The tumor necrosis factor in blood could be a possible biomarker for colorectal cancer, it has been found. Those with higher baseline levels of the TNF benefited by taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). Hence the discovery could help in deciding on aspirin treatment for the problem.
In a paper in the March issue of Gastroenterology, investigators from Massachusetts General Hospital (MGH) and Dana-Farber Cancer Institute report their research.
Andrew Chan, MD, MPH, of the MGH Gastrointestinal Unit, the lead author, says, "The findings show that chronic inflammatory pathways are quite complex and further studies are needed to understand which facets of the inflammatory response are most associated with the development of colorectal cancer."
The current study analyzed data from NHS participants who had provided a blood sample in 1989 or 1990 and were cancer-free at that time. After identifying 280 participants who developed colorectal cancer during the subsequent 14 years and 555 age-matched controls who did not, the research team analyzed their baseline levels of three inflammatory factors C-reactive protein (CRP), interleukin-6 (IL-6) and soluble tumor necrosis factor receptor-2 (sTNFR-2). Although no association was seen between levels of CRP or IL-6 and risk of developing colorectal cancer, participants with the highest levels of sTNFR-2 had a 60 percent greater risk than did those with the lowest levels of the factor. In addition, the reduced risk of developing colorectal tumors associated with regularly taking aspirin or NSAIDs was primarily seen among participants with high baseline sTNFR-2 levels.
"Our results suggest that, even though chronic inflammation may increase colorectal cancer risk, not all blood markers of inflammation are markers of that risk," says Chan. "The most common blood biomarkers of inflammation CRP and IL-6 do not appear to be relevant, while sTNFR-2 does. A better understanding of the significance of these markers will help us identify individuals most likely to benefit from chemoprevention using aspirin or NSAIDs."
Charles Fuchs, MD, MPH, of Dana-Farber, the study's senior author adds, "Understanding the specific inflammatory pathways that influence risk for colorectal cancer will be critical. While there is widespread agreement that inflammation is broadly related to cancer risk, some pathways may be protective while others are detrimental. More clearly defining the relevant pathways should help us better tailor therapies and interventions that will reduce cancer risk."