Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
Institute of Pathology, University Medical Center Mainz, Mainz, Germany.
Eur J Epidemiol. 2017 May;32(5):409-418. doi: 10.1007/s10654-017-0275-6. Epub 2017 Jun 23.
Red and processed meat is an established risk factor for colorectal cancer (CRC). However, exact mechanisms to explain the associations remain unclear. Few studies have investigated the association with CRC by molecular tumor features, which could provide relevant information on associated molecular pathways. In this population-based case-control study from Germany (DACHS), 2449 cases and 2479 controls provided information on risk factors of CRC and completed a food frequency questionnaire. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) for the associations between meat intake and risk of CRC by molecular pathologic features and specific subtypes. Red and processed meat intake was associated with increased risk of colorectal (>1 time/day vs ≤1 time/week OR 1.66, 95% CI 1.34-2.07), colon and rectal cancer. Among the single molecular tumor features investigated, the results were similar for associations of red and processed meat with CRC risk by microsatellite instability, CpG island methylator phenotype, BRAF, oestrogen receptor-β and p53 status. Red and processed meat intake was associated less strongly with risk of KRAS-mutated CRC (OR >1 time/day vs ≤1 time/week: 1.49, 95% CI 1.09-2.03) than with risk of KRAS-wildtype CRC (OR 1.82, 95% CI 1.42-2.34; p 0.04). These results support an association between red and processed meat and CRC risk similar for subsites of CRC and most of the investigated major molecular pathological features. Potential differences were observed in more specific subtype analyses. Further large studies are needed to confirm these results and to help further elucidate potential underlying mechanisms.
红色和加工肉类是结直肠癌（CRC）的既定危险因素。然而，确切的机制尚不清楚。很少有研究通过分子肿瘤特征来研究与 CRC 的相关性，这可以提供与相关分子途径相关的信息。在德国这项基于人群的病例对照研究（DACHS）中，2449 例病例和 2479 例对照提供了 CRC 危险因素信息，并完成了食物频率问卷。多变量逻辑回归用于估计红色和加工肉类摄入量与分子病理特征和特定亚型 CRC 风险之间关联的比值比（OR）和 95％置信区间（CI）。红色和加工肉类的摄入量与结直肠（>1 次/天与≤1 次/周 OR 1.66，95％CI 1.34-2.07）和结肠直肠癌的风险增加相关。在所研究的单个分子肿瘤特征中，红色和加工肉类与 CRC 风险的关联结果与微卫星不稳定性、CpG 岛甲基化表型、BRAF、雌激素受体-β和 p53 状态的结果相似。与 KRAS 野生型 CRC 相比（OR >1 次/天与≤1 次/周：1.49，95％CI 1.09-2.03），红色和加工肉类的摄入量与 KRAS 突变型 CRC 的风险相关性较弱（OR 1.82，95％CI 1.42-2.34；p 0.04）。这些结果支持红色和加工肉类与 CRC 风险之间的相关性，对于 CRC 的亚部位和大多数研究的主要分子病理特征都是相似的。在更具体的亚型分析中观察到潜在的差异。需要进一步的大型研究来证实这些结果，并帮助进一步阐明潜在的机制。
