Paniagua Estévez M, Roque Lozano J, Cerdán Cordoví A, Rodríguez Miranda A
Instituto Nacional de Gastroenterología, Habana, Cuba.
Acta Gastroenterol Latinoam. 1994;24(2):99-104.
Since several years ago, the biliar acids have been incriminated in the etiopathogeny of colon cancer and adenomatous polyps, above all the secondary ones, involved by its aggressive action over the colonic epithelium in these mechanisms. The dietetical habits of developed countries have the high responsibility for this situation, their food pattern being a high animal fat diet, high in refined carbohydrates, animal proteins and low in dietetic fiber (diet type "occidental") unlike to developing countries that have a high natural fiber diet, having a much lower incidence in colon cancer and adenomatous polyps. Dietetic fiber has been studied considering it with a protector effect over the aggressive action of biliar acids on the colon mucous. We have studied 60 patients, 20 of them with colon cancer, 20 with adenomatous and 20 case controls without colonic pathology. All of them had total high biliar acids in stools, a dietetical screening was carried out to determine the intake of animal fat and dietetic fibre during a week. There was a significant correlation in cases of cancer, polyps and biliar acids high in stools. There was also a significant correlation between the undue dietetic habits in colon cancer patients and high bilar acids. In those cases of adenomatous polyps, there was not a significant relation to dietetic habits.
自数年前起,胆汁酸就被认为与结肠癌和腺瘤性息肉的病因发病机制有关,尤其是继发性的结肠癌和腺瘤性息肉,这是因为胆汁酸对结肠上皮具有侵袭作用,参与了这些机制。发达国家的饮食习惯对这种情况负有很大责任,其食物模式为高动物脂肪饮食、高精制碳水化合物、高动物蛋白且低膳食纤维(“西方”饮食类型),这与发展中国家不同,发展中国家的饮食富含天然纤维,结肠癌和腺瘤性息肉的发病率要低得多。人们对膳食纤维进行了研究,认为它对胆汁酸对结肠黏膜的侵袭作用具有保护效应。我们研究了60名患者,其中20名患有结肠癌,20名患有腺瘤,20名作为无结肠病变的对照。所有患者粪便中的总胆汁酸含量都很高,我们进行了饮食筛查,以确定一周内动物脂肪和膳食纤维的摄入量。癌症、息肉病例与粪便中高胆汁酸含量之间存在显著相关性。结肠癌患者不当的饮食习惯与高胆汁酸之间也存在显著相关性。在腺瘤性息肉病例中,与饮食习惯没有显著关系。