Voorrips L E, Goldbohm R A, Brants H A, van Poppel G A, Sturmans F, Hermus R J, van den Brandt P A
Department of Nutritional Epidemiology, TNO Nutrition and Food Research Institute, Zeist, The Netherlands.
Cancer Epidemiol Biomarkers Prev. 2000 Apr;9(4):357-65.
Many studies have reported inverse associations between vegetable and fruit consumption and lung cancer risk. The aim of the present study was to elucidate the role of several antioxidants and folate in this relationship. In the Netherlands Cohort Study on Diet and Cancer, 58,279 men of ages 55-69 years at baseline in 1986 returned a questionnaire including a 150-item food frequency questionnaire. After 6.3 years of follow-up, 939 male lung cancer cases were registered. A new Dutch carotenoid database was used to estimate intake of alpha-carotene, beta-carotene, lutein + zeaxanthin, beta-cryptoxanthin, and lycopene, completed with the antioxidant vitamins C and E and folate. Using case-cohort analysis, rate ratios were calculated, adjusted for age, smoking, educational level, and family history of lung cancer. Protective effects on lung cancer incidence were found for lutein + zeaxanthin, beta-cryptoxanthin, folate, and vitamin C. Other carotenoids (alpha-carotene, beta-carotene, and lycopene) and vitamin E did not show significant associations. After adjustment for vitamin C, only folate remained inversely associated, and after adjustment for folate, only beta-cryptoxanthin and vitamin C remained significantly associated. Inverse associations were strongest among current smokers and weaker for former smokers at baseline. Inverse associations with carotenes, lutein + zeaxanthin, and beta-cryptoxanthin seemed to be limited to small cell and squamous cell carcinomas. Only folate and vitamin C intake appeared to be inversely related to small cell and squamous cell carcinomas and adenocarcinomas. Folate, vitamin C, and beta-cryptoxanthin might be better protective agents against lung cancer in smokers than alpha-carotene, beta-carotene, lutein + zeaxanthin, and lycopene.
许多研究报告了蔬菜和水果摄入量与肺癌风险之间的负相关关系。本研究的目的是阐明几种抗氧化剂和叶酸在这种关系中的作用。在荷兰饮食与癌症队列研究中，1986年基线时年龄在55 - 69岁的58279名男性返回了一份问卷，其中包括一份150项的食物频率问卷。经过6.3年的随访，登记了939例男性肺癌病例。使用一个新的荷兰类胡萝卜素数据库来估计α-胡萝卜素、β-胡萝卜素、叶黄素+玉米黄质、β-隐黄质和番茄红素的摄入量，并补充抗氧化维生素C、E和叶酸。采用病例队列分析计算率比，并对年龄、吸烟、教育水平和肺癌家族史进行调整。发现叶黄素+玉米黄质、β-隐黄质、叶酸和维生素C对肺癌发病率有保护作用。其他类胡萝卜素（α-胡萝卜素、β-胡萝卜素和番茄红素）和维生素E未显示出显著关联。在调整维生素C后，只有叶酸仍呈负相关，在调整叶酸后，只有β-隐黄质和维生素C仍呈显著相关。目前吸烟者中的负相关最强，基线时既往吸烟者的负相关较弱。与胡萝卜素、叶黄素+玉米黄质和β-隐黄质的负相关似乎仅限于小细胞癌和鳞状细胞癌。只有叶酸和维生素C的摄入量似乎与小细胞癌、鳞状细胞癌和腺癌呈负相关。对于吸烟者，叶酸、维生素C和β-隐黄质可能比α-胡萝卜素、β-胡萝卜素、叶黄素+玉米黄质和番茄红素更能有效预防肺癌。
