Department of Biomedical Sciences, Seoul National University, Seoul, Republic of Korea.
Nutr J. 2012 Aug 28;11:59. doi: 10.1186/1475-2891-11-59.
The 5-year survival rate for breast cancer among Korean women has increased steadily; however, breast cancer remains the leading cause of cancer mortality among women. One-carbon metabolism, which requires an adequate supply of methyl group donors and B vitamins, may affect the prognosis of breast cancer. This aim of this study was to investigate the associations of dietary intake of vitamin B2, vitamin B6 and folate before diagnosis on the prognosis of breast cancer.
We assessed the dietary intake using a food frequency questionnaire with 980 women who were newly diagnosed and histopathologically confirmed to have primary breast cancer from hospitals in Korea, and 141 disease progression events occurred. Cox's proportional hazard regression models were used to estimate the hazard ratio (HR) and 95% confidence interval (95% CI) adjusting for age, education, recruitment sites, TNM stage, hormone status, nuclear grade and total calorie.
There was no significant association between any one-carbon metabolism related nutrients (vitamin B2, B6 and folate) and the progression of breast cancer overall. However, one-carbon metabolism related nutrients were associated with disease progression in breast cancer patients stratified by subtypes. In ER + and/or PR + breast cancers, no association was observed; however, in ER-/PR- breast cancers, a high intake of vitamin B2 and folate statistically elevated the HR of breast cancer progression (HR = 2.28; 95% CI, 1.20-4.35, HR = 1.84; 95% CI, 1.02-3.32, respectively) compared to a low intake. This positive association between the ER/PR status and progression of the disease was profound when the nutrient intakes were categorized in a combined score (Pinteraction = 0.018). In ER-/PR- breast cancers, high combined scores were associated with a significantly poor DFS compared to those belonging to the low score group (HR = 3.84; 95% CI, 1.70-8.71).
In conclusion, our results suggest that one-carbon related nutrients have a role in the prognosis of breast cancer depending on the ER/PR status.
韩国女性的乳腺癌 5 年生存率稳步上升，但乳腺癌仍是女性癌症死亡的主要原因。一碳代谢需要充足的甲基供体和 B 族维生素供应，可能会影响乳腺癌的预后。本研究旨在探讨诊断前维生素 B2、维生素 B6 和叶酸的饮食摄入量与乳腺癌预后的关系。
我们使用食物频率问卷评估了 980 名新诊断为原发性乳腺癌并经韩国医院组织病理学证实的女性的饮食摄入量，其中发生了 141 例疾病进展事件。使用 Cox 比例风险回归模型，在调整年龄、教育程度、招募地点、TNM 分期、激素状态、核分级和总热量后，估计风险比（HR）和 95%置信区间（95%CI）。
在整体乳腺癌中，与一碳代谢相关的营养素（维生素 B2、B6 和叶酸）与疾病进展之间没有显著关联。然而，在按亚型分层的乳腺癌患者中，一碳代谢相关营养素与疾病进展相关。在 ER+/PR+乳腺癌中，未观察到相关性；然而，在 ER-/PR-乳腺癌中，维生素 B2 和叶酸的高摄入量统计学上提高了乳腺癌进展的 HR（HR=2.28；95%CI，1.20-4.35，HR=1.84；95%CI，1.02-3.32）与低摄入量相比。当营养素摄入量按综合评分分类时，这种 ER/PR 状态与疾病进展之间的正相关关系非常明显（Pinteraction=0.018）。在 ER-/PR-乳腺癌中，高综合评分与低评分组相比，DFS 显著较差（HR=3.84；95%CI，1.70-8.71）。
总之，我们的结果表明，一碳相关营养素的作用取决于 ER/PR 状态，与乳腺癌的预后有关。
