Potischman N, Brinton L A, Laiming V A, Reeves W C, Brenes M M, Herrero R, Tenorio F, de Britton R C, Gaitan E
Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland 20892.
Cancer Res. 1991 Sep 15;51(18):4785-9.
Although small intervention trials have suggested that folate supplementation reduces cervical dysplasia, the association of blood folate concentrations with invasive cervical cancer risk has not been investigated in well-controlled epidemiological studies. A study was conducted with newly diagnosed Stage I and II invasive cervical cancer cases and controls in 4 Latin American countries. Ninety-five% of subjects donated blood samples, resulting in 330 case and 565 control serum samples analyzed for folate concentrations by radioassay. Cases did not differ significantly from controls in mean levels of folate (5.00 and 4.90 ng/ml, respectively). No associations were observed between quartiles of serum folate and risk of cervical cancer after adjustment for other risk factors, and no interactions with established risk factors were observed. Folate levels were also unrelated to risk among women who might have compromised folate status because of recent or extended oral contraceptive usage or multiple pregnancies. Further, mean levels of folate were similar by stage of disease, arguing against an effect of disease progression on serum values. These results do not support a role for serum folate in the etiology of invasive cervical cancer.
尽管小型干预试验表明补充叶酸可降低宫颈发育异常的发生率，但在严格控制的流行病学研究中，尚未对血叶酸浓度与浸润性宫颈癌风险之间的关联进行调查。在4个拉丁美洲国家，针对新诊断的I期和II期浸润性宫颈癌病例及对照开展了一项研究。95%的受试者捐献了血样，最终对330例病例和565例对照的血清样本进行了放射分析以测定叶酸浓度。病例组和对照组的叶酸平均水平无显著差异（分别为5.00和4.90纳克/毫升）。在对其他风险因素进行调整后，未观察到血清叶酸四分位数与宫颈癌风险之间存在关联，也未观察到与既定风险因素之间存在相互作用。对于近期或长期使用口服避孕药或多次怀孕可能导致叶酸状态受损的女性，叶酸水平与风险也无关。此外，叶酸平均水平在疾病分期方面相似，这表明疾病进展对血清值没有影响。这些结果不支持血清叶酸在浸润性宫颈癌病因学中发挥作用。
