Circulating Biomarkers of Inflammation and Ovarian Cancer Risk in the Nurses' Health Studies

Cancer Epidemiol Biomarkers Prev. 2021 Apr;30(4):710-718. doi: 10.1158/1055-9965.EPI-20-1390. Epub 2021 Feb 9.


Background: Chronic inflammation is a well-established mechanism of ovarian carcinogenesis; however, the specific immunogenic processes influencing ovarian tumor development remain unclear. In a case-control study nested within the Nurses' Health Study (NHS) and the NHSII, we examined the association between six inflammatory chemokines and cytokines [B-cell activating factor (BAFF), C-X-C motif chemokine ligand 13 (CXCL13), IL8, soluble(s)IL2-receptor-α(Rα), sIL6Rα] and epithelial ovarian cancer risk.

Methods: Among 299 epithelial ovarian cancer cases and 334 matched controls, six inflammatory biomarkers were measured in plasma collected 1-24 years before diagnosis or index date using two custom multiplex Luminex panels. ORs and 95% confidence intervals (CI) were estimated for the association between each biomarker and risk using multivariable conditional logistic regression with adjustment for relevant confounders. We additionally assessed heterogeneity in the risk associations by histotype [high-grade serous carcinoma (HGSC) vs. non-HGSC], body mass index, smoking status, menopausal status, and aspirin use.

Results: Women with the highest versus lowest quartile (Q) levels of CXCL13 had a 72% increased ovarian cancer risk (OR = 1.72; 95% CI = 1.04-2.83; P trend = 0.007). The positive association with CXCL13 was stronger in magnitude for non-HGSC, overweight or obese women, and postmenopausal women, although only menopausal status demonstrated statistically significant heterogeneity (P interaction = 0.04). The remaining biomarkers were not associated with risk.

Conclusions: This first evidence that prediagnostic CXCL13, a B-cell chemoattractant, is associated with an increased risk of epithelial ovarian cancer expands current understanding of the role of inflammation in ovarian carcinogenesis.

Impact: CXCL13 may represent a novel biomarker for ovarian cancer.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Biomarkers, Tumor / blood*
  • Carcinoma, Ovarian Epithelial / blood*
  • Case-Control Studies
  • Chemokine CXCL13 / blood*
  • Chemokines / blood
  • Cytokines / blood
  • Female
  • Humans
  • Inflammation / blood*
  • Middle Aged
  • Nurses
  • Ovarian Neoplasms / blood*


  • Biomarkers, Tumor
  • Chemokine CXCL13
  • Chemokines
  • Cytokines