Schwartz L H, Urban T, Hercberg S
Service de Cancérologie-Radiothérapie, Hôpital Tenon, Paris.
Presse Med. 1994 Dec 10;23(39):1826-30.
Cancer is a disease of the genome and free-radicals can damage genomic DNA, hence the interest in the potential protective antioxidant effect of vitamin and minerals. Indeed, the findings of most retrospective studies suggest that diets rich in fruits and vegetables have a protective effect against cancer. Prospective randomized trials have however given controversial results. Beta