Li S S, Tan H Z, Xu Y W, Wu Z Y, Wu J Y, Zhao X K, Wang L D, Long L, Li E M, Xu L Y, Zhang J J
Department of Preventive Medicine, Sichuan Nursing Vocational College, Chengdu 610000, China.
Shantou University Medical College/Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou 515041, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2019 Nov 6;53(11):1124-1129. doi: 10.3760/cma.j.issn.0253-9624.2019.11.010.
To investigate the association between the whole blood riboflavin level and the occurrence, development and prognosis of esophageal squamous cell carcinoma (ESCC) in China. From March 2014 to September 2018, ESCC patients from three hospitals (the Affiliated Hospital of Medical College of Shantou University, Shantou Central Hospital in Southern Chaoshan area and First Affiliated Hospital of Zhengzhou University in Northern Taihang Mountain) were selected as a case group; non-esophageal patients who had a physical examination were selected as a control group. The case and control group were paired by age (±5 years) and a 1:1 ration. A total of 1 528 subjects were enrolled including 764 patients in the case group and 764 patients in the control group. About 3-5 ml venous blood samples were collected, and the erythrocyte glutathione reductase activity coefficient (GRAC) was measured to assess the whole blood riboflavin level. A multivariate conditional logistic regression model was used to analyze the association between the GRAC and the risk of ESCC. The association between the GRAC and the prognosis of ESCC was analyzed by using Cox proportional risk regression model based on 288 patients with complete survival data. They were divided into two groups, the high GRAC group (GRAC≥7.87) group and the low GRAC group (GRAC<7.87) according to the strongest correlation between the total survival time, survival outcome and GRAC (GRAC=7.87). Among the 1 528 patients, 958 patients were from Southern Chaoshan area, including 479 patients in the case group with an average age about (59.90±9.34) years and 479 patients in the control group with an average age about (59.55±8.77) years. Other 570 patients were from Northern Taihang Mountain area, including 285 patients in the case group with an average age (58.39±5.19) years and 285 patients in the control group with an average age about (58.74±4.57) years. The multivariate conditional logistic regression showed that the (95) of the GRAC and the risk of ESCC was 1.009 (0.998-1.019). The Cox proportional hazard regression model analysis showed that the (95) of the high GRAC group was 1.712 (1.034-2.824) compared with the low GRAC group in the 50-70 years group. The whole blood riboflavin level might not be associated with the occurrence of ESCC. The high whole blood riboflavin level would be more beneficial to the prognosis of ESCC patients aged 50-70 years.
探讨中国人群全血中核黄素水平与食管鳞状细胞癌（ESCC）发生、发展及预后的关系。2014年3月至2018年9月，选取来自三家医院（汕头大学医学院附属肿瘤医院、粤东地区的汕头市中心医院及豫北地区的郑州大学第一附属医院）的ESCC患者作为病例组；选取进行体检的非食管疾病患者作为对照组。病例组与对照组按年龄（±5岁）1:1配对。共纳入1528名受试者，其中病例组764例，对照组764例。采集约3 - 5 ml静脉血样本，检测红细胞谷胱甘肽还原酶活性系数（GRAC）以评估全血核黄素水平。采用多因素条件logistic回归模型分析GRAC与ESCC发病风险的关系。基于288例有完整生存数据的患者，采用Cox比例风险回归模型分析GRAC与ESCC预后的关系。根据总生存时间、生存结局与GRAC的最强相关性（GRAC = 7.87），将患者分为高GRAC组（GRAC≥7.87）和低GRAC组（GRAC＜7.87）。1528例患者中，958例来自潮汕地区，其中病例组479例，平均年龄约（59.90±9.34）岁，对照组479例，平均年龄约（59.55±8.77）岁。另外570例患者来自太行山区，其中病例组285例，平均年龄（58.39±5.19）岁，对照组285例，平均年龄约（58.74±4.57）岁。多因素条件logistic回归显示，GRAC与ESCC发病风险的比值比（95%CI）为1.009（0.998 - 1.019）。Cox比例风险回归模型分析显示，50 - 70岁组中，高GRAC组与低GRAC组相比，风险比（95%CI）为1.712（1.034 - 2.824）。全血核黄素水平可能与ESCC的发生无关。全血核黄素水平较高对50 - 70岁的ESCC患者预后更有益。
