Xu Chang, Zeng Xian-Tao, Liu Tong-Zu, Zhang Chao, Yang Zhong-Hua, Li Sheng, Chen Xiao-Yan
From the Department of Urology (CX, T-ZL, Z-HY, SL, X-YC); Center for Evidence-Based and Translational Medicine, Zhongnan Hospital (CX, X-TZ, T-ZL, CZ, SL); and Center for Evidence-Based and Translational Medicine, Wuhan University, Wuhan, PR China (X-TZ, SL).
Medicine (Baltimore). 2015 May;94(17):e759. doi: 10.1097/MD.0000000000000759.
Clinical practice recommends eating ≥2.5 cups of fruits and vegetables (FVs) each day for cancer prevention, in which the evidence from epidemiological studies for the association between FVs intake and bladder cancer (BC) prevention is inconsistent.We searched the PubMed, Embase, and Willy online Library for relevant studies published up to September 27, 2014. Prospective cohort studies investigated FVs intake, and the risk of BC with ≥3 categories of exposure was included. A dose-response meta-analysis was carried out to evaluate the association between FVs intake and risk of BC.Fourteen cohorts with 17 studies including 9447 cases were identified. No evidence of nonlinear association was examined between FVs intake and risk of BC. The summarized relevant risk (RR) of every 0.2 serving increment a day was 1.00 (95%CI: 0.99, 1.00; P = 0.17; I = 41.7%; n = 14) for total fruits; 0.99 (95%CI: 0.96, 1.01; P = 0.28; I = 37.0%; n = 13) for total vegetables; and 0.99 (95%CI: 0.97, 1.01; P = 0.24; I = 57.5%; n = 8) for both FVs. In further analysis, we observed inverse association between every 0.2 serving increment of green leafy vegetables intake a day and risk of BC (RR = 0.98, 95%CI: 0.96, 0.99; I = 0.0%; P < 0.01; Power = 0.76; n = 6), but neither for cruciferous vegetables (RR = 0.97, 95%CI: 0.93, 1.01; P = 0.19; I = 55.8%; n = 8) nor for citrus (RR = 1.00, 95%CI: 1.00, 1.00; P = 0.83; I = 0.0%; n = 7). Subgroup analysis showed consistent results.Little evidence supports a beneficial effect for total fruits, vegetables, both FVs, and citrus intake against bladder cancer. Green leafy vegetables may help prevent bladder cancer.
临床实践建议每天食用≥2.5杯水果和蔬菜以预防癌症，然而，关于水果和蔬菜摄入量与膀胱癌预防之间关联的流行病学研究证据并不一致。我们检索了PubMed、Embase和Willy在线图书馆，查找截至2014年9月27日发表的相关研究。纳入前瞻性队列研究，这些研究调查了水果和蔬菜摄入量，且暴露水平有≥3个类别，同时纳入了膀胱癌风险。进行剂量反应荟萃分析以评估水果和蔬菜摄入量与膀胱癌风险之间的关联。
共识别出14个队列，包含17项研究，涉及9447例病例。未发现水果和蔬菜摄入量与膀胱癌风险之间存在非线性关联的证据。每天每增加0.2份水果的汇总相对风险（RR）为1.00（95%置信区间：0.99，1.00；P = 0.17；I² = 41.7%；n = 14）；每天每增加0.2份蔬菜的RR为0.99（95%置信区间：0.96，1.01；P = 0.28；I² = 37.0%；n = 13）；每天每增加0.2份水果和蔬菜的RR为0.99（95%置信区间：0.97，1.01；P = 0.24；I² = 57.5%；n = 8）。在进一步分析中，我们观察到每天绿叶蔬菜摄入量每增加0.2份与膀胱癌风险呈负相关（RR = 0.98，95%置信区间：0.96，0.99；I² = 0.0%；P < 0.01；检验效能 = 0.76；n = 6），但十字花科蔬菜（RR = 0.97，95%置信区间：0.93，1.01；P = 0.19；I² = 55.8%；n = 8）和柑橘类水果（RR = 1.00，95%置信区间：1.00，1.00；P = 0.83；I² = 0.0%；n = 7）均未显示出这种关联。亚组分析显示结果一致。
几乎没有证据支持水果、蔬菜、水果和蔬菜整体以及柑橘类水果摄入量对预防膀胱癌有有益作用。绿叶蔬菜可能有助于预防膀胱癌。
