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Epidemiology

Eosinophilia in routine blood samples as a biomarker for solid tumor development – A study based on The Copenhagen Primary Care Differential Count (CopDiff) Database

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Pages 1245-1250 | Received 19 Jan 2014, Accepted 21 Jan 2014, Published online: 10 Mar 2014
 

Abstract

Background. Eosinophilia may represent an early paraclinical sign of malignant disease and a host anti-tumor effect. The association between eosinophilia and the development of solid tumors has never before been examined in an epidemiological setting. The aim of the present study was to investigate eosinophilia in routine blood samples as a potential biomarker of solid tumor development in a prospective design.

Material and methods. From the Copenhagen Primary Care Differential Count (CopDiff) Database, we identified 356 196 individuals with at least one differential cell count (DIFF) encompassing the eosinophil count during 2000–2007. From these, one DIFF was randomly chosen and categorized according to no (< 0.5 × 109/l), mild (≥ 0.5–1.0 × 109/l) or severe (≥ 1.0 × 109/l) eosinophilia. From the Danish Civil Registration System and the Danish Cancer Registry we ascertained all-cause death and solid tumors within the first three years following the DIFF. Using multivariable logistic regression, odds ratios (OR) were calculated and adjusted for previous eosinophilia, sex, age, year, month, C-reactive protein, previous cancer and Charlson's Comorbidity Index.

Results. The risk of bladder cancer was increased with mild eosinophilia [OR 1.93 (CI 1.29–2.89), p = 0.0013]. No associations with eosinophilia were observed for the remaining solid cancers.

Conclusion. We demonstrate that eosinophilia in routine blood samples associates with an increased risk of bladder cancer. Our data emphasize that additional preclinical studies are needed in order to shed further light on the role of eosinophils in carcinogenesis, where it is still unknown whether the cells contribute to tumor immune surveillance or neoplastic evolution.

Acknowledgments

Christen Lykkegaard Andersen wishes to thank The Danish Cancer Society, which has granted a three-year scholarship (2010–2013). The authors would also like to express their gratitude to Eva & Henry Frænkels’ memorial foundation and Axel Muusfeldts memorial foundation for financial support and to Willy Karlslund, The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark for skillful technical assistance. None of the sponsors have had any role in the study design, in the collection, analysis and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication. Christen Lykkegaard Andersen co-designed the study, collected, analyzed and interpreted data and drafted the manuscript. Volkert Siersma performed the statistical analyses. Hans Carl Hasselbalch, Hanne Lindegaard, Hanne Vestergaard, Volkert Siersma and Peter Felding analyzed and interpreted data. Niels de Fine Olivarius and Ole Weis Bjerrum co-designed the study, collected, analyzed and interpreted data. All authors revised the manuscript critically for important intellectual content, and approved the version to be submitted.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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