrinogen. Semin Arthritis Rheum 20(3):129–147PubMedCrossRef
9.
Uhlar CM, Whitehead AS (1999) Serum amyloid A, the major vertebrate acute-phase reactant. Eur J Biochem 265(2):501–523PubMedCrossRef
10.
Manley PN, Ancsin JB, Kisilevsky R (2006) Rapid recycling of cholesterol: the joint biologic role of C-reactive protein and serum amyloid A. Med Hypotheses 66(4):784–792PubMedCrossRef
11.
McArdle PA, Mir K, Almushatat AS et al (2006) Systemic inflammatory response, prostate-specific antigen and survival in patients with metastatic prostate cancer. Urol Int 77(2):127–129PubMedCrossRef
12.
Crumley AB, McMillan DC, McKernan M et al (2006) An elevated C-reactive protein concentration, prior to surgery, predicts poor cancer-specific survival in patients undergoing resection for gastro-oesophageal cancer. Br J Cancer 94(11):1568–1571PubMed
13.
Wong VK, Malik HZ, Hamady ZZ et al (2007) C-reactive protein as a predictor of prognosis following curative resection for colorectal liver metastases. Br J Cancer 96(2):222–225PubMedCrossRef
14.
McMillan DC, Canna K, McArdle CS (2003) Systemic inflammatory response predicts survival following curative resection of colorectal cancer. Br J Surg 90(2):215–219PubMedCrossRef
15.
Scott HR, McMillan DC, Forrest LM et al (2002) The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer. Br J Cancer 87(3):264–267PubMedCrossRef
16.
Barber MD, Powell JJ, Lynch SF et al (1999) Two polymorphisms of the tumour necrosis factor gene do not influence survival in pancreatic cancer. Clin Exp Immunol 117(3):425–429PubMedCrossRef
17.
O’Hanlon DM, Lynch J, Cormican M et al (2002) The acute phase response in breast carcinoma. Anticancer Res 22(2B):1289–1293PubMed
18.
Blann AD, Byrne GJ, Baildam AD (2002) Increased soluble intercellular adhesion molecule-1, breast cancer and the acute phase response. Blood Coagul Fibrinolysis 13(2):165–168PubMedCrossRef
19.
Heikkila K, Ebrahim S, Rumley A et al (2007) Associations of circulating C-reactive protein and Interleukin-6 with survival in women with and without cancer: findings from the British women’s heart and health study. Cancer Epidemiol Biomarkers Prev 16(6):1155–1159PubMedCrossRef
20.
Hooning MJ, Botma A, Aleman BM et al (2007) Long-term risk of cardiovascular disease in 10-year survivors of breast cancer. J Natl Cancer Inst 99(5):365–375PubMedCrossRef
21.
Danesh J, Whincup P, Walker M et al (2000) Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses. BMJ 321(7255):199–204PubMedCrossRef
22.
Visser M, Bouter LM, McQuillan GM et al (1999) Elevated C-reactive protein levels in overweight and obese adults [see comments]. Jama 282(22):2131–2135PubMedCrossRef
23.
Geffken DF, Cushman M, Burke GL et al (2001) Association between physical activity and markers of inflammation in a healthy elderly population. Am J Epidemiol 153(3):242–250PubMedCrossRef
24.
Abramson JL, Vaccarino V (2002) Relationship between physical activity and inflammation among apparently healthy middle-aged and older US adults. Arch Intern Med 162(11):1286–1292PubMedCrossRef
25.
LaMonte MJ, Durstine JL, Yanowitz FG et al (2002) Cardiorespiratory fitness and C-reactive protein among a tri-ethnic sample of women. Circulation 106(4):403–406PubMedCrossRef
26.
Pitsavos C, Chrysohoou C, Panagiotakos DB et al (2003) Association of leisure-time physical activity on inflammation markers (C-reactive protein, white cell blood count, serum amyloid A, and fibrinogen) in healthy subjects (from the ATTICA study). Am J Cardiol 91(3):368–370PubMedCrossRef
27.
Mohamed-Ali V, Goodrick S, Rawesh A et al (1997) Subcutaneous adipose tissue releases interleukin-6, but not tumor necrosis factor-alpha, in vivo. J Clin Endocrinol Metab 82(12):4196–4200PubMedCrossRef
28.
Tchernof A, Nolan A, Sites CK et al (2002) Weight loss reduces C-reactive protein levels in obese postmenopausal women. Circulation 105(5):564–569PubMedCrossRef
29.
