Woodson K, Tangrea J A, Barrett M J, Virtamo J, Taylor P R, Albanes D
Cancer Prevention Studies Branch, Division of Clinical Sciences, National Cancer Institute, Bethesda, MD, USA.
J Natl Cancer Inst. 1999 Oct 20;91(20):1738-43. doi: 10.1093/jnci/91.20.1738.
Higher blood levels of alpha-tocopherol, the predominant form of vitamin E, have been associated in some studies with a reduced risk of lung cancer, but other studies have yielded conflicting results. To clarify this association, we examined the relationship between prospectively collected serum alpha-tocopherol and lung cancer in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study cohort.
The ATBC Study was a randomized, clinical trial of 29 133 white male smokers from Finland who were 50-69 years old and who had received alpha-tocopherol (50 mg), beta-carotene (20 mg), both, or neither daily for 5-8 years. Data regarding medical histories, smoking, and dietary factors were obtained at study entry, as was a serum specimen for baseline alpha-tocopherol determination. alpha-Tocopherol measurements were available for 29 102 of the men, among whom 1144 incident cases of lung cancer were diagnosed during a median observation period of 7.7 years. The association between alpha-tocopherol and lung cancer was evaluated with the use of multivariate proportional hazards regression.
A 19% reduction in lung cancer incidence was observed in the highest versus lowest quintile of serum alpha-tocopherol (relative risk = 0.81; 95% confidence interval = 0. 67-0.97). There was a stronger inverse association among younger men (<60 years), among men with less cumulative tobacco exposure (<40 years of smoking), and possibly among men receiving alpha-tocopherol supplementation.
In the ATBC Study cohort, higher serum alpha-tocopherol status is associated with lower lung cancer risk; this relationship appears stronger among younger persons and among those with less cumulative smoke exposure. These findings suggest that high levels of alpha-tocopherol, if present during the early critical stages of tumorigenesis, may inhibit lung cancer development.
在一些研究中，血液中较高水平的α-生育酚（维生素E的主要形式）与肺癌风险降低有关，但其他研究得出了相互矛盾的结果。为了阐明这种关联，我们在α-生育酚、β-胡萝卜素癌症预防（ATBC）研究队列中，研究了前瞻性收集的血清α-生育酚与肺癌之间的关系。
ATBC研究是一项针对29133名来自芬兰的50 - 69岁白人男性吸烟者的随机临床试验，他们每天接受α-生育酚（50毫克）、β-胡萝卜素（20毫克）、两者或两者都不服用，持续5 - 8年。在研究开始时获取了有关病史、吸烟和饮食因素的数据，以及用于测定基线α-生育酚的血清样本。对29102名男性进行了α-生育酚测量，在中位观察期7.7年期间，其中有1144例肺癌确诊病例。使用多变量比例风险回归评估α-生育酚与肺癌之间的关联。
血清α-生育酚最高五分位数组与最低五分位数组相比，肺癌发病率降低了19%（相对风险 = 0.81；95%置信区间 = 0.67 - 0.97）。在较年轻男性（<60岁）、累积烟草暴露较少的男性（吸烟<40年）以及可能接受α-生育酚补充的男性中，存在更强的负相关。
在ATBC研究队列中，较高的血清α-生育酚水平与较低的肺癌风险相关；这种关系在较年轻人群和累积吸烟暴露较少的人群中似乎更强。这些发现表明，在肿瘤发生的早期关键阶段，如果存在高水平的α-生育酚，可能会抑制肺癌的发展。
