Abnet Christian C, Qiao You-Lin, Dawsey Sanford M, Buckman Dennis W, Yang Chung S, Blot William J, Dong Zhi-Wei, Taylor Philip R, Mark Steven D
Cancer Prevention Studies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892-7058, USA.
Cancer Causes Control. 2003 Sep;14(7):645-55. doi: 10.1023/a:1025619608851.
This study examined the relationship between pretrial serum concentrations of retinol, beta-carotene, beta-cryptoxanthin, and lutein/zeaxanthin and the subsequent risk of developing esophageal squamous cell carcinoma and gastric cardia or non-cardia adenocarcinoma in subjects selected from a randomized nutritional intervention trial in Linxian, China, a region with epidemic rates of esophageal and gastric cardia cancer.
We used a stratified case-cohort design to select cohort members for inclusion in this study. In all we measured serum concentrations of the above vitamins in 590 esophageal, 395 gastric cardia, and 87 gastric non-cardia case subjects as well as in 1053 control subjects. Relative risks (RRs) were estimated using Cox proportional hazards models.
Median values in our cohort were low for serum retinol (33.6 microg/dl), beta-carotene (4.3 microg/dl), and beta-cryptoxanthin (3.5 microg/dl), but were high for lutein/zeaxanthin (40.0 microg/dl). Gastric cardia cancer incidence fell 10% for each quartile increase in serum retinol (RR = 0.90, 95% CI = 0.83-0.99). For esophageal cancer, an inverse association with retinol levels was found only in male non-smokers (RR = 0.79 per quartile increase, 95% CI = 0.63-0.99). For gastric non-cardia cancer, an inverse association was limited to subjects 50 years old or younger (RR = 0.58 per quartile, 95% CI = 0.31-0.96). For beta-cryptoxanthin there was a borderline significant protective association for gastric non-cardia cancer (RR = 0.88 per quartile, 95% CI = 0.76-1.0). In contrast, we found the incidence of gastric non-cardia cancer increased (RR = 1.2 per quartile, 95% CI = 1.0-1.3) with increasing concentration of serum lutein/zeaxanthin.
In this population, we found that low retinol and high lutein/zeaxanthin concentrations increased the risks of gastric cardia and gastric non-cardia cancer respectively. We found that there were no strong associations between any of the other analytes and any of the cancer sites.
本研究在中国食管癌和贲门癌高发地区林县开展的一项随机营养干预试验中，探讨了视黄醇、β-胡萝卜素、β-隐黄质和叶黄素/玉米黄质的血清浓度与随后发生食管鳞状细胞癌、贲门腺癌或非贲门腺癌风险之间的关系。
我们采用分层病例队列设计来选择纳入本研究的队列成员。我们共检测了590例食管癌、395例贲门癌和87例非贲门癌病例以及1053例对照对象的上述维生素血清浓度。使用Cox比例风险模型估计相对风险（RR）。
我们队列中血清视黄醇（33.6微克/分升）、β-胡萝卜素（4.3微克/分升）和β-隐黄质（3.5微克/分升）的中位数较低，但叶黄素/玉米黄质（40.0微克/分升）的中位数较高。血清视黄醇每增加一个四分位数，贲门癌发病率下降10%（RR = 0.90，95%CI = 0.83 - 0.99）。对于食管癌，仅在男性非吸烟者中发现视黄醇水平与之呈负相关（每增加一个四分位数RR = 0.79，95%CI = 0.63 - 0.99）。对于非贲门癌，负相关仅限于50岁及以下的受试者（每四分位数RR = 0.58，95%CI = 0.31 - 0.96）。对于β-隐黄质，其对非贲门癌有临界显著的保护作用（每四分位数RR = 0.88，95%CI = 0.76 - 1.0）。相反，我们发现血清叶黄素/玉米黄质浓度升高时，非贲门癌发病率增加（每四分位数RR = 1.2，95%CI = 1.0 - 1.3）。
在该人群中，我们发现低视黄醇浓度和高叶黄素/玉米黄质浓度分别增加了贲门癌和非贲门癌的风险。我们发现其他任何分析物与任何癌症部位之间均无强关联。
