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目的探讨高敏C反应蛋白(hs-CRP)对子宫内膜癌(EC)发病的影响。方法采用前瞻性队列研究方法,于2006年1月-2007年12月在邯郸市285医院参加健康体检的女性作为研究对象,符合入选标准的19 941例组成观察队列。根据hs-CRP水平,将观察对象(按中位数分组)分为高hs-CRP组(9 965例)和低hs-CRP组(9 976例)。观察人群通过定期电话、短信等方式询问新发恶性肿瘤情况,同时利用邯郸市医保系统信息记录查找因恶性肿瘤住院情况,通过上述2种方式收集新发的EC病例。采用多因素Cox比例风险回归模型分析基线hs-CRP和EC发病风险的关系。结果 1在19 941例研究对象中,低hs-CRP组9 976例,高hs-CRP组9 965例。高hs-CRP组的年龄、BMI、WC、SBP、DBP、FBG、TG水平均明显高于低hs-CRP组(均P<0.05);高hs-CRP组的单身、吸烟所占比例均明显高于低hs-CRP组(均P<0.05)。2在随访(6.99±0.42)年内,高hs-CRP组发生EC33例,累积发病率为2019/10万,低hs-CRP组发生EC12例,累积发病率为561/10万(Log-Rank检验:χ~2=7.65,P=0.006)。3校正年龄、体重指数(BMI)、婚姻、吸烟、饮酒和代谢综合征(MS)其他组分后,多因素Cox比例风险回归模型分析显示,高hs-CRP组发生EC的风险是低hs-CRP组的2.01(95%CI:1.02~3.98)倍。结论基线hs-CRP水平可能与EC发病风险有关。
Objective To investigate the effect of high-sensitivity C-reactive protein (hs-CRP) on the pathogenesis of endometrial carcinoma (EC). Methods A prospective cohort study was conducted. From January 2006 to December 2007, women enrolled in health check-ups in 285 hospitals in Handan City were enrolled in this study. A total of 19 941 observation cohorts were enrolled in the study. Subjects were divided into median hs-CRP (9 965) and low hs-CRP (9 976) groups based on hs-CRP levels. The observers asked for new cases of malignant tumors through regular phone calls, text messages, etc. Meanwhile, they used the information of Handan City Medicare System to find the hospitalization of malignant tumors and collected the newly-emerged EC cases through the above two methods. The relationship between baseline hs-CRP and the risk of EC was analyzed by multivariate Cox proportional hazards regression model. Results 1 Among 19 941 subjects, 9 976 were in low hs-CRP group and 9 965 in high hs-CRP group. The levels of BMI, WC, SBP, DBP, FBG and TG in high hs-CRP group were significantly higher than those in low hs-CRP group (all P <0.05) Higher than low hs-CRP group (all P <0.05). 2 In follow-up (6.99 ± 0.42) years, EC33 cases were found in high-hs-CRP group and the cumulative incidence was 2019/10 million. There were EC12 cases in low hs-CRP group with cumulative incidence of 561/100000 (Log-Rank test : χ ~ 2 = 7.65, P = 0.006). 3 After adjusting for age, body mass index (BMI), marital status, smoking, drinking and other components of metabolic syndrome (MS), multivariate Cox proportional hazards regression analysis showed that the risk of EC in high hs-CRP group was low hs- The CRP group 2.01 (95% CI: 1.02 ~ 3.98) times. Conclusion The baseline hs-CRP level may be related to the risk of EC.