Ng K, Wolpin B M, Meyerhardt J A, Wu K, Chan A T, Hollis B W, Giovannucci E L, Stampfer M J, Willett W C, Fuchs C S
Department of Medical Oncology, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115, USA.
Br J Cancer. 2009 Sep 15;101(6):916-23. doi: 10.1038/sj.bjc.6605262. Epub 2009 Aug 18.
In an earlier study, a 25-hydroxyvitamin D(3) (25(OH)D) score calculated from known predictors of vitamin D status significantly predicted plasma levels of 25(OH)D and the risk of colorectal cancer, but the influence of the 25(OH)D score on survival after diagnosis is unknown.
We prospectively examined the influence of post-diagnosis predicted 25(OH)D levels on mortality among 1017 participants in the Nurses' Health Study and Health Professionals Follow-Up Study who were diagnosed with colorectal cancer from 1986 to 2004. Colorectal cancer-specific and overall mortality according to quintiles of predicted 25(OH)D levels were assessed. Cox proportional hazards models were used to calculate hazard ratios (HRs) adjusted for other risk factors of survival.
Higher predicted 25(OH)D levels were associated with a significant reduction in colorectal cancer-specific (P trend=0.02) and overall mortality (P trend=0.002). Compared with levels in the lowest quintile, participants with predicted 25(OH)D levels in the highest quintile had an adjusted HR of 0.50 (95% CI, 0.26-0.95) for cancer-specific mortality and 0.62 (95% CI, 0.42-0.93) for overall mortality.
Higher predicted 25(OH)D levels after a diagnosis of colorectal cancer may be associated with improved survival. Further study of the vitamin D pathway in colorectal cancer is warranted.
在一项早期研究中，根据维生素D状态的已知预测因素计算得出的25-羟基维生素D(3)[25(OH)D]评分能够显著预测血浆25(OH)D水平以及结直肠癌风险，但该评分对诊断后生存率的影响尚不清楚。
我们前瞻性地研究了1986年至2004年间在护士健康研究和卫生专业人员随访研究中被诊断为结直肠癌的1017名参与者，诊断后预测的25(OH)D水平对死亡率的影响。根据预测的25(OH)D水平五分位数评估结直肠癌特异性死亡率和总死亡率。采用Cox比例风险模型计算经其他生存风险因素调整后的风险比(HRs)。
较高的预测25(OH)D水平与结直肠癌特异性死亡率显著降低相关(P趋势=0.02)，与总死亡率也显著降低相关(P趋势=0.002)。与最低五分位数水平相比，预测25(OH)D水平处于最高五分位数的参与者，其癌症特异性死亡率的调整后HR为0.50(95%CI，0.26 - 0.95)，总死亡率的调整后HR为0.62(95%CI，0.42 - 0.93)。
结直肠癌诊断后较高的预测25(OH)D水平可能与生存率提高相关。有必要对结直肠癌中维生素D途径进行进一步研究。
