GROW-School for Oncology and Developmental Biology, Department of Epidemiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Gastroenterology. 2010 May;138(5):1704-13. doi: 10.1053/j.gastro.2009.12.004. Epub 2009 Dec 16.
BACKGROUND & AIMS: Selenium may protect against the development of esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC), and gastric cardia adenocarcinoma (GCA). Only in very few studies have the associations with ESCC and GCA been investigated, and no epidemiologic studies exist on EAC.
We studied the association between selenium and risk of ESCC, EAC, and GCA within the prospective Netherlands Cohort Study, conducted among 120,852 men and women aged 55-69 years at baseline. In September 1986, the cohort members completed a questionnaire on risk factors for cancer and provided toenail clippings for determination of baseline selenium status. After 16.3 years of follow-up, 64 ESCC, 112 EAC, and 114 GCA cases and 2072 subcohort members were available for case-cohort analysis. Incidence rate ratios (RR) were calculated using Cox proportional hazards models.
In multivariable analyses of selenium status, we found an inverse association with ESCC (RR(per standard unit increment), 0.80; 95% confidence interval [CI]: 0.67-0.96) and a borderline significant inverse association with GCA (RR, 0.91; 95% CI: 0.80-1.02). No overall association was observed for EAC (RR, 1.05; 95% CI: 0.95-1.15), but, for women and never smokers, significant inverse associations were found (RR(per standard unit increment), 0.72; 95% CI: 0.61-0.84 and RR(per standard unit increment), 0.74; 95% CI: 0.64-0.86, respectively).
This prospective study supports an inverse association between toenail selenium and risk of ESCC and GCA and suggests an inverse association with risk of EAC in subgroups (women, never smokers, and low antioxidant consumers). These associations need confirmation.
硒可能对食管鳞状细胞癌（ESCC）、食管腺癌（EAC）和贲门腺癌（GCA）的发生有保护作用。只有少数研究调查了与 ESCC 和 GCA 的相关性，并且 EAC 也没有流行病学研究。
我们在荷兰前瞻性队列研究中研究了硒与 ESCC、EAC 和 GCA 风险之间的关系，该研究在基线时纳入了 120852 名年龄在 55-69 岁的男性和女性。1986 年 9 月，队列成员完成了一份关于癌症危险因素的问卷，并提供了趾甲屑以确定基线硒状态。经过 16.3 年的随访，64 例 ESCC、112 例 EAC 和 114 例 GCA 病例和 2072 名亚队列成员可用于病例-亚队列分析。使用 Cox 比例风险模型计算发病率比（RR）。
在对硒状态的多变量分析中，我们发现与 ESCC 呈负相关（每增加一个标准单位的 RR，0.80；95%置信区间 [CI]：0.67-0.96），与 GCA 呈边缘显著负相关（RR，0.91；95% CI：0.80-1.02）。未观察到 EAC 的总体相关性（RR，1.05；95% CI：0.95-1.15），但对于女性和从不吸烟者，发现了显著的负相关（每增加一个标准单位的 RR，0.72；95% CI：0.61-0.84 和 RR（每增加一个标准单位的增量），0.74；95% CI：0.64-0.86）。
这项前瞻性研究支持趾甲硒与 ESCC 和 GCA 风险之间的负相关，并表明在亚组（女性、从不吸烟者和低抗氧化剂消费者）中与 EAC 风险呈负相关。这些关联需要进一步证实。
