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Published in: BMC Oral Health 1/2023

Open Access 01-12-2023 | Oropharyngeal Cancer | Research

Causal association of serum biomarkers with oral cavity and oropharyngeal cancer: a mendelian randomization study

Authors: Weixing Liu, Yue Liu, Pei Li, Zhiyuan Wang, Jia Chen, Hui Liu, Jin Ye

Published in: BMC Oral Health | Issue 1/2023

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Abstract

Background

Observational epidemiological studies revealed that multiple serum biomarkers can be associated with the risk of oral and oropharyngeal cancer (OC/OPC). However, the causal relationship between them remains largely unknown. This study aimed to investigate the causal relationship between potential serum biomarkers and (OC/OPC).

Methods

A two-sample Mendelian randomization (MR) approach was performed to assess the causal association of 10 serum biomarkers with the risk of OC / OPC. Summary data on OC/OPC were obtained from a GWAS meta-analysis that included 2497 cases and 2928 controls. The TwoSampleMR package in R was used to perform MR analyzes. Inverse-variance weighted (IVW), Weighted median and MR-Egger methods were used to assess causal effects.

Results

Suggestive associations with increased risk of C-reactive protein (CRP) (OR 1.52, 95% CI 1.14 to 2.02), using the IVW method. MR-Egger regression suggested that directional pleiotropy was unlikely to bias the result (P = 0.19). The findings were robust to sensitivity analyzes. The risk of OC/OPC was not associated with serum 25-hydroxyvitamin D, HDL cholesterol, LDL cholesterol, total cholesterol, triglycerides, adiponectin, leptin, HbA1C and Insulin-like growth factor 1 (IGF 1).

