La Vecchia Carlo
Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea 62, 20157 Milan, Italy.
Exp Biol Med (Maywood). 2002 Nov;227(10):860-3. doi: 10.1177/153537020222701004.
Tomato consumption showed a consistent inverse relation with the risk of digestive tract neoplasms in Italy in an integrated series of studies conducted in the 1980s. Another series of case-control studies was conducted between 1992 and 1999 in different areas of Italy. Cases were patients below age 80 with incident, histologically confirmed cancer of the oral cavity and pharynx (n = 754), esophagus (n = 304), colorectum (n = 1953), breast (n = 2529), and ovary (n = 1031). The comparison group involved, overall, over 5000 patients below age 80 with acute, non-neoplastic, nonhormone-related diseases, unrelated to long-term diet modifications and admitted to the same network of hospitals. Information was collected in hospital by trained interviewers using a validated food frequency questionnaire, including 78 foods or groups of foods, various alcoholic beverage, and fat-intake pattern. The multivariate relative risk (RR) of oral, pharyngeal, and esophageal cancer decreased across subsequent levels of lycopene intake to reach 0.7 (95% confidence interval [CI] 0.4-1.0) for oral and pharyngeal, and 0.7 (95% CI 0.4-1.1) for esophageal cancer in the highest quintile of intake. Both trends in risk were of borderline statistical significance. With reference to colorectal, breast, and ovarian cancer, although no consistent association was observed for lycopene (RR = 1.0 for colorectal, 1.2 for breast, and 1.1 for ovary in the highest quintile), tomato intake was inversely and significantly related with colorectal cancer (RR = 0.8). The inverse relation between lycopene and upper digestive tract neoplasms was not explained by alcohol or tobacco, sociodemographic factors, or total energy intake. The interpretation of such an inverse relation, however, remains open to discussion because it may be related to an effect of lycopene due to its antioxidant effect and/or a potential role of lycopene in decreasing insulin growth factor I, which is a promoter in the process of carcinogenesis.
在20世纪80年代开展的一系列综合研究中，意大利的番茄食用量与消化道肿瘤风险呈现出持续的负相关关系。1992年至1999年间，在意大利不同地区又进行了另一系列病例对照研究。病例为80岁以下患有口腔和咽癌（n = 754）、食管癌（n = 304）、结直肠癌（n = 1953）、乳腺癌（n = 2529）和卵巢癌（n = 1031）的新发、经组织学确诊的患者。对照组总体上包括5000多名80岁以下患有急性、非肿瘤性、非激素相关疾病的患者，这些疾病与长期饮食改变无关，且入住同一医院网络。由经过培训的访谈员在医院使用经过验证的食物频率问卷收集信息，该问卷包括78种食物或食物组、各种酒精饮料以及脂肪摄入模式。口腔、咽和食管癌的多变量相对风险（RR）随着番茄红素摄入量的后续水平降低，在摄入量最高的五分位数中，口腔和咽癌的RR达到0.7（95%置信区间[CI] 0.4 - 1.0），食管癌的RR达到0.7（95% CI 0.4 - 1.1）。两种风险趋势均具有临界统计学意义。关于结直肠癌、乳腺癌和卵巢癌，尽管未观察到番茄红素的一致关联（摄入量最高的五分位数中，结直肠癌的RR = 1.0，乳腺癌的RR = 1.2，卵巢癌的RR = 1.1），但番茄摄入量与结直肠癌呈显著负相关（RR = 0.8）。番茄红素与上消化道肿瘤之间的负相关关系不能用酒精、烟草、社会人口统计学因素或总能量摄入来解释。然而，这种负相关关系的解释仍有待讨论，因为它可能与番茄红素的抗氧化作用以及/或者番茄红素在降低胰岛素生长因子I方面的潜在作用有关，胰岛素生长因子I是致癌过程中的一个促进因子。
