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饮食生活方式与结直肠癌的发病、复发及生存:是神话还是现实?

Dietary lifestyle and colorectal cancer onset, recurrence, and survival: myth or reality?

作者信息

Lofano Katia, Principi Mariabeatrice, Scavo Maria Principia, Pricci Maria, Ierardi Enzo, Di Leo Alfredo

机构信息

Department of Emergency and Organ Transplantation, Section of Gastroenterology, Bari, Italy.

出版信息

J Gastrointest Cancer. 2013 Mar;44(1):1-11. doi: 10.1007/s12029-012-9425-y.

Abstract

BACKGROUND AND PURPOSE

Interest in the possibility that diet might help to reduce the risk of colorectal cancer dates back to 1970 based on both the large variation in rates of specific cancers in different countries and the impressive changes observed in the incidence of cancer in migrants from low- to high-risk areas. Here, we report the state of art of literature data about this topic.

METHODS

Three sections have been separately considered: chemoprevention of first tumor onset, chemoprevention of recurrence after surgery, and chemoprevention of polyp recurrence in the course of the follow-up of subjects with elevated risk. A particular attention has been pointed to dietary factors and survival, whose relevance is showing a growing interest.

RESULTS

The relationship between diet and colorectal cancer has been extensively studied about the onset, sometimes with controversial results. Its influence on recurrence and survival has been examined in only few studies.

CONCLUSIONS

Literature data are convincing for a protective role on the onset of preneoplastic and neoplastic lesions for some foods such as fibers, vitamin A and D, folic acid, calcium, antioxidants, and promising perspectives for some substances such as phyto-estrogens. Less evidence-based data are available on the possibility to avoid the recurrence of the disease or to affect its mortality with dietary habits. Future perspectives will be directed be not only to identify new dietary style able to prevent the onset of neoplastic lesion of the colon but also to realize an effective chemoprevention.

摘要

背景与目的

基于不同国家特定癌症发病率的巨大差异以及从低风险地区迁移至高风险地区的移民中癌症发病率的显著变化,人们对饮食可能有助于降低结直肠癌风险的可能性的关注可追溯到1970年。在此,我们报告关于该主题的文献数据的现状。

方法

分别考虑了三个部分:首次肿瘤发生的化学预防、手术后复发的化学预防以及高危受试者随访过程中息肉复发的化学预防。特别关注了饮食因素与生存率,其相关性正受到越来越多的关注。

结果

关于饮食与结直肠癌发生之间的关系已进行了广泛研究,有时结果存在争议。仅在少数研究中考察了其对复发和生存的影响。

结论

文献数据表明,某些食物如纤维、维生素A和D、叶酸、钙、抗氧化剂对癌前病变和肿瘤性病变的发生具有保护作用,一些物质如植物雌激素也有前景。关于通过饮食习惯避免疾病复发或影响其死亡率的可能性,基于证据的数据较少。未来的研究方向不仅是确定能够预防结肠肿瘤性病变发生的新饮食方式,还要实现有效的化学预防。

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