Conclusions

This study supports that CRP was causally associated with an increased risk of oral and oropharyngeal cancer.
Literature
1.
go back to reference Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer statistics 2020: GLOBOCAN estimates of incidence and Mortality Worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–49.PubMedCrossRef Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer statistics 2020: GLOBOCAN estimates of incidence and Mortality Worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–49.PubMedCrossRef
2.
go back to reference Marur S, Forastiere AA. Head and Neck Squamous Cell Carcinoma: Update on Epidemiology, Diagnosis, and Treatment. Mayo Clin Proc. 2016;91:386–96. Marur S, Forastiere AA. Head and Neck Squamous Cell Carcinoma: Update on Epidemiology, Diagnosis, and Treatment. Mayo Clin Proc. 2016;91:386–96.
3.
go back to reference O’Sullivan B, Huang SH, Su J, Garden AS, Sturgis EM, Dahlstrom K, et al. Development and validation of a staging system for HPV-related oropharyngeal cancer by the International collaboration on oropharyngeal cancer network for staging (ICON-S): a multicentre cohort study. Lancet Oncol. 2016;17:440–51.PubMedCrossRef O’Sullivan B, Huang SH, Su J, Garden AS, Sturgis EM, Dahlstrom K, et al. Development and validation of a staging system for HPV-related oropharyngeal cancer by the International collaboration on oropharyngeal cancer network for staging (ICON-S): a multicentre cohort study. Lancet Oncol. 2016;17:440–51.PubMedCrossRef
4.
go back to reference Chan KKW, Glenny A-M, Weldon JC, Furness S, Worthington HV, Wakeford H. Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy. Cochrane Database Syst Rev. 2015;:CD010341. Chan KKW, Glenny A-M, Weldon JC, Furness S, Worthington HV, Wakeford H. Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy. Cochrane Database Syst Rev. 2015;:CD010341.
5.
6.
go back to reference Peres LC, Mallen AR, Townsend MK, Poole EM, Trabert B, Allen NE, et al. High levels of C-Reactive protein are Associated with an increased risk of Ovarian Cancer: results from the Ovarian Cancer Cohort Consortium. Cancer Res. 2019;79:5442–51.PubMedPubMedCentralCrossRef Peres LC, Mallen AR, Townsend MK, Poole EM, Trabert B, Allen NE, et al. High levels of C-Reactive protein are Associated with an increased risk of Ovarian Cancer: results from the Ovarian Cancer Cohort Consortium. Cancer Res. 2019;79:5442–51.PubMedPubMedCentralCrossRef
7.
go back to reference Park S, Miller BJ. Meta-analysis of cytokine and C-reactive protein levels in high-risk psychosis. Schizophr Res. 2020;226:5–12.PubMedCrossRef Park S, Miller BJ. Meta-analysis of cytokine and C-reactive protein levels in high-risk psychosis. Schizophr Res. 2020;226:5–12.PubMedCrossRef
8.
go back to reference Vankadara S, K P, Balmuri PK. Evaluation of serum C-Reactive protein levels in oral premalignancies and malignancies: a comparative study. J Dent (Tehran). 2018;15:358–64.PubMed Vankadara S, K P, Balmuri PK. Evaluation of serum C-Reactive protein levels in oral premalignancies and malignancies: a comparative study. J Dent (Tehran). 2018;15:358–64.PubMed
9.
go back to reference Johnson-Obaseki S, Caulley L, Corsten M, Liu G, Dimitroulakos J, Goldstein D, et al. C-reactive protein in HPV-Positive and HPV-Negative Oropharyngeal Cancer. Otolaryngol neck Surg off J Am Acad Otolaryngol Neck Surg. 2019;160:494–501.CrossRef Johnson-Obaseki S, Caulley L, Corsten M, Liu G, Dimitroulakos J, Goldstein D, et al. C-reactive protein in HPV-Positive and HPV-Negative Oropharyngeal Cancer. Otolaryngol neck Surg off J Am Acad Otolaryngol Neck Surg. 2019;160:494–501.CrossRef
10.
