Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Epidemiology and Biostatistics, The Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China.
Thorac Cancer. 2020 Jul;11(7):1918-1926. doi: 10.1111/1759-7714.13482. Epub 2020 May 29.
The objective of this study was to explore the association between fresh fruit consumption and long-term risk of upper gastrointestinal cancer (UGI) in the Linxian Dysplasia Nutrition Intervention Trial (NIT) cohort.
A cohort of 3318 subjects with esophageal squamous dysplasia participated in the Linxian Dysplasia NIT in May 1985 and were followed up until 30 September 2015. Demographic characteristics, lifestyle, and history of diseases were collected at the baseline. The primary endpoint was death from esophageal squamous cell carcinoma (ESCC), gastric cardia carcinoma (GCC), and gastric noncardia carcinoma (GNCC). Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using the Cox proportional hazard model.
In the 30-year follow-up, a total of 541 ESCC, 284 GCC, and 77 GNCC deaths occurred. Relative to those who never or rarely consumed fresh fruit, the risk of ESCC mortality in participants who consumed fresh fruit more than 12 times/year were significantly decreased by 37.3% (HR = 0.63, 95% CI: 0.49-0.81). In the subgroup analyses, significantly protective effects on ESCC mortality were observed especially in females (HR = 0.59, 95% CI: 0.40-0.89), non-smokers (HR = 0.67, 95% CI: 0.48-0.94), and nondrinkers (HR = 0.69, 95% CI: 0.51-0.93).
Consuming fresh fruit more than 12 times/year may reduce the long-term risk of ESCC mortality in this dysplasia population, particularly in females, non-smokers, and nondrinkers. Future studies are needed to confirm these findings.
本研究旨在探讨林县上皮内瘤变营养干预试验（NIT）队列中新鲜水果摄入与上消化道癌症（UGI）长期风险之间的关联。
1985 年 5 月，3318 名食管鳞状上皮内瘤变患者参加了林县上皮内瘤变 NIT，并随访至 2015 年 9 月 30 日。基线时收集了人口统计学特征、生活方式和疾病史。主要终点是死于食管鳞状细胞癌（ESCC）、贲门癌（GCC）和胃非贲门癌（GNCC）。使用 Cox 比例风险模型估计风险比（HR）和 95%置信区间（95%CI）。
在 30 年的随访中，共有 541 例 ESCC、284 例 GCC 和 77 例 GNCC 死亡。与从不或很少食用新鲜水果的人相比，每年食用新鲜水果超过 12 次的参与者 ESCC 死亡风险显著降低 37.3%（HR=0.63，95%CI：0.49-0.81）。在亚组分析中，在女性（HR=0.59，95%CI：0.40-0.89）、不吸烟者（HR=0.67，95%CI：0.48-0.94）和不饮酒者（HR=0.69，95%CI：0.51-0.93）中观察到对 ESCC 死亡的显著保护作用。
在该上皮内瘤变人群中，每年食用新鲜水果超过 12 次可能降低 ESCC 死亡的长期风险，尤其是在女性、不吸烟者和不饮酒者中。需要进一步的研究来证实这些发现。
