Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Cancer Epidemiol Biomarkers Prev. 2019 Aug;28(8):1379-1387. doi: 10.1158/1055-9965.EPI-18-1190. Epub 2019 Jun 11.
Higher levels of circulating 25-hydroxyvitamin D [25(OH)D] are associated with longer survival in several cancers, but the results have differed across cancer sites. The association between serum 25(OH)D levels and overall survival (OS) time in esophageal adenocarcinoma remains unclear.
We utilized serum samples from 476 patients with primary esophageal adenocarcinoma, recruited from Massachusetts General Hospital (Boston, MA) between 1999 and 2015. We used log-rank tests to test the difference in survival curves across quartiles of 25(OH)D levels and extended Cox modeling to estimate adjusted HRs. We tested for interactions between clinical stage or BMI on the association between 25(OH)D and OS. We additionally performed sensitivity analyses to determine whether race or timing of blood draw (relative to treatment) affected these results.
We found no evidence that survival differed across quartiles of 25(OH)D (log rank = 0.48). Adjusting for confounders, we found no evidence that the hazard of death among the highest quartile of 25(OH)D (quartile 1) differed from any other quartile [quartile 2 HR = 0.90, 95% confidence interval (CI), 0.67-1.23; quartile 3 HR = 1.03, 95% CI, 0.76-1.38; quartile 4 (lowest) HR = 0.98, 95% CI, 0.72-1.33]. Sensitivity analyses yielded consistent results when accounting for race or time between diagnosis and blood draw. Moreover, we did not find evidence of interaction between 25(OH)D and clinical stage or BMI on OS.
Serum level of 25(OH)D near time of diagnosis was not associated with OS in patients with esophageal adenocarcinoma.
Screening 25(OH)D levels among patients with esophageal adenocarcinoma at diagnosis is not clinically relevant to their cancer prognosis based on present evidence.
在几种癌症中，循环 25-羟维生素 D [25(OH)D]水平较高与生存时间延长有关，但不同癌症部位的结果有所不同。血清 25(OH)D 水平与食管腺癌总生存时间（OS）之间的关系仍不清楚。
我们利用了 1999 年至 2015 年期间从马萨诸塞州综合医院（波士顿）招募的 476 名原发性食管腺癌患者的血清样本。我们使用对数秩检验检验了生存曲线在 25(OH)D 水平四分位数之间的差异，并使用扩展 Cox 模型估计了调整后的 HR。我们检验了临床分期或 BMI 对 25(OH)D 与 OS 之间关联的交互作用。我们还进行了敏感性分析，以确定种族或采血时间（相对于治疗）是否会影响这些结果。
我们没有发现生存在 25(OH)D 四分位数之间存在差异的证据（对数秩检验=0.48）。在调整混杂因素后，我们没有发现最高四分位数（四分位数 1）的 25(OH)D 与任何其他四分位数的死亡风险不同的证据[四分位数 2 HR=0.90，95%置信区间（CI）0.67-1.23；四分位数 3 HR=1.03，95% CI 0.76-1.38；四分位数 4（最低）HR=0.98，95% CI 0.72-1.33]。在考虑种族或诊断与采血之间的时间时，敏感性分析得出了一致的结果。此外，我们没有发现 25(OH)D 与临床分期或 BMI 对 OS 的交互作用的证据。
食管腺癌患者诊断时的血清 25(OH)D 水平与 OS 无关。
根据现有证据，在诊断时对食管腺癌患者进行 25(OH)D 水平筛查与癌症预后无临床相关性。