go back to reference Chawda JG, Jain SS, Patel HR, Chaduvula N, Patel K. The relationship between serum lipid levels and the risk of Oral cancer. Indian J Med Paediatr Oncol off J Indian Soc Med Paediatr Oncol. 2011;32:34–7.CrossRef Chawda JG, Jain SS, Patel HR, Chaduvula N, Patel K. The relationship between serum lipid levels and the risk of Oral cancer. Indian J Med Paediatr Oncol off J Indian Soc Med Paediatr Oncol. 2011;32:34–7.CrossRef
11.
go back to reference Guo X-H, Wang J-Y, Gao Y, Gao M, Yu G-Y, Xiang R-L, et al. Decreased adiponectin level is associated with aggressive phenotype of tongue squamous cell carcinoma. Cancer Sci. 2013;104:206–13.PubMedPubMedCentralCrossRef Guo X-H, Wang J-Y, Gao Y, Gao M, Yu G-Y, Xiang R-L, et al. Decreased adiponectin level is associated with aggressive phenotype of tongue squamous cell carcinoma. Cancer Sci. 2013;104:206–13.PubMedPubMedCentralCrossRef
12.
go back to reference Pagoni P, Dimou NL, Murphy N, Stergiakouli E. Using mendelian randomisation to assess causality in observational studies. Evid Based Ment Health. 2019;22:67–71.PubMedPubMedCentralCrossRef Pagoni P, Dimou NL, Murphy N, Stergiakouli E. Using mendelian randomisation to assess causality in observational studies. Evid Based Ment Health. 2019;22:67–71.PubMedPubMedCentralCrossRef
13.
go back to reference Burgess S, Butterworth A, Thompson SG. Mendelian randomization analysis with multiple genetic variants using summarized data. Genet Epidemiol. 2013;37:658–65.PubMedPubMedCentralCrossRef Burgess S, Butterworth A, Thompson SG. Mendelian randomization analysis with multiple genetic variants using summarized data. Genet Epidemiol. 2013;37:658–65.PubMedPubMedCentralCrossRef
14.
go back to reference Lesseur C, Diergaarde B, Olshan AF, Wünsch-Filho V, Ness AR, Liu G, et al. Genome-wide association analyses identify new susceptibility loci for oral cavity and pharyngeal cancer. Nat Genet. 2016;48:1544–50.PubMedPubMedCentralCrossRef Lesseur C, Diergaarde B, Olshan AF, Wünsch-Filho V, Ness AR, Liu G, et al. Genome-wide association analyses identify new susceptibility loci for oral cavity and pharyngeal cancer. Nat Genet. 2016;48:1544–50.PubMedPubMedCentralCrossRef
15.
16.
go back to reference Brion M-JA, Shakhbazov K, Visscher PM. Calculating statistical power in mendelian randomization studies. Int J Epidemiol. 2013;42:1497–501.PubMedCrossRef Brion M-JA, Shakhbazov K, Visscher PM. Calculating statistical power in mendelian randomization studies. Int J Epidemiol. 2013;42:1497–501.PubMedCrossRef
17.
go back to reference Ligthart S, Vaez A, Võsa U, Stathopoulou MG, de Vries PS, Prins BP, et al. Genome analyses of > 200,000 individuals identify 58 Loci for Chronic Inflammation and highlight pathways that Link inflammation and Complex disorders. Am J Hum Genet. 2018;103:691–706.PubMedPubMedCentralCrossRef Ligthart S, Vaez A, Võsa U, Stathopoulou MG, de Vries PS, Prins BP, et al. Genome analyses of > 200,000 individuals identify 58 Loci for Chronic Inflammation and highlight pathways that Link inflammation and Complex disorders. Am J Hum Genet. 2018;103:691–706.PubMedPubMedCentralCrossRef
18.
go back to reference Revez JA, Lin T, Qiao Z, Xue A, Holtz Y, Zhu Z, et al. Genome-wide association study identifies 143 loci associated with 25 hydroxyvitamin D concentration. Nat Commun. 2020;11:1647.PubMedPubMedCentralCrossRef Revez JA, Lin T, Qiao Z, Xue A, Holtz Y, Zhu Z, et al. Genome-wide association study identifies 143 loci associated with 25 hydroxyvitamin D concentration. Nat Commun. 2020;11:1647.PubMedPubMedCentralCrossRef
19.
go back to reference Willer CJ, Schmidt EM, Sengupta S, Peloso GM, Gustafsson S, Kanoni S, et al. Discovery and refinement of loci associated with lipid levels. Nat Genet. 2013;45:1274–83.PubMedPubMedCentralCrossRef Willer CJ, Schmidt EM, Sengupta S, Peloso GM, Gustafsson S, Kanoni S, et al. Discovery and refinement of loci associated with lipid levels. Nat Genet. 2013;45:1274–83.PubMedPubMedCentralCrossRef