Smith JK, Dykes R, Douglas JE et al (1999) Long-term exercise and atherogenic activity of blood mononuclear cells in persons at risk of developing ischemic heart disease. JAMA 281(18):1722–1727PubMedCrossRef
30.
Gielen S, Adams V, Mobius-Winkler S et al (2003) Anti-inflammatory effects of exercise training in the skeletal muscle of patients with chronic heart failure.[comment]. J Am Coll Cardiol 42(5):861–868PubMedCrossRef
31.
Wener MH, Daum PR, McQuillan GM (2000) The influence of age, sex, and race on the upper reference limit of serum C-reactive protein concentration. J Rheumatol 27(10):2351–2359PubMed
32.
33.
Al Murri AM, Bartlett JM, Canney PA et al (2006) Evaluation of an inflammation-based prognostic score (GPS) in patients with metastatic breast cancer. Br J Cancer 94(2):227–230PubMedCrossRef
34.
Al Murri AM, Wilson C, Lannigan A et al (2007) Evaluation of the relationship between the systemic inflammatory response and cancer-specific survival in patients with primary operable breast cancer. Br J Cancer 96(6):891–895PubMedCrossRef
35.
McShane LM, Altman DG, Sauerbrei W et al (2006) REporting recommendations for tumor MARKer prognostic studies (REMARK). Breast Cancer Res Treat 100(2):229–235PubMedCrossRef
36.
Irwin ML, Crumley D, McTiernan A et al (2003) Physical activity levels before and after a diagnosis of breast carcinoma: the Health, Eating, Activity, and Lifestyle (HEAL) study. Cancer 97(7):1746–1757PubMedCrossRef
37.
Irwin ML, McTiernan A, Bernstein L et al (2004) Physical activity levels among breast cancer survivors. Med Sci Sports Exerc 36(9):1484–1491PubMed
38.
McTiernan A, Rajan KB, Tworoger SS et al (2003) Adiposity and sex hormones in postmenopausal breast cancer survivors. J Clin Oncol 21(10):1961–1966PubMedCrossRef
39.
Ledue TB, Weiner DL, Sipe JD et al (1998) Analytical evaluation of particle-enhanced immunonephelometric assays for C-reactive protein, serum amyloid A and mannose-binding protein in human serum. Ann Clin Biochem 35(Pt 6):745–753PubMed
40.
Khera A, McGuire DK, Murphy SA et al (2005) Race and gender differences in C-reactive protein levels. J Am Coll Cardiol 46(3):464–469PubMedCrossRef
41.
Yanbaeva DG, Dentener MA, Creutzberg EC et al (2007) Systemic effects of smoking. Chest 131(5):1557–1566PubMedCrossRef
42.
Fairey AS, Courneya KS, Field CJ et al (2005) Effect of exercise training on C-reactive protein in postmenopausal breast cancer survivors: a randomized controlled trial. Brain Behav Immun 19(5):381–388PubMedCrossRef
43.
Singh U, Jialal I (2004) Anti-inflammatory effects of alpha-tocopherol. Ann N Y Acad Sci 1031:195–203PubMedCrossRef
44.
Devaraj S, Jialal I (2000) Alpha tocopherol supplementation decreases serum C-reactive protein and monocyte interleukin-6 levels in normal volunteers and type 2 diabetic patients. Free Radic Biol Med 29(8):790–792PubMedCrossRef
45.
Upritchard JE, Sutherland WH, Mann JI (2000) Effect of supplementation with tomato juice, vitamin E, and vitamin C on LDL oxidation and products of inflammatory activity in type 2 diabetes. Diabetes Care 23(6):733–738PubMedCrossRef
46.
Murphy RT, Foley JB, Tome MT et al (2004) Vitamin E modulation of C-reactive protein in smokers with acute coronary syndromes. Free Radic Biol Med 36(8):959–965PubMedCrossRef
47.
Bonanni B, Johansson H, Gandini S et al (2003) Effect of tamoxifen at low doses on ultrasensitive C-reactive protein in healthy women. J Thromb Haemost 1(10):2149–2152PubMedCrossRef
48.
Cushman M, Costantino JP, Tracy RP et al (2001) Tamoxifen and cardiac risk factors in healthy women: suggestion of an anti-inflammatory effect. Arterioscler Thromb Vasc Biol 21(2):255–261PubMed
49.
Dietrich M, Jialal I (2005) The effect of weight loss on a stable biomarker of inflammation, C-reactive protein. Nutr Rev 63(1):22–28PubMedCrossRef
50.
