欧洲癌症与营养前瞻性调查（EPIC）队列中蔬菜和水果的摄入量与激素受体定义的乳腺癌风险
Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort.
作者信息
Emaus Marleen J, Peeters Petra H M, Bakker Marije F, Overvad Kim, Tjønneland Anne, Olsen Anja, Romieu Isabelle, Ferrari Pietro, Dossus Laure, Boutron-Ruault Marie Christine, Baglietto Laura, Fortner Renée T, Kaaks Rudolf, Boeing Heiner, Trichopoulou Antonia, Lagiou Pagona, Trichopoulos Dimitrios, Masala Giovanna, Pala Valeria, Panico Salvatore, Tumino Rosario, Polidoro Silvia, Skeie Guri, Lund Eiliv, Weiderpass Elisabete, Quirós J Ramón, Travier Noémie, Sánchez María-José, Chirlaque Maria-Dolores, Ardanaz Eva, Dorronsoro Miren, Winkvist Anna, Wennberg Maria, Bueno-de-Mesquita H Bas, Khaw Kay-Tee, Travis Ruth C, Key Timothy J, Aune Dagfinn, Gunter Marc, Riboli Elio, van Gils Carla H
机构信息
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands;
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom;
出版信息
Am J Clin Nutr. 2016 Jan;103(1):168-77. doi: 10.3945/ajcn.114.101436. Epub 2015 Nov 25.
BACKGROUND
The recent literature indicates that a high vegetable intake and not a high fruit intake could be associated with decreased steroid hormone receptor-negative breast cancer risk.
OBJECTIVE
This study aimed to investigate the association between vegetable and fruit intake and steroid hormone receptor-defined breast cancer risk.
DESIGN
A total of 335,054 female participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were included in this study (mean ± SD age: 50.8 ± 9.8 y). Vegetable and fruit intake was measured by country-specific questionnaires filled out at recruitment between 1992 and 2000 with the use of standardized procedures. Cox proportional hazards models were stratified by age at recruitment and study center and were adjusted for breast cancer risk factors.
RESULTS
After a median follow-up of 11.5 y (IQR: 10.1-12.3 y), 10,197 incident invasive breast cancers were diagnosed [3479 estrogen and progesterone receptor positive (ER+PR+); 1021 ER and PR negative (ER-PR-)]. Compared with the lowest quintile, the highest quintile of vegetable intake was associated with a lower risk of overall breast cancer (HRquintile 5-quintile 1: 0.87; 95% CI: 0.80, 0.94). Although the inverse association was most apparent for ER-PR- breast cancer (ER-PR-: HRquintile 5-quintile 1: 0.74; 95% CI: 0.57, 0.96; P-trend = 0.03; ER+PR+: HRquintile 5-quintile 1: 0.91; 95% CI: 0.79, 1.05; P-trend = 0.14), the test for heterogeneity by hormone receptor status was not significant (P-heterogeneity = 0.09). Fruit intake was not significantly associated with total and hormone receptor-defined breast cancer risk.
CONCLUSION
This study supports evidence that a high vegetable intake is associated with lower (mainly hormone receptor-negative) breast cancer risk.
背景
近期文献表明，高蔬菜摄入量而非高水果摄入量可能与类固醇激素受体阴性乳腺癌风险降低有关。
目的
本研究旨在调查蔬菜和水果摄入量与类固醇激素受体定义的乳腺癌风险之间的关联。
设计
欧洲癌症与营养前瞻性调查（EPIC）队列中的335,054名女性参与者纳入本研究（平均±标准差年龄：50.8±9.8岁）。蔬菜和水果摄入量通过1992年至2000年招募时填写的特定国家问卷，采用标准化程序进行测量。Cox比例风险模型按招募时的年龄和研究中心分层，并对乳腺癌风险因素进行调整。
结果
中位随访11.5年（四分位间距：10.1 - 12.3年）后，诊断出10,197例浸润性乳腺癌[3479例雌激素和孕激素受体阳性（ER+PR+）；1021例ER和PR阴性（ER-PR-）]。与最低五分位数相比，蔬菜摄入量最高五分位数与总体乳腺癌风险较低相关（五分位数5 - 五分位数1的风险比：0.87；95%置信区间：0.80, 0.94）。虽然这种负相关在ER-PR-乳腺癌中最为明显（ER-PR-：五分位数5 - 五分位数1的风险比：0.74；95%置信区间：0.57, 0.96；P趋势 = 0.03；ER+PR+：五分位数5 - 五分位数1的风险比：0.91；95%置信区间：0.79, 1.05；P趋势 = 0.14），但按激素受体状态进行的异质性检验不显著（P异质性 = 0.09）。水果摄入量与总体及激素受体定义的乳腺癌风险无显著关联。
结论
本研究支持高蔬菜摄入量与较低（主要是激素受体阴性）乳腺癌风险相关的证据。
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