20.
go back to reference Dastani Z, Hivert M-F, Timpson N, Perry JRB, Yuan X, Scott RA, et al. Novel loci for adiponectin levels and their influence on type 2 Diabetes and metabolic traits: a multi-ethnic meta-analysis of 45,891 individuals. PLoS Genet. 2012;8:e1002607.PubMedPubMedCentralCrossRef Dastani Z, Hivert M-F, Timpson N, Perry JRB, Yuan X, Scott RA, et al. Novel loci for adiponectin levels and their influence on type 2 Diabetes and metabolic traits: a multi-ethnic meta-analysis of 45,891 individuals. PLoS Genet. 2012;8:e1002607.PubMedPubMedCentralCrossRef
21.
go back to reference Yaghootkar H, Zhang Y, Spracklen CN, Karaderi T, Huang LO, Bradfield J, et al. Genetic studies of leptin concentrations implicate leptin in the regulation of early adiposity. Diabetes. 2020;69:2806–18.PubMedPubMedCentralCrossRef Yaghootkar H, Zhang Y, Spracklen CN, Karaderi T, Huang LO, Bradfield J, et al. Genetic studies of leptin concentrations implicate leptin in the regulation of early adiposity. Diabetes. 2020;69:2806–18.PubMedPubMedCentralCrossRef
22.
go back to reference Soranzo N, Sanna S, Wheeler E, Gieger C, Radke D, Dupuis J, et al. Common variants at 10 genomic loci influence hemoglobin A1(C) levels via glycemic and nonglycemic pathways. Diabetes. 2010;59:3229–39.PubMedPubMedCentralCrossRef Soranzo N, Sanna S, Wheeler E, Gieger C, Radke D, Dupuis J, et al. Common variants at 10 genomic loci influence hemoglobin A1(C) levels via glycemic and nonglycemic pathways. Diabetes. 2010;59:3229–39.PubMedPubMedCentralCrossRef
23.
go back to reference Larsson SC, Carter P, Vithayathil M, Kar S, Mason AM, Burgess S. Insulin-like growth factor-1 and site-specific cancers: a mendelian randomization study. Cancer Med. 2020;9:6836–42.PubMedPubMedCentralCrossRef Larsson SC, Carter P, Vithayathil M, Kar S, Mason AM, Burgess S. Insulin-like growth factor-1 and site-specific cancers: a mendelian randomization study. Cancer Med. 2020;9:6836–42.PubMedPubMedCentralCrossRef
24.
go back to reference Wang X, Dai JY, Albanes D, Arndt V, Berndt SI, Bézieau S, et al. Mendelian randomization analysis of C-reactive protein on Colorectal cancer risk. Int J Epidemiol. 2019;48:767–80.PubMedCrossRef Wang X, Dai JY, Albanes D, Arndt V, Berndt SI, Bézieau S, et al. Mendelian randomization analysis of C-reactive protein on Colorectal cancer risk. Int J Epidemiol. 2019;48:767–80.PubMedCrossRef
25.
go back to reference Robinson T, Martin RM, Yarmolinsky J. Mendelian randomisation analysis of circulating adipokines and C-reactive protein on Breast cancer risk. Int J cancer. 2020;147:1597–603.PubMedPubMedCentralCrossRef Robinson T, Martin RM, Yarmolinsky J. Mendelian randomisation analysis of circulating adipokines and C-reactive protein on Breast cancer risk. Int J cancer. 2020;147:1597–603.PubMedPubMedCentralCrossRef
26.
go back to reference Barahona Ponce C, Scherer D, Brinster R, Boekstegers F, Marcelain K, Gárate-Calderón V, et al. Gallstones, body Mass Index, C-Reactive protein, and Gallbladder Cancer: mendelian randomization analysis of Chilean and European Genotype Data. Hepatology. 2021;73:1783–96.PubMedCrossRef Barahona Ponce C, Scherer D, Brinster R, Boekstegers F, Marcelain K, Gárate-Calderón V, et al. Gallstones, body Mass Index, C-Reactive protein, and Gallbladder Cancer: mendelian randomization analysis of Chilean and European Genotype Data. Hepatology. 2021;73:1783–96.PubMedCrossRef
28.
go back to reference Colotta F, Allavena P, Sica A, Garlanda C, Mantovani A. Cancer-related inflammation, the seventh hallmark of cancer: links to genetic instability. Carcinogenesis. 2009;30:1073–81.PubMedCrossRef Colotta F, Allavena P, Sica A, Garlanda C, Mantovani A. Cancer-related inflammation, the seventh hallmark of cancer: links to genetic instability. Carcinogenesis. 2009;30:1073–81.PubMedCrossRef