Plaisance EP, Grandjean PW (2006) Physical activity and high-sensitivity C-reactive protein. Sports Med 36(5):443–458PubMedCrossRef
51.
Ryu SY, Kim CB, Nam CM et al (2001) Is body mass index the prognostic factor in breast cancer?: a meta-analysis. J Korean Med Sci 16(5):610–614PubMed
52.
Majed B, Moreau T, Senouci K et al (2007) Is obesity an independent prognosis factor in woman breast cancer? Breast Cancer Res Treat (Online publication ahead of print)
53.
La Guardia M, Giammanco M (2001) Breast cancer and obesity. Panminerva Med 43(2):123–133PubMed
54.
Kasapis C, Thompson PD (2005) The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. J Am Coll Cardiol 45(10):1563–1569PubMedCrossRef
55.
Abrahamson PE, Gammon MD, Lund MJ et al (2006) Recreational physical activity and survival among young women with breast cancer. Cancer 107(8):1777–1785PubMedCrossRef
56.
Holmes MD, Chen WY, Feskanich D et al (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293(20):2479–2486PubMedCrossRef
57.
Borugian MJ, Sheps SB, Kim-Sing C et al (2004) Insulin, macronutrient intake, and physical activity: are potential indicators of insulin resistance associated with mortality from breast cancer? Cancer Epidemiol Biomarkers Prev 13(7):1163–1172PubMed
58.
Enger SM, Bernstein L (2004) Exercise activity, body size and premenopausal breast cancer survival. Br J Cancer 90(11):2138–2141PubMed
59.
Rohan TE, Fu W, Hiller JE (1995) Physical activity and survival from breast cancer. Eur J Cancer Prev 4(5):419–424PubMedCrossRef
60.
Hoffman-Goetz L, Apter D, Demark-Wahnefried W et al (1998) Possible mechanisms mediating an association between physical activity and breast cancer. Cancer 83(3 Suppl):621–628PubMedCrossRef
61.
Licastro F, Candore G, Lio D et al (2005) Innate immunity and inflammation in ageing: a key for understanding age-related diseases. Immun Ageing 2:8PubMedCrossRef
62.
Yancik R, Wesley MN, Ries LA et al (2001) Effect of age and comorbidity in postmenopausal breast cancer patients aged 55 years and older. JAMA 285(7):885–892PubMedCrossRef
63.
Yankaskas BC (2005) Epidemiology of breast cancer in young women. Breast Dis 23:3–8PubMed
64.
Althuis MD, Brogan DD, Coates RJ et al (2003) Breast cancers among very young premenopausal women (United States). Cancer Causes Control 14(2):151–160PubMedCrossRef
65.
Yu GP, Ostroff JS, Zhang ZF et al (1997) Smoking history and cancer patient survival: a hospital cancer registry study. Cancer Detect Prev 21(6):497–509PubMed
66.
Manjer J, Andersson I, Berglund G et al (2000) Survival of women with breast cancer in relation to smoking. Eur J Surg 166(11):852–858PubMedCrossRef
67.
Holmes MD, Murin S, Chen WY et al (2007) Smoking and survival after breast cancer diagnosis. Int J Cancer 120(12):2672–2677PubMedCrossRef
68.
Ewertz M, Gillanders S, Meyer L et al (1991) Survival of breast cancer patients in relation to factors which affect the risk of developing breast cancer. Int J Cancer 49(4):526–530PubMedCrossRef
69.
Murin S, Pinkerton KE, Hubbard NE et al (2004) The effect of cigarette smoke exposure on pulmonary metastatic disease in a murine model of metastatic breast cancer. Chest 125(4):1467–1471PubMedCrossRef
70.
Early Breast Cancer Trialists’ Collaborative Group (1998) Tamoxifen for early breast cancer: an overview of the randomised trials. Lancet 351(9114):1451–1467CrossRef
71.
Decensi A, Robertson C, Viale G et al (2003) A randomized trial of low-dose tamoxifen on breast cancer proliferation and blood estrogenic biomarkers. J Natl Cancer Inst 95(11):779–790PubMedCrossRef
Metadata
Title
Correlates of circulating C-reactive protein and serum amyloid A concentrations in breast cancer survivors
Authors
Brandon L. Pierce
Marian L. Neuhouser
Mark H. Wener
Leslie Bernstein
Richard N. Baumgartner
Rachel Ballard-Barbash
Frank D. Gilliland
Kathy B. Baumgartner
Bess Sorensen
Anne McTiernan
Cornelia M. Ulrich
Publication date
01-03-2009
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2009
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-008-9985-5

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