Abstract：
Resistin is a protein involved in inflammation and angiogenesis processes and may play a role in the progression of colorectal cancer (CRC). However, it remains unclear whether resistin is associated with increased mortality after CRC diagnosis. We examined pre-diagnostic serum resistin concentrations in relation to CRC-specific and all-cause mortality among 1343 incident CRC cases from the European Prospective Investigation into Cancer and Nutrition cohort. For CRC-specific mortality as the primary outcome, hazard ratios (HRs) and 95% confidence intervals (95% CI) were estimated from competing risk analyses based on cause-specific Cox proportional hazards models and further in sensitivity analyses using Fine-Gray proportional subdistribution hazards models. For all-cause mortality as the secondary outcome, Cox proportional hazards models were used. Subgroup analyses were performed by sex, tumor subsite, tumor stage, body mass index and time to CRC diagnosis. Resistin was measured on a median of 4.8 years before CRC diagnosis. During a median follow-up of 8.2 years, 474 deaths from CRC and 147 deaths from other causes were observed. Resistin concentrations were not associated with CRC-specific mortality (HRQ4vsQ1 = 0.95, 95% CI: 0.73-1.23; Ptrend = .97; and HRper doubling of resistin concentration = 1.00; 95% CI: 0.84-1.19; P = .98) or all-cause mortality. Results from competing risk (sensitivity) analysis were similar. No associations were found in any subgroup analyses. These findings suggest no association between pre-diagnostic circulating resistin concentrations and CRC-specific or all-cause mortality among persons with CRC, and the potential insignificance of resistin in CRC progression.
摘要：
抵抗素是一种参与炎症和血管生成过程的蛋白质，可能在结直肠癌（CRC）的进展中起作用。然而,目前尚不清楚抵抗素是否与CRC诊断后死亡率增加相关.我们检查了来自欧洲癌症和营养前瞻性调查队列的1343例CRC事件中，诊断前血清抵抗素浓度与CRC特异性和全因死亡率的关系。对于CRC特异性死亡率作为主要结果，风险比(HR)和95%置信区间(95%CI)通过基于特定原因的Cox比例风险模型的竞争性风险分析,以及使用Fine-Gray比例子分布风险模型的敏感性分析进行了估算.对于作为次要结果的全因死亡率，使用Cox比例风险模型。亚组分析按性别进行，肿瘤亚位点，肿瘤分期,体重指数和CRC诊断时间。抵抗素在CRC诊断前的中位数为4.8年。在8.2年的中位随访期间，观察到474例CRC死亡和147例其他原因死亡。抵抗素浓度与CRC特异性死亡率(HRQ4vsQ1=0.95,95%CI:0.73-1.23;Ptrend=.97;抵抗素浓度每加倍的HR=1.00;95%CI:0.84-1.19;P=.98)或全因死亡率无关。竞争风险（敏感性）分析的结果相似。在任何亚组分析中均未发现关联。这些发现表明，在CRC患者中，诊断前循环抵抗素浓度与CRC特异性或全因死亡率之间没有关联。以及抵抗素在CRC进展中的潜在意义。