32.
go back to reference Ghazi-Khanloosani M, Bandegi AR, Kokhaei P, Barati M, Pakdel A. CRP and LOX-1: a mechanism for increasing the tumorigenic potential of Colorectal Cancer Carcinoma Cell line. Pathol Oncol Res. 2019;25:1467–75.PubMedCrossRef Ghazi-Khanloosani M, Bandegi AR, Kokhaei P, Barati M, Pakdel A. CRP and LOX-1: a mechanism for increasing the tumorigenic potential of Colorectal Cancer Carcinoma Cell line. Pathol Oncol Res. 2019;25:1467–75.PubMedCrossRef
33.
go back to reference Guha N, Boffetta P, Wünsch Filho V, Eluf Neto J, Shangina O, Zaridze D, et al. Oral health and risk of squamous cell carcinoma of the head and neck and esophagus: results of two multicentric case-control studies. Am J Epidemiol. 2007;166:1159–73.PubMedCrossRef Guha N, Boffetta P, Wünsch Filho V, Eluf Neto J, Shangina O, Zaridze D, et al. Oral health and risk of squamous cell carcinoma of the head and neck and esophagus: results of two multicentric case-control studies. Am J Epidemiol. 2007;166:1159–73.PubMedCrossRef
34.
go back to reference Ahrens W, Pohlabeln H, Foraita R, Nelis M, Lagiou P, Lagiou A, et al. Oral health, dental care and mouthwash associated with upper aerodigestive tract cancer risk in Europe: the ARCAGE study. Oral Oncol. 2014;50:616–25.PubMedCrossRef Ahrens W, Pohlabeln H, Foraita R, Nelis M, Lagiou P, Lagiou A, et al. Oral health, dental care and mouthwash associated with upper aerodigestive tract cancer risk in Europe: the ARCAGE study. Oral Oncol. 2014;50:616–25.PubMedCrossRef
35.
go back to reference Huang S-F, Wei F-C, Liao C-T, Wang H-M, Lin C-Y, Lo S, et al. Risk stratification in oral cavity squamous cell carcinoma by preoperative CRP and SCC antigen levels. Ann Surg Oncol. 2012;19:3856–64.PubMedCrossRef Huang S-F, Wei F-C, Liao C-T, Wang H-M, Lin C-Y, Lo S, et al. Risk stratification in oral cavity squamous cell carcinoma by preoperative CRP and SCC antigen levels. Ann Surg Oncol. 2012;19:3856–64.PubMedCrossRef
36.
go back to reference Chen I-H, Liao C-T, Wang H-M, Huang J-J, Kang C-J, Huang S-F. Using SCC antigen and CRP levels as prognostic biomarkers in recurrent oral cavity squamous cell carcinoma. PLoS ONE. 2014;9:e103265.PubMedPubMedCentralCrossRef Chen I-H, Liao C-T, Wang H-M, Huang J-J, Kang C-J, Huang S-F. Using SCC antigen and CRP levels as prognostic biomarkers in recurrent oral cavity squamous cell carcinoma. PLoS ONE. 2014;9:e103265.PubMedPubMedCentralCrossRef
37.
go back to reference Ullah N, Ma F-R, Han J, Liu X-L, Fu Y, Liu Y-T, et al. Monomeric C-reactive protein regulates fibronectin mediated monocyte adhesion. Mol Immunol. 2020;117:122–30.PubMedCrossRef Ullah N, Ma F-R, Han J, Liu X-L, Fu Y, Liu Y-T, et al. Monomeric C-reactive protein regulates fibronectin mediated monocyte adhesion. Mol Immunol. 2020;117:122–30.PubMedCrossRef
38.
go back to reference Ramos G, de O, Bernardi L, Lauxen I, Sant’Ana Filho M, Horwitz AR, Lamers ML. Fibronectin modulates cell adhesion and signaling to promote single cell Migration of highly invasive oral squamous cell carcinoma. PLoS ONE. 2016;11:e0151338.PubMedPubMedCentralCrossRef Ramos G, de O, Bernardi L, Lauxen I, Sant’Ana Filho M, Horwitz AR, Lamers ML. Fibronectin modulates cell adhesion and signaling to promote single cell Migration of highly invasive oral squamous cell carcinoma. PLoS ONE. 2016;11:e0151338.PubMedPubMedCentralCrossRef
40.
