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结直肠癌的饮食化学预防

Dietary chemoprevention of colorectal cancer.

作者信息

Forte Angelo, De Sanctis Rita, Leonetti Giovanni, Manfredelli Simone, Urbano Vincenzo, Bezzi Marcello

机构信息

IV School of Specialization in General Surgery, Francesco Durante Department of General Surgery, Policlinico Umberto I Hospital, Sapienza University, Rome, Italy.

出版信息

Ann Ital Chir. 2008 Jul-Aug;79(4):261-7.

Abstract

AIMS AND BACKGROUND

Colorectal cancer is the second cause of morbidity and death in Italy. Genetic and environmental factors, i.e. inappropriate nutrition, are strongly involved in the aetiology of colon cancer. In the present review the authors analyze the possible mechanisms by which certain nutritive factors may interfere with the complex process of carcinogenesis.

METHODS

The authors identify studies by a literature search of Medline from January 1, 1970, through December 31, 2006.

RESULTS

The mechanism of every protective compound is detailed, in particular the impact of antioxidant vitamins and minerals on tumor development. At present, the data suggest that vegetables are associated with lower risk and that their fbre content alone does not account for this association. Further, meat consumption is associated with an increased risk but this, too, is not explained solely by its fat content. Several microconstituents of the diet may be associated with reduced risk, including folate, methionine, calcium and vitamin D. Short chain fatty acids also contribute to colonic health. Nevertheless agricultural products contain several dangerous pesticides. Mutagenic compounds, particularly heterocyclic amines, produced when protein is cooked, plausibly explain the meat association.

CONCLUSIONS

Healthy nutrition is a necessary but not sufficient condition for colon cancer prevention: accepted the feasibility of an accurate control on every patient's diet, fequently the difficulty encountered in nutritional chemoprevention is to establish individual metabolic profiles.

摘要

目的与背景

在意大利,结直肠癌是发病和死亡的第二大原因。遗传和环境因素,即营养不当,在结肠癌病因中起着重要作用。在本综述中,作者分析了某些营养因素可能干扰致癌复杂过程的潜在机制。

方法

作者通过检索1970年1月1日至2006年12月31日期间的Medline文献来确定研究。

结果

详细阐述了每种保护化合物的作用机制,尤其是抗氧化维生素和矿物质对肿瘤发展的影响。目前的数据表明,蔬菜与较低风险相关,但其纤维含量本身并不能解释这种关联。此外,肉类消费与风险增加相关,但这也不能仅由其脂肪含量来解释。饮食中的几种微量成分可能与风险降低相关,包括叶酸、蛋氨酸、钙和维生素D。短链脂肪酸也有助于结肠健康。然而,农产品含有多种危险农药。蛋白质烹饪时产生的诱变化合物,特别是杂环胺,可能解释了肉类与癌症的关联。

结论

健康的营养是预防结肠癌的必要但非充分条件:虽然认可对每位患者饮食进行精确控制的可行性,但营养化学预防中经常遇到的困难是建立个体代谢谱。

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