Faivre J, Couillault C, Belghiti C
Registre des tumeurs digestives (équipe associée Inserm-DGS), faculté de médecine, Dijon, France.
Bull Cancer. 1995 Jul;82 Suppl 3:172s-177s.
Results from case-control studies and prospective studies suggest that diet is involved in the causation of large bowel cancer either as initiator, promoter or inhibitor of carcinogenesis. Available data are not sufficient to serve as a basis for firm specific dietary advice. In the present situation it is attractive to investigate available hypotheses within the frame work of intervention trials. The adenoma appears to be one of the most appropriate end point of intervention studies. Several arguments indicate that the adenoma-carcinoma sequence is a multistep process. Colorectal cancer could possibly be prevented by intervening in the development of a small adenoma or in the growth into a large adenoma. Four intervention trials have been published so far. One of them suggest a protective effect of antioxidants vitamins on adenoma recurrence and three of them conclude to the absence of effect of these vitamins. A protective effect of lactulose on adenoma recurrence has also been suggested. Three studies are currently evaluating the effect of calcium supplementation on adenoma recurrence or growth of calcium supplementation, three studies the effect of fibre supplements, two studies the effect of antioxidants (one of them with calcium) and two studies the effect of diet intervention. The results of these studies will be available within three years.
病例对照研究和前瞻性研究的结果表明，饮食在大肠癌的病因中可能作为致癌作用的起始因素、促进因素或抑制因素。现有数据不足以作为给出确切具体饮食建议的依据。在当前情况下，在干预试验的框架内研究现有假设很有吸引力。腺瘤似乎是干预研究最合适的终点之一。有几个论据表明腺瘤-癌序列是一个多步骤过程。通过干预小腺瘤的发展或阻止其发展成大腺瘤，有可能预防结直肠癌。到目前为止，已经发表了四项干预试验。其中一项试验表明抗氧化维生素对腺瘤复发有保护作用，另外三项试验得出这些维生素没有效果的结论。也有人提出乳果糖对腺瘤复发有保护作用。目前有三项研究在评估补充钙对腺瘤复发或生长的影响，三项研究评估纤维补充剂的影响，两项研究评估抗氧化剂（其中一项与钙一起）的影响，两项研究评估饮食干预的影响。这些研究的结果将在三年内得出。