go back to reference Le Q-T, Fisher R, Oliner KS, Young RJ, Cao H, Kong C, et al. Prognostic and predictive significance of plasma HGF and IL-8 in a phase III trial of chemoradiation with or without tirapazamine in locoregionally advanced Head and Neck cancer. Clin cancer Res an off J Am Assoc Cancer Res. 2012;18:1798–807.CrossRef Le Q-T, Fisher R, Oliner KS, Young RJ, Cao H, Kong C, et al. Prognostic and predictive significance of plasma HGF and IL-8 in a phase III trial of chemoradiation with or without tirapazamine in locoregionally advanced Head and Neck cancer. Clin cancer Res an off J Am Assoc Cancer Res. 2012;18:1798–807.CrossRef
41.
go back to reference de la Cour CD, Dehlendorff C, Aalborg GL, von Buchwald C, Friis S, Verdoodt F, et al. Use of nonaspirin nonsteroidal anti-inflammatory Drugs and risk of Head and Neck cancer: a nationwide case-control study. Int J cancer. 2020;146:2139–46.PubMedCrossRef de la Cour CD, Dehlendorff C, Aalborg GL, von Buchwald C, Friis S, Verdoodt F, et al. Use of nonaspirin nonsteroidal anti-inflammatory Drugs and risk of Head and Neck cancer: a nationwide case-control study. Int J cancer. 2020;146:2139–46.PubMedCrossRef
42.
go back to reference Yan Y, Guo T-M, Zhu C. Effects of nonsteroidal anti-inflammatory Drugs on serum proinflammatory cytokines in the treatment of ankylosing spondylitis. Biochem Cell Biol. 2018;96:450–6.PubMedCrossRef Yan Y, Guo T-M, Zhu C. Effects of nonsteroidal anti-inflammatory Drugs on serum proinflammatory cytokines in the treatment of ankylosing spondylitis. Biochem Cell Biol. 2018;96:450–6.PubMedCrossRef
43.
go back to reference Cinelli C, LaPierre N, Hill BL, Sankararaman S, Eskin E. Robust mendelian randomization in the presence of residual population stratification, batch effects and horizontal pleiotropy. Nat Commun. 2022;13:1093.PubMedPubMedCentralCrossRef Cinelli C, LaPierre N, Hill BL, Sankararaman S, Eskin E. Robust mendelian randomization in the presence of residual population stratification, batch effects and horizontal pleiotropy. Nat Commun. 2022;13:1093.PubMedPubMedCentralCrossRef
44.
go back to reference Zhu M, Ma Z, Zhang X, Hang D, Yin R, Feng J, et al. C-reactive protein and cancer risk: a pan-cancer study of prospective cohort and mendelian randomization analysis. BMC Med. 2022;20:301.PubMedPubMedCentralCrossRef Zhu M, Ma Z, Zhang X, Hang D, Yin R, Feng J, et al. C-reactive protein and cancer risk: a pan-cancer study of prospective cohort and mendelian randomization analysis. BMC Med. 2022;20:301.PubMedPubMedCentralCrossRef
45.
go back to reference Sadri Nahand J, Moghoofei M, Salmaninejad A, Bahmanpour Z, Karimzadeh M, Nasiri M, et al. Pathogenic role of exosomes and microRNAs in HPV-mediated inflammation and Cervical cancer: a review. Int J cancer. 2020;146:305–20.PubMedCrossRef Sadri Nahand J, Moghoofei M, Salmaninejad A, Bahmanpour Z, Karimzadeh M, Nasiri M, et al. Pathogenic role of exosomes and microRNAs in HPV-mediated inflammation and Cervical cancer: a review. Int J cancer. 2020;146:305–20.PubMedCrossRef
46.
go back to reference Liu X, Ma X, Lei Z, Feng H, Wang S, Cen X, et al. Chronic inflammation-related HPV: a Driving Force Speeds Oropharyngeal Carcinogenesis. PLoS ONE. 2015;10:e0133681.PubMedPubMedCentralCrossRef Liu X, Ma X, Lei Z, Feng H, Wang S, Cen X, et al. Chronic inflammation-related HPV: a Driving Force Speeds Oropharyngeal Carcinogenesis. PLoS ONE. 2015;10:e0133681.PubMedPubMedCentralCrossRef
47.
go back to reference Chi AC, Day TA, Neville BW. Oral cavity and oropharyngeal squamous cell carcinoma–an update. CA Cancer J Clin. 2015;65:401–21.PubMedCrossRef Chi AC, Day TA, Neville BW. Oral cavity and oropharyngeal squamous cell carcinoma–an update. CA Cancer J Clin. 2015;65:401–21.PubMedCrossRef
Metadata
Title
Causal association of serum biomarkers with oral cavity and oropharyngeal cancer: a mendelian randomization study
Authors
Weixing Liu
Yue Liu
Pei Li
Zhiyuan Wang
Jia Chen
Hui Liu
Jin Ye
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-03729-x

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