Competing risk method has not been used in a large-scale prospective study to investigate whether increased levels of high-sensitivity C-reactive protein (hs-CRP) elevate the risk of primary liver cancer (PLC). Our study aims to prospectively investigate the relationship between hs-CRP and new-onset PLC. Ninety-five thousand seven hundred fifty-nine participants without the diagnosis of PLC, and who had their demographic characteristics and biochemical parameters recorded, were analyzed from the Kailuan Cohort study. Cox proportional hazards regression models and competing risk regression models were used to evaluate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of PLC. During a median follow-up of 11.07 years, 357 incidental PLC cases were identified over a total of 1,035,039 person-years. The multivariable HRs (95%CI) for the association of hs-CRP of 1–3 mg/L group and hs-CRP>3 mg/L with PLC were 1.07(0.82 ~ 1.38), 1.51(1.15 ~ 1.98) in a Cox proportional hazard regression analysis adjusted for other potential confounders. In the cause-specific hazard model, the multivariable HRs (95%CI) for the association of hs-CRP of 1–3 mg/L group and hs-CRP>3 mg/L with PLC were 1.06(0.81 ~ 1.40), 1.50(1.14 ~ 1.99). Similar results were also observed in the sub-distribution hazard function model with corresponding multivariate HRs (95%CI) of 1.05(0.80 ~ 1.40), 1.49(1.13 ~ 1.98) in hs-CRP of 1–3 mg/L group and hs-CRP>3 mg/L group, respectively. This prospective study found a significant association of higher levels of hs-CRP with new-onset PLC. The main clinical implications would be an increased awareness of hs-CRP and its correlation to the risk of PLC. This study should be a steppingstone to further research on chronic inflammation and PLC. Registration number: ChiCTR–TNRC–11001489 .

中文翻译：

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高敏C反应蛋白与原发性肝癌关系的前瞻性随访研究

竞争性风险方法尚未用于大规模的前瞻性研究中，以研究高水平的C反应蛋白（hs-CRP）水平升高是否会增加原发性肝癌（PLC）的风险。我们的研究旨在前瞻性地研究hs-CRP与新发PLC之间的关系。从开lu队列研究中分析了没有诊断为PLC，记录了其人口统计学特征和生化参数的9.559万名参与者。使用Cox比例风险回归模型和竞争风险回归模型来评估PLC的风险比（HR）和95％置信区间（95％CI）。在11.07年的中位数随访期间，在总共1,035,039人年中发现了357例PLC偶然病例。1-3 mg / L组hs-CRP与PLC结合hs-CRP> 3 mg / L的多变量HRs（95％CI）分别为1.07（0.82〜1.38），1.51（1.15〜1.98）。 Cox比例风险回归分析已针对其他潜在混杂因素进行了调整。在特定原因的危害模型中，1-3 mg / L组的hs-CRP与PLC的hs-CRP> 3 mg / L的关联的多变量HR（95％CI）为1.06（0.81〜1.40）， 1.50（1.14〜1.99）。在亚分布危险函数模型中也观察到类似的结果，在1-3 mg / L组的hs-CRP和hs中，相应的多元HR（95％CI）分别为1.05（0.80〜1.40），1.49（1.13〜1.98）。 -CRP> 3 mg / L组。这项前瞻性研究发现，高水平的hs-CRP与新发病的PLC之间存在显着关联。主要的临床意义是提高对hs-CRP及其与PLC风险的相关性的认识。这项研究应成为进一步研究慢性炎症和PLC的垫脚石。注册号：ChiCTR–TNRC–11001489。