Bae Jong-Myon
Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea.
Epidemiol Health. 2016 Jun 2;38:e2016024. doi: 10.4178/epih.e2016024. eCollection 2016.
A pooled analysis of 18 prospective cohort studies reported in 2012 for evaluating carotenoid intakes and breast cancer risk defined by estrogen receptor (ER) and progesterone receptor (PR) statuses by using the "highest versus lowest intake" method (HLM). By applying the interval collapsing method (ICM) to maximize the use of the estimated information, we reevaluated the results of the previous analysis in order to reinterpret the inferences made.
In order to estimate the summary effect size (sES) and its 95% confidence interval (CI), meta-analyses with the random-effects model were conducted for adjusted relative risks and their 95% CI from the second to the fifth interval according to five kinds of carotenoids and ER/PR status.
The following new findings were identified: α-Carotene and β-cryptoxanthin have protective effects on overall breast cancer. All five kinds of carotenoids showed protective effects on ER- breast cancer. β-Carotene level increased the risk of ER+ or ER+/PR+ breast cancer. α-Carotene, β-carotene, lutein/zeaxanthin, and lycopene showed a protective effect on ER-/PR+ or ER-/PR- breast cancer.
The new facts support the hypothesis that carotenoids that show anticancer effects with anti-oxygen function might reduce the risk of ER- breast cancer. Based on the new facts, the modification of the effects of α-carotene, β-carotene, and β-cryptoxanthin should be evaluated according to PR and ER statuses.
2012年发表的一项对18项前瞻性队列研究的汇总分析,采用“最高摄入量与最低摄入量”方法(HLM)评估类胡萝卜素摄入量与雌激素受体(ER)和孕激素受体(PR)状态所定义的乳腺癌风险。通过应用区间合并方法(ICM)以最大限度地利用估计信息,我们重新评估了先前分析的结果,以便重新解释所得出的推论。
为了估计汇总效应量(sES)及其95%置信区间(CI),针对根据五种类胡萝卜素和ER/PR状态从第二个到第五个区间调整后的相对风险及其95%CI,采用随机效应模型进行荟萃分析。
发现了以下新结果:α-胡萝卜素和β-隐黄质对总体乳腺癌具有保护作用。所有五种类胡萝卜素对ER阴性乳腺癌均显示出保护作用。β-胡萝卜素水平增加了ER阳性或ER阳性/PR阳性乳腺癌的风险。α-胡萝卜素、β-胡萝卜素、叶黄素/玉米黄质和番茄红素对ER阴性/PR阳性或ER阴性/PR阴性乳腺癌显示出保护作用。
这些新发现支持了这样一种假设,即具有抗氧化功能且显示出抗癌作用的类胡萝卜素可能会降低ER阴性乳腺癌的风险。基于这些新发现,应根据PR和ER状态评估α-胡萝卜素、β-胡萝卜素和β-隐黄质作用的改变。