Terry P, Lagergren J, Wolk A, Nyrén O
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Nutr Cancer. 2000;38(2):186-91. doi: 10.1207/S15327914NC382_7.
Gastroesophageal reflux (GER) is the strongest known risk factor for esophageal adenocarcinoma. For long-term sufferers with severe symptoms, the excess risk may exceed 40-fold. GER has also been shown to increase the risk of cancers of the gastric cardia more than fourfold. Several foods, including dietary fat, chocolate, mints, coffee, onions, citrus fruit, and tomatoes, have been associated with temporary symptoms of reflux, most likely through a relaxation of the lower esophageal sphincter (LES). Our aim was to determine whether these foods are associated with risk of adenocarcinoma of the esophagus or gastric cardia. We studied intakes of LES-relaxing foods and other dietary habits potentially associated with reflux in a nationwide population-based case-control study in Sweden, with 185 and 258 cases of esophageal adenocarcinoma and gastric cardia adenocarcinoma, respectively, and 815 controls. We found no association between LES-relaxing foods and symptoms of chronic reflux, although this might be due to avoidance of these foods among sufferers. In addition, we found no association between dietary factors known to cause LES relaxation and the risk of adenocarcinoma of the esophagus or gastric cardia. Our findings indicate that dietary factors associated with LES relaxation and transient GER (but perhaps not severe chronic reflux) are not associated with any important risk of esophageal malignancy.
胃食管反流（GER）是已知的食管腺癌最强风险因素。对于有严重症状的长期患者，额外风险可能超过40倍。GER还被证明会使贲门癌风险增加四倍多。包括膳食脂肪、巧克力、薄荷、咖啡、洋葱、柑橘类水果和西红柿在内的几种食物，已被证实与反流的暂时症状有关，很可能是通过降低食管下括约肌（LES）张力来实现的。我们的目的是确定这些食物是否与食管腺癌或贲门癌风险有关。我们在瑞典一项基于全国人口的病例对照研究中，研究了摄入降低LES张力的食物以及其他可能与反流相关的饮食习惯，该研究分别有185例食管腺癌和258例贲门腺癌病例以及815名对照。我们发现降低LES张力的食物与慢性反流症状之间没有关联，尽管这可能是由于患者避免食用这些食物所致。此外，我们发现已知会导致LES松弛的饮食因素与食管腺癌或贲门腺癌风险之间没有关联。我们的研究结果表明，与LES松弛和短暂性GER（但可能与严重慢性反流无关）相关的饮食因素与食管恶性肿瘤的任何重要风险均无关联。
