De Stefani Eduardo, Boffetta Paolo, Fagundes Renato B, Deneo-Pellegrini Hugo, Ronco Alvaro L, Acosta Giselle, Mendilaharsu María
Grupo de Epidemiología, Departamento de Anatomía Patológica, Hospital de Clínicas, Facultad de Medicina, Montevideo, Uruguay.
Anticancer Res. 2008 Jul-Aug;28(4C):2499-506.
Squamous cell carcinoma of the esophagus is a common disease, with an age-standardized incidence rate of 55 cases per 100,000 persons in the northern counties of Uruguay. These rates are comparable to those observed in Iran and China.
In order to contribute to the clarification of the etiology of this lethal disease, a case-control study which included 234 cases and 936 controls, frequency matched for age, sex and residence, was conducted. Factor analysis (principal components) was conducted on the controls and three factors were retained, high-fat, carbohydrates and antioxidants. These nutrient patterns were submitted to multiple logistic unconditional regression in order to estimate the odds ratios of esophageal cancer.
The nutrient patterns (labeled as high-fat, carbohydrates and antioxidants) were significantly associated with the risk of esophageal squamous cell cancer. Whereas the high-fat and carbohydrates patterns were directly associated with an increased risk of esophageal cancer, the antioxidants pattern was strongly protective (OR 0.39, 95% CI 0.23-0.66).
In squamous cell carcinoma of the esophagus an antioxidant dietary pattern is protective, probably due to its action against oxidative stress while high-fat and carbohydrates patterns are associated with an increased risk which may be due to the meat and sodium content, respectively.
食管鳞状细胞癌是一种常见疾病,在乌拉圭北部各县,其年龄标准化发病率为每10万人中有55例。这些发病率与在伊朗和中国观察到的发病率相当。
为了有助于阐明这种致命疾病的病因,开展了一项病例对照研究,该研究纳入了234例病例和936例对照,按照年龄、性别和居住地进行频率匹配。对对照进行了因子分析(主成分分析),保留了三个因子,即高脂肪、碳水化合物和抗氧化剂。将这些营养模式纳入多重非条件逻辑回归,以估计食管癌的比值比。
营养模式(标记为高脂肪、碳水化合物和抗氧化剂)与食管鳞状细胞癌风险显著相关。高脂肪和碳水化合物模式与食管癌风险增加直接相关,而抗氧化剂模式具有很强的保护作用(比值比0.39,95%置信区间0.23 - 0.66)。
在食管鳞状细胞癌中,抗氧化剂饮食模式具有保护作用,可能是由于其对抗氧化应激的作用,而高脂肪和碳水化合物模式与风险增加相关,这可能分别归因于肉类和钠的含量。