Carman Sarah, Kamangar Farin, Freedman Neal D, Wright Margaret E, Dawsey Sanford M, Dixon L Beth, Subar Amy, Schatzkin Arthur, Abnet Christian C
NEB/DCEG, National Cancer Institute, Bethesda, MD 20892-7232, USA.
Int J Cancer. 2009 Jul 1;125(1):165-70. doi: 10.1002/ijc.24342.
We investigated the association of dietary alpha-tocopherol, gamma-tocopherol and supplemental vitamin E intake with the risk of esophageal squamous cell carcinoma (n = 158), esophageal adenocarcinoma (n = 382), gastric cardia adenocarcinoma (n = 320) and gastric noncardia adenocarcinoma (GNCA; n = 327) in the NIH-AARP Diet and Health Study, a cohort of approximately 500,000 people. Data on dietary and supplemental vitamin E intake were collected using a validated questionnaire at baseline and were analyzed using Cox regression models. Intakes were analyzed as continuous variables and as quartiles. For dietary alpha-tocopherol, we found some evidence of association with decreased esophageal squamous cell carcinoma and increased esophageal adenocarcinoma risk in the continuous analyses, with adjusted hazard ratios and 95% confidence intervals of 0.90 (0.81-0.99) and 1.05 (1.00-1.11), respectively, per 1.17 mg (half the interquartile range) increased intake. However, in quartile analyses, the p value for trend was nonsignificant for both these cancers. There was no association between dietary alpha-tocopherol and gastric cardia adenocarcinoma or GNCA. We observed no statistically significant associations with gamma-tocopherol. For supplemental vitamin E, the results were mainly null, except for a significantly lower risk of GNCA with higher doses of supplemental vitamin E. An increase of 71 mg/day (half the interquartile range) in supplemental vitamin E had an hazard ratio (95% confidence interval) of 0.92 (0.85-1.00) and the p value for trend in the quartile analysis was 0.015.
在国立卫生研究院-美国退休人员协会饮食与健康研究（一项约有50万人的队列研究）中，我们调查了膳食α-生育酚、γ-生育酚和补充维生素E的摄入量与食管鳞状细胞癌（n = 158）、食管腺癌（n = 382）、胃贲门腺癌（n = 320）和胃非贲门腺癌（GNCA；n = 327）风险之间的关联。膳食和补充维生素E摄入量的数据在基线时通过一份经过验证的问卷收集，并使用Cox回归模型进行分析。摄入量作为连续变量和四分位数进行分析。对于膳食α-生育酚，在连续分析中，我们发现一些证据表明其与食管鳞状细胞癌风险降低以及食管腺癌风险增加有关，每增加1.17毫克（四分位间距的一半）摄入量，调整后的风险比和95%置信区间分别为0.90（0.81 - 0.99）和1.05（1.00 - 1.11）。然而，在四分位数分析中，这两种癌症的趋势p值均无统计学意义。膳食α-生育酚与胃贲门腺癌或胃非贲门腺癌之间无关联。我们未观察到与γ-生育酚有统计学显著关联。对于补充维生素E，结果主要为无关联，除了较高剂量的补充维生素E使胃非贲门腺癌风险显著降低。补充维生素E每天增加71毫克（四分位间距的一半），风险比（95%置信区间）为0.92（0.85 - 1.00），四分位数分析中的趋势p值为0.015。
