Cross Amanda J, Freedman Neal D, Ren Jiansong, Ward Mary H, Hollenbeck Albert R, Schatzkin Arthur, Sinha Rashmi, Abnet Christian C
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, Maryland 20852, USA.
Am J Gastroenterol. 2011 Mar;106(3):432-42. doi: 10.1038/ajg.2010.415. Epub 2010 Oct 26.
Red and processed meats could increase cancer risk through several potential mechanisms involving iron, heterocyclic amines, polycyclic aromatic hydrocarbons, and N-nitroso compounds. Although there have been multiple studies of meat and colorectal cancer, other gastrointestinal malignancies are understudied.
We estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association between meat, meat components, and meat cooking by-products and risk of esophageal or gastric cancer in a large cohort study. During ∼10 years of follow-up, we accrued 215 esophageal squamous cell carcinomas, 630 esophageal adenocarcinomas, 454 gastric cardia adenocarcinomas, and 501 gastric non-cardia adenocarcinomas.
Red meat intake was positively associated with esophageal squamous cell carcinoma (HR for the top versus bottom quintile=1.79, 95% CI: 1.07-3.01, P for trend=0.019). Individuals in the highest intake quintile of 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (DiMeIQx) had an increased risk for gastric cardia cancer (HR=1.44, 95% CI: 1.01-2.07, P for trend=0.104). Furthermore, those in the highest quintile of 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx), 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP), or heme iron intake had a suggestive increased risk for esophageal adenocarcinoma (HR=1.35, 95% CI: 0.97-1.89, P for trend=0.022; HR=1.45, 95% CI: 0.99-2.12, P for trend=0.463; or HR=1.47, 95% CI: 0.99-2.20, P for trend=0.063, respectively). Benzo[a]pyrene, nitrate, and nitrite were not associated with esophageal or gastric cancer.
We found positive associations between red meat intake and esophageal squamous cell carcinoma, and between DiMeIQx intake and gastric cardia cancer.
红肉和加工肉类可能通过涉及铁、杂环胺、多环芳烃和N-亚硝基化合物的多种潜在机制增加患癌风险。尽管已经有多项关于肉类与结直肠癌的研究，但其他胃肠道恶性肿瘤的研究较少。
在一项大型队列研究中，我们估计了肉类、肉类成分和肉类烹饪副产品与食管癌或胃癌风险之间关联的风险比（HR）和95%置信区间（CI）。在约10年的随访期间，我们累计了215例食管鳞状细胞癌、630例食管腺癌、454例贲门腺癌和501例非贲门腺癌。
红肉摄入量与食管鳞状细胞癌呈正相关（最高五分位数与最低五分位数的HR=1.79，95%CI：1.07-3.01，趋势P值=0.019）。2-氨基-3,4,8-三甲基咪唑并[4,5-f]喹喔啉（DiMeIQx）摄入量最高五分位数的个体患贲门癌的风险增加（HR=1.44，95%CI：1.01-2.07，趋势P值=0.104）。此外，2-氨基-3,8-二甲基咪唑并[4,5-f]喹喔啉（MeIQx）、2-氨基-1-甲基-6-苯基咪唑并[4,5-b]吡啶（PhIP）或血红素铁摄入量最高五分位数的个体患食管腺癌的风险有增加的趋势（HR分别为1.35，95%CI：0.97-1.89，趋势P值=0.022；HR=1.45，95%CI：0.99-2.12，趋势P值=0.463；或HR=1.47，95%CI：0.99-2.20，趋势P值=0.063）。苯并[a]芘、硝酸盐和亚硝酸盐与食管癌或胃癌无关。
我们发现红肉摄入量与食管鳞状细胞癌之间以及DiMeIQx摄入量与贲门癌之间存在正相关。
