Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Cancer Epidemiol Biomarkers Prev. 2013 Aug;22(8):1451-6. doi: 10.1158/1055-9965.EPI-13-0446. Epub 2013 Jun 13.
Cruciferous vegetables are a major source of glucosinolate-derived bioactive compounds such as isothiocyanates, which have been shown in animal and in vitro studies to inhibit cancer growth and progression. Few studies have investigated cruciferous vegetable intake after diagnosis and breast cancer outcomes. Using data from the After Breast Cancer Pooling Project, which includes prospective data from U.S. and Chinese breast cancer survivors, we evaluated the association of cruciferous vegetables with breast cancer outcomes. Analyses included 11,390 women diagnosed with stage I-III invasive breast cancer (1990-2006) from four cohorts. Cruciferous vegetable intake (g/day) was assessed using food frequency questionnaires (mean of 22 months postdiagnosis). Study heterogeneity was evaluated by the Q statistic; hazard ratios (HRs) and 95% confidence intervals (CI) were estimated using delayed-entry Cox regression models stratified by study. After a median follow-up of 9.0 years, 1,725 deaths and 1,421 recurrences were documented. In pooled analyses using study-specific quartiles, cruciferous vegetable intake was not associated with breast cancer outcomes, adjusting for known clinical prognostic factors and selected lifestyle factors. HRs (95% CIs) by increasing quartiles (reference = lowest quartile) were 1.08 (0.93-1.25), 1.01 (0.87-1.18), and 1.10 (0.95-1.28) for recurrence (P(trend) = 0.34) and 1.01 (0.88-1.15), 0.97 (0.84-1.11), and 0.99 (0.86-1.13) for total mortality (P(trend) = 0.84). No associations were observed for subgroups defined by estrogen receptor status, stage, or tamoxifen therapy. Cruciferous vegetable intake at approximately two years after diagnosis was not associated with recurrence or mortality. Our results do not support an association between postdiagnosis cruciferous vegetable intake and breast cancer outcomes.
十字花科蔬菜是硫代葡萄糖苷衍生的生物活性化合物(如异硫氰酸酯)的主要来源,动物和体外研究表明这些化合物能抑制癌症的生长和发展。很少有研究调查过诊断后十字花科蔬菜的摄入量与乳腺癌结局之间的关系。利用来自美国和中国乳腺癌幸存者的前瞻性数据的乳腺癌后汇总项目(After Breast Cancer Pooling Project)的数据,我们评估了十字花科蔬菜与乳腺癌结局的关系。分析包括四个队列中 11390 名诊断为 I 期-III 期浸润性乳腺癌(1990-2006 年)的女性。十字花科蔬菜摄入量(g/天)通过食物频率问卷(诊断后平均 22 个月)进行评估。通过 Q 统计量评估研究异质性;使用延迟进入 Cox 回归模型分层分析,估计危险比(HRs)和 95%置信区间(CI)。中位随访 9.0 年后,记录了 1725 例死亡和 1421 例复发。在使用研究特异性四分位数的汇总分析中,调整已知临床预后因素和选定的生活方式因素后,十字花科蔬菜的摄入量与乳腺癌结局无关。按递增四分位数(参考=最低四分位数)的 HRs(95%CI)分别为复发(趋势 P = 0.34)为 1.08(0.93-1.25)、1.01(0.87-1.18)和 1.10(0.95-1.28),总死亡率(趋势 P = 0.84)为 1.01(0.88-1.15)、0.97(0.84-1.11)和 0.99(0.86-1.13)。按雌激素受体状态、分期或他莫昔芬治疗定义的亚组未观察到关联。诊断后大约两年时十字花科蔬菜的摄入量与复发或死亡率无关。我们的结果不支持诊断后十字花科蔬菜摄入量与乳腺癌结局之间的关联。