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J Clin Pathol. 2014 Jun;67(6):482-90. doi: 10.1136/jclinpath-2013-202148. Epub 2014 Feb 11.

Comprehensive analysis of clinico-pathological data reveals heterogeneous relations between atherosclerosis and cancer.

Author information

1
Institute of Pathology, Charité University Hospital, Berlin, Germany.
2
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
3
Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.
4
Institute of Legal Medicine, University Hospital Münster, Münster, Germany.

Abstract

AIMS:

Atherosclerosis and cancer share common risk factors and involve similar molecular pathomechanisms. Most clinical and epidemiological studies show a positive correlation between atherosclerosis and smoking-related cancers and heterogeneous results for non-smoking-related cancers. However, up-to-date large-scale autopsy studies including a detailed analysis of cancer types are lacking. Therefore, we sought to investigate the relation between major cancer types and the grade of atherosclerosis in a recent well-powered autopsy cohort.

METHODS:

In 2101 patients, both autopsy data and clinical data including demographics, disease groups, tumour type, cause of death and grade of atherosclerosis were reviewed and statistically analysed.

RESULTS:

We found cancer in general is associated with less atherosclerosis (OR 0.60, p<0.0001). In particular, haematological neoplasm and sarcomas were associated with much less atherosclerosis (OR=0.45, p<0.0001 and OR=0.43, p=0.087), while carcinomas were associated with moderately less atherosclerosis (OR=0.72, p=0.002). Furthermore, non-smoking-related cancers were associated with much less atherosclerosis (OR=0.41, p<0.0001), while possibly smoking-related cancer and smoking-related cancer showed no significant association. In a comprehensive analysis of 21 cancer types, biliary tract cancer, lymphomas/lymphoid leukaemias and kidney cancer were associated with much less atherosclerosis (OR=0.19, p<0.0001; OR=0.41, p<0.0001; and OR=0.48, p=0.029). In an exploratory analysis of treatment strategies, we found that tumours with a recommendation of oxazaphosphorines and pyrimidine antagonist treatment were significantly associated with less atherosclerosis (OR=0.33, p=0.0068 and OR=0.58, p=0.012).

CONCLUSIONS:

In conclusion, the study showed an inverse association between cancer and atherosclerosis postmortem that depends on the cancer type and suggests a possible impact of chemotherapy regimens.

KEYWORDS:

ARTERIES; CANCER; CANCER RESEARCH

PMID:
24519989
DOI:
10.1136/jclinpath-2013-202148
[Indexed for MEDLINE]
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