ASPO Abstracts
Associations between post-treatment inflammatory biomarkers and survival among stage II-III colorectal cancer patients
Category: Molecular Epidemiology & Environment
Conference Year: 2020
Abstract Body:
Purpose: We aimed to evaluate post-treatment inflammatory biomarkers, namely C-reactive protein (CRP),
interleukin-6 (IL6), monocytes chemoattractant protein-1 (MCP1), leptin and adiponectin, in relation to overall
survival (OS) in stage II-III colorectal cancer (CRC) patients.
Methods: Participants were incident, invasive CRC cases who were 22-74 years of age, diagnosed between 1997-
2008 from the population-based Seattle Colon Cancer Family Registry. We included stage II-III cases who were at
the greatest risk for disease progression. Further restriction to 308 participants with a blood draw 1-3 years after
diagnosis was made to preclude acute treatment effects. We measured concentrations of all five markers in
EDTA-plasma samples using the Meso Scale Discovery immunoassays. Biomarker levels were log-transformed to
ensure normality. We also divided patients into sex-specific quartiles for each marker to test for a dose-effect of a
biomarker on disease progression. Mortality and cause of death were assessed through linkage to the National
Death Index. We used Cox proportional hazard regression to estimate hazard ratios (HR) and 95% confidence
intervals (CI) for associations of post-treatment inflammatory markers with OS. HRs were adjusted for potential
confounders selected a priori, including age at blood draw, sex, body mass index, plasma storage time, the time
between diagnosis and blood draw, and stage at diagnosis.
Results: Elevated CRP levels were associated with poorer OS (HR=1.32 per unit increase of log-CRP, 95%
CI=1.13-1.55). For circulating IL6, a dose-response relationship with survival was evident: compared with the
lowest quartile of IL6, the 2nd, 3rd and 4th quartiles were significantly associated with OS, with HRs (95% CIs) of
2.72 (1.42-5.21), 4.23 (2.24-7.99), and 6.80 (3.56-12.96) respectively (p for trend<0.0001). For MCP1, we
observed a 2-fold increase in the risk of overall mortality per unit increase in log-MCP1 (HR=2.17, 95% CI=1.39-
3.39). Circulating levels of leptin and adiponectin were not significantly associated with OS.
Conclusions: Circulating inflammatory markers, specifically CRP, IL6, and MCP1, are prognostic markers in stage
II/III CRC patients and should be considered for incorporation into studies of CRC outcomes.
Keywords: Inflammatory biomarkers, colorectal cancer survival