Roy P, Owen R W, Faivre J, Scheppach W, Saldanha M H, Beckly D E, Boutron M C
Registre des Cancers Digestifs (INSERM CRI 9505), Faculte de Medecine, Dijon, France.
Eur J Cancer Prev. 1999 Oct;8(5):409-15. doi: 10.1097/00008469-199910000-00006.
It is unclear whether neutral steroids and bile acids are involved in large bowel carcinogenesis. This study was conducted to compare the concentration of these faecal constituents at the different stages of the adenoma-carcinoma sequence. Neutral sterols and free bile acid concentrations were determined from stool samples collected form patients with large bowel cancer (n = 47), large adenoma > or = 1 cm (n = 42), small adenoma (n = 24), and controls (n = 104). The distribution of tertiles between cases and controls was analysed using odds ratio (OR), with 95% confidence interval (CI), comparing (two-sided tests) the second tertile (OR2) and the third tertile (OR3) to the first one. Persistence of primary bile acids appeared as a protective factor against cancer: (OR = 0.09, 95% CI 0.02-0.54). High values of cholesterol were associated with cancer risk (OR2 = 5.8, 95% CI 1.3-26.6; OR3 6.4, 95% CI 1.3-31.4). High values of cholesterol were more frequently observed in patients with large adenomas than in controls (OR2 = 8.5, 95% CI 1.9-37.5; OR3 = 4.3, 95% CI 0.9-20.9). Neutral sterols, cholesterol especially, may play a role in adenoma growth and adenoma transformation into carcinoma. Persistence of primary bile acids may afford protection.
目前尚不清楚中性类固醇和胆汁酸是否与大肠癌的发生有关。本研究旨在比较腺瘤 - 癌序列不同阶段这些粪便成分的浓度。从大肠癌患者（n = 47）、直径≥1 cm的大腺瘤患者（n = 42）、小腺瘤患者（n = 24）和对照组（n = 104）收集的粪便样本中测定中性固醇和游离胆汁酸浓度。使用比值比（OR）及95%置信区间（CI）分析病例组和对照组三分位数的分布情况，将第二三分位数（OR2）和第三三分位数（OR3）与第一三分位数进行比较（双侧检验）。原发性胆汁酸的持续存在似乎是预防癌症的一个保护因素：（OR = 0.09，95% CI 0.02 - 0.54）。高胆固醇值与癌症风险相关（OR2 = 5.8，95% CI 1.3 - 26.6；OR3 = 6.4，95% CI 1.3 - 31.4）。大腺瘤患者中高胆固醇值的出现频率高于对照组（OR2 = 8.5，95% CI 1.9 - 37.5；OR3 = 4.3，95% CI 0.9 - 20.9）。中性固醇，尤其是胆固醇，可能在腺瘤生长及腺瘤向癌的转变中起作用。原发性胆汁酸的持续存在可能具有保护作用。
