Systemic inflammation markers and cancer incidence in the UK Biobank

Abstract

Systemic inflammation markers have been linked to increased cancer risk and mortality in a number of studies. However, few studies have estimated pre-diagnostic associations of systemic inflammation markers and cancer risk. Such markers could serve as biomarkers of cancer risk and aid in earlier identification of the disease. This study estimated associations between pre-diagnostic systemic inflammation markers and cancer risk in the prospective UK Biobank cohort of approximately 440,000 participants recruited between 2006 and 2010. We assessed associations between four immune-related markers based on blood cell counts: systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and risk for 17 cancer sites by estimating hazard ratios (HR) using flexible parametric survival models. We observed positive associations with risk for seven out of 17 cancers with SII, NLR, PLR, and negative associations with LMR. The strongest associations were observed for SII for colorectal and lung cancer risk, with associations increasing in magnitude for cases diagnosed within one year of recruitment. For instance, the HR for colorectal cancer per standard deviation increment in SII was estimated at 1.09 (95% CI 1.02–1.16) in blood drawn five years prior to diagnosis and 1.50 (95% CI 1.24–1.80) in blood drawn one month prior to diagnosis. We observed associations between systemic inflammation markers and risk for several cancers. The increase in risk the last year prior to diagnosis may reflect a systemic immune response to an already present, yet clinically undetected cancer. Blood cell ratios could serve as biomarkers of cancer incidence risk with potential for early identification of disease in the last year prior to clinical diagnosis.

Systemic-Immune-Inflammation Index as a Promising Biomarker for Predicting Perioperative Ischemic Stroke in Older Patients Who Underwent Non-cardiac Surgery

“…Furthermore, preoperative chronic inflammation, characterized by the aberrant accumulation of inflammatory cells and inflammatory factors, increases postoperative cardiovascular complications and all-cause mortality ( Ettinger et al, 2015 ; Fragiadakis et al, 2015 ). Systemic inflammation levels can be evaluated and quantified using a variety of hematological markers routinely measured in the clinical settings or the indices calculated from these measurements ( Nøst et al, 2021 ). Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), and Glasgow prognostic score (GPS) are closely associated with postoperative outcomes in patients who undergo tumor resection ( Jomrich et al, 2021 ).…”

Bidirectional Interaction Between Cancer Cells and Platelets Provides Potential Strategies for Cancer Therapies

“…also suggested that platelet count was non-independent prognostic factors for overall survival in esophageal squamous cell carcinoma ( 38 ). Studies showed that a combination of platelet counts and other factors often has higher prediction value than a single index, such as platelet-to-lymphocyte ratio (PLR) ( 39 – 41 ) and hemoglobin/albumin/lymphocyte/platelet (HALP) levels ( 42 ). Aside from neutrophil–lymphocyte ratio (NLR) and lymphocyte–monocyte ratio (LMR), patients with high PLR were at higher risk of distant metastases and worse prognoses in renal cell cancer ( 43 ), cervical cancer ( 44 ), bladder cancer ( 45 ), colorectal adenocarcinoma ( 46 ), head and neck squamous cell carcinoma ( 47 ), and gastric cancer ( 48 ).…”

Assessment of Systemic Inflammation and Nutritional Indicators in Predicting Recurrence-Free Survival After Surgical Resection of Gastrointestinal Stromal Tumors

“…Systemic Immunoinflammatory Index (SII), as a composite index based on peripheral blood platelet, neutrophil, and lymphocyte counts, has been extensively studied and has proven to be a valid predictor of prognosis in various malignancies (20)(21)(22)(23). Nøst et al (24) found that compared with NLR, PLR, LMR, and other indicators, SII had the strongest association with the risk of colorectal cancer and lung cancer, and the degree of association increased in the cases diagnosed within one year after recruitment. Katayama et al (25) found that in bladder cancer, preoperative SII can identify non-muscle invasive bladder cancer patients who have worse disease and prognosis.…”