Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China.
Nutr Cancer. 2012 Aug;64(6):806-19. doi: 10.1080/01635581.2012.707277. Epub 2012 Aug 3.
The effects of diet on breast cancer are controversial and whether the effects vary with hormone receptor status has not been well investigated. This study evaluated the associations of dietary factors with risk for breast cancer overall and by the hormone receptor status of tumors among Chinese women. The Shanghai Breast Cancer Study, a large, population-based, case-control study, enrolled 3,443 cases and 3,474 controls in 1996-1998 (phase I) and 2002-2005 (phase II); 2676 cases had estrogen receptor (ER) and progesterone receptor (PR) data. Dietary intake was assessed using a validated, quantitative, food frequency questionnaire. Odds ratios (OR) and 95% confidence intervals (95% CI) were derived from multivariate, polychotomous, unconditional logistic regression models. Total vegetable intake was inversely related to breast cancer risk, with an adjusted OR for the highest quintile of 0.80 (95% CI = 0.67-0.95; P trend = 0.02). Reduced risk was also related to high intake of allium vegetables (P trend = 0.01) and fresh legumes (P trend = 0.0008). High intake of citrus fruits and rosaceae fruits were inversely associated with breast cancer risk (P trend = 0.003 and 0.004, respectively), although no consistent association was seen for total fruit intake. Elevated risk was observed for all types of meat and fish intake (all P trend < 0.05), whereas intakes of eggs and milk were associated with a decreased risk of breast cancer (both P trend <0.05). There was little evidence that associations with dietary intakes varied across the 4 tumor subtypes or between ER+/PR+ and ER-/PR- tumors (P for heterogeneity >0.05). Our results suggest that high intake of total vegetables, certain fruits, milk, and eggs may reduce the risk of breast cancer, whereas high consumption of animal-source foods may increase risk. The dietary associations did not appear to vary by ER/PR status.
饮食对乳腺癌的影响存在争议,其影响是否因激素受体状态而异尚未得到充分研究。本研究评估了饮食因素与中国女性乳腺癌总体风险以及肿瘤激素受体状态的相关性。上海乳腺癌研究是一项大型的基于人群的病例对照研究,在 1996-1998 年(I 期)和 2002-2005 年(II 期)期间共招募了 3443 例病例和 3474 例对照;2676 例病例有雌激素受体(ER)和孕激素受体(PR)数据。饮食摄入情况采用经过验证的定量食物频率问卷进行评估。多变量、多项无序、非条件逻辑回归模型得出比值比(OR)和 95%置信区间(95%CI)。总蔬菜摄入量与乳腺癌风险呈负相关,最高五分位数的调整 OR 为 0.80(95%CI=0.67-0.95;P 趋势=0.02)。摄入大量的葱属蔬菜(P 趋势=0.01)和新鲜豆类(P 趋势=0.0008)也与风险降低有关。柑橘类水果和蔷薇科水果的高摄入量与乳腺癌风险呈负相关(P 趋势分别为 0.003 和 0.004),尽管总水果摄入量没有一致的相关性。所有类型的肉类和鱼类摄入均与风险升高相关(所有 P 趋势<0.05),而鸡蛋和牛奶的摄入与乳腺癌风险降低相关(均 P 趋势<0.05)。饮食摄入与 4 种肿瘤亚型之间或 ER+/PR+和 ER-/PR-肿瘤之间的相关性差异很小(异质性 P>0.05)。我们的研究结果表明,高摄入总蔬菜、某些水果、牛奶和鸡蛋可能降低乳腺癌风险,而大量摄入动物源性食物可能增加风险。饮食相关性似乎不受 ER/PR 状态的影响。