The University of Queensland, School of Medicine, Burns, Trauma & Critical Care Research Centre, Brisbane, QLD 4029, Australia.
BMC Cancer. 2010 Jun 16;10:292. doi: 10.1186/1471-2407-10-292.
BACKGROUND: Chronic gastro-oesophageal reflux disease and excessive body fat are considered principal causes of Barrett's oesophagus (a metaplastic change in the cells lining the oesophagus) and its neoplastic progression, oesophageal adenocarcinoma. Metabolic disturbances including altered levels of obesity-related cytokines, chronic inflammation and insulin resistance have also been associated with oesophageal cancer development, especially in males. Physical activity may have the potential to abrogate metabolic disturbances in males with Barrett's oesophagus and elicit beneficial reductions in body fat and gastro-oesophageal reflux symptoms. Thus, exercise may be an effective intervention in reducing oesophageal adenocarcinoma risk. However, to date this hypothesis remains untested.The 'Exercise and the Prevention of Oesophageal Cancer Study' will determine whether 24 weeks of exercise training will lead to alterations in risk factors or biomarkers for oesophageal adenocarcinoma in males with Barrett's oesophagus. Our primary outcomes are serum concentrations of leptin, adiponectin, tumour necrosis factor-alpha, C-reactive protein and interleukin-6 as well as insulin resistance. Body composition, gastro-oesophageal reflux disease symptoms, cardiovascular fitness and muscular strength will also be assessed as secondary outcomes. METHODS/DESIGN: A randomized controlled trial of 80 overweight or obese, inactive males with Barrett's oesophagus will be conducted in Brisbane, Australia. Participants will be randomized to an intervention arm (60 minutes of moderate-intensity aerobic and resistance training, five days per week) or a control arm (45 minutes of stretching, five days per week) for 24 weeks. Primary and secondary endpoints will be measured at baseline (week 0), midpoint (week 12) and at the end of the intervention (week 24). DISCUSSION: Due to the increasing incidence and very high mortality associated with oesophageal adenocarcinoma, interventions effective in preventing the progression of Barrett's oesophagus are urgently needed. We propose that exercise may be successful in reducing oesophageal adenocarcinoma risk. This primary prevention trial will also provide information on whether the protective association between physical activity and cancer is causal. TRIAL REGISTRATION: ACTRN12609000401257.
背景：慢性胃食管反流病和过多的体脂被认为是巴雷特食管（食管细胞的化生改变）及其肿瘤进展，食管腺癌的主要原因。代谢紊乱，包括肥胖相关细胞因子水平改变、慢性炎症和胰岛素抵抗，也与食管癌的发展有关，尤其是在男性中。身体活动可能有潜力消除巴雷特食管男性的代谢紊乱，并引起体脂和胃食管反流症状的有益减少。因此，运动可能是降低食管腺癌风险的有效干预措施。然而，到目前为止，这一假设仍未得到验证。“运动与食管癌预防研究”将确定 24 周的运动训练是否会导致巴雷特食管男性的食管癌风险因素或生物标志物发生变化。我们的主要结果是血清瘦素、脂联素、肿瘤坏死因子-α、C 反应蛋白和白细胞介素-6以及胰岛素抵抗的浓度。身体成分、胃食管反流病症状、心血管健康和肌肉力量也将作为次要结果进行评估。
方法/设计：在澳大利亚布里斯班，一项针对 80 名超重或肥胖、不活跃的巴雷特食管男性的随机对照试验将进行。参与者将被随机分配到干预组（每周 5 天，每次 60 分钟中等强度有氧运动和阻力训练）或对照组（每周 5 天，每次 45 分钟伸展运动），持续 24 周。主要和次要终点将在基线（第 0 周）、中点（第 12 周）和干预结束时（第 24 周）进行测量。
讨论：由于食管腺癌的发病率不断增加和死亡率非常高，迫切需要有效的干预措施来预防巴雷特食管的进展。我们提出，运动可能有助于降低食管腺癌的风险。这项初级预防试验还将提供关于身体活动与癌症之间的保护关联是否具有因果关系的信息。
试验注册：ACTRN12609000401257。
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