Dworkin B M, Rosenthal W S, Mittelman A, Weiss L, Applebee-Brady L, Arlin Z
Sarah C. Upham Division of Gastroenterology, New York Medical College, Valhalla.
Am J Gastroenterol. 1988 Jul;83(7):748-51.
Diminished blood selenium levels have been associated with increased risk of gastrointestinal cancers in man, while dietary selenium supplementation reduces the incidence of experimental colon cancer in rats. However, no previously published data are available concerning selenium and the evolution of colon cancer from benign neoplastic colonic polyps through localized and metastatic cancer. To assess any influence of selenium on this polyp to cancer sequence, we measured plasma and erythrocyte selenium levels in colonoscopically and histologically evaluated patients with adenomatous polyps (group I), locally resectable colon cancer (group II), metastatic colon cancer (group III), and selected colonoscopy negative controls (group IV). We found no difference in selenium levels between groups IV versus groups I or II. Likewise, within group I, no difference in selenium was present for different polyp histologies or numbers of polyps. However, selenium levels did drop progressively (p = 0.028, ANOVA) from polyp (group I) to local cancer (group II, p = NS vs group I) to metastatic cancer (group III, p less than 0.05 vs group I or group II). Parallel changes were seen in both plasma and erythrocyte levels, suggesting that these selenium abnormalities are of long duration, reflecting tissue stores, and therefore capable of influencing cancer risk. We conclude that selenium stores may not be an important factor in the de novo formation of benign neoplastic colonic polyps. Although these data suggest that selenium does not affect the polyp-cancer sequence, it is possible that a subset of patients with polyps and the lowest selenium levels are at higher risk for malignant transformation. However, these human data do not support a significant role for selenium in colon carcinogenesis.
血液中硒水平降低与人类患胃肠道癌症的风险增加有关，而膳食补充硒可降低大鼠实验性结肠癌的发病率。然而，以前没有关于硒与结肠癌从良性肿瘤性结肠息肉发展到局部和转移性癌症的演变的公开数据。为了评估硒对这种息肉到癌症序列的任何影响，我们测量了经结肠镜和组织学评估的腺瘤性息肉患者（第一组）、局部可切除结肠癌患者（第二组）、转移性结肠癌患者（第三组）以及选定的结肠镜检查阴性对照者（第四组）的血浆和红细胞硒水平。我们发现第四组与第一组或第二组之间的硒水平没有差异。同样，在第一组中，不同息肉组织学类型或息肉数量的患者硒水平也没有差异。然而，从息肉（第一组）到局部癌症（第二组，与第一组相比无统计学意义）再到转移性癌症（第三组，与第一组或第二组相比p<0.05），硒水平确实逐渐下降（方差分析，p = 0.028）。血浆和红细胞水平都出现了平行变化，表明这些硒异常持续时间较长，反映了组织储存情况，因此能够影响癌症风险。我们得出结论，硒储存可能不是良性肿瘤性结肠息肉新生形成的重要因素。尽管这些数据表明硒不影响息肉到癌症的序列，但有可能息肉患者中硒水平最低的一部分人发生恶性转化的风险更高。然而，这些人体数据不支持硒在结肠癌发生中起重要作用。
