Lai Bo, Li Zhong, Li Junjie
Department of Interventional Radiology, Inner Mongolia Forestry General Hospital, The Second Clinical Medical School of Inner Mongolia University for the Nationalities, No.81, Lincheng Road, 022150, Yakeshi, China.
Department of Medical Imaging, Inner Mongolia Forestry General Hospital, The Second Clinical Medical School of Inner Mongolia University for the Nationalities, Yakeshi, China.
BMC Gastroenterol. 2025 Aug 11;25(1):575. doi: 10.1186/s12876-025-04163-9.
Colon cancer (CC) is the third most diagnosed malignancy and second leading cause of cancer mortality globally, with ~ 1.9 million new cases and 903,859 deaths annually (Bray et al. in CA Cancer J Clin 68(6):394-424, 2018). Diet represents a key modifiable risk factor for CC pathogenesis (Herr and Buchler in Cancer Treat Rev 36:377-383, 2010). Cruciferous vegetables (CV)-rich in glucosinolates that hydrolyze into bioactive isothiocyanates (Willett in Cancer Epidem Biomar 10:3-8, 2001; Murillo and Mehta in Nutr Cancer. 41(1-2):17-28, 2001; Higdon et al. in Pharmacol Res 55:224-36, 2007)-exhibit chemopreventive properties through carcinogen detoxification, apoptosis induction, and cell cycle arrest (Zhang et al. in Proc Nutr Soc 65:68-75, 2006). While prior meta-analyses report an inverse association between CV intake and CC risk (Tse and Eslick in Nutr Cancer 66(1):128-39, 2014), the quantitative dose-response relationship remains uncharacterized, limiting translational insights for dietary guidance.
A thorough search of the literature was conducted in Embase, Scopus,Web of Science, PubMed, and Cochrane Library from inception to June 28, 2025, using a predetermined strategy encompassing both cohort and case-control studies. Two independent reviewers selected studies based on predefined inclusion criteria, with discrepancies resolved by consensus or senior investigator adjudication. Statistical analyses were performed using Stata (version 14.2). Subgroup analyses accounted for study design, geographic location, and potential confounders. Publication bias was assessed using Egger's test, the LFK index, and the trim-and-fill method. Sensitivity analyses employed the leave-one-out approach. The dose-response relationship was evaluated using restricted cubic spline models.
Data from 17 research-including 7 cohort studies and 10 case-control studies-with 97,595 patients were methodically combined in this investigation.Consumption of CV was found to be inversely correlated with CC risk (odds ratios [OR] = 0.8; 95% confidence interval [CI] 0.72-0.90) in the pooled analysis using a random-effects model. Furthermore, a progressive decrease in risk was shown by the non-linear dose-response analysis as consumption levels increased.
This meta-analysis suggests a potential inverse association between higher CV intake and CC incidence. However, these findings should be interpreted cautiously due to methodological limitations, including heterogeneity in study designs, dietary assessment methods and potential residual confounding.
结肠癌（CC）是全球第三大最常被诊断出的恶性肿瘤，也是癌症死亡的第二大主要原因，每年约有190万新发病例和903,859例死亡（Bray等人，《CA：A Cancer Journal for Clinicians》68(6):394 - 424, 2018）。饮食是CC发病机制中一个关键的可改变风险因素（Herr和Buchler，《Cancer Treatment Reviews》36:377 - 383, 2010）。十字花科蔬菜（CV）富含硫代葡萄糖苷，可水解为生物活性异硫氰酸盐（Willett，《Cancer Epidemiology, Biomarkers & Prevention》10:3 - 8, 2001；Murillo和Mehta，《Nutrition and Cancer》41(1 - 2):17 - 28, 2001；Higdon等人，《Pharmacological Research》55:224 - 36, 2007），通过致癌物解毒、诱导凋亡和细胞周期阻滞表现出化学预防特性（Zhang等人，《Proceedings of the Nutrition Society》65:68 - 75, 2006）。虽然先前的荟萃分析报告了CV摄入量与CC风险之间存在负相关（Tse和Eslick，《Nutrition and Cancer》66(1):128 - 39, 2014），但定量剂量反应关系仍未明确，限制了饮食指导的转化性见解。
从创刊到2025年6月28日，在Embase、Scopus、Web of Science、PubMed和Cochrane图书馆中进行了全面的文献检索，采用了涵盖队列研究和病例对照研究的预定策略。两名独立评审员根据预定义的纳入标准选择研究，分歧通过共识或由资深研究员裁决解决。使用Stata（版本14.2）进行统计分析。亚组分析考虑了研究设计、地理位置和潜在混杂因素。使用Egger检验、LFK指数和修剪填充法评估发表偏倚。敏感性分析采用留一法。使用受限立方样条模型评估剂量反应关系。
本研究系统地合并了来自17项研究的数据，包括7项队列研究和10项病例对照研究，共97,595名患者。在使用随机效应模型的汇总分析中，发现CV的摄入量与CC风险呈负相关（比值比[OR] = 0.8；95%置信区间[CI] 0.72 - 0.90）。此外，非线性剂量反应分析表明，随着消费水平的增加，风险逐渐降低。
这项荟萃分析表明，较高的CV摄入量与CC发病率之间可能存在负相关。然而，由于方法学上的局限性，包括研究设计、饮食评估方法的异质性以及潜在的残余混杂因素，这些发现应谨慎解释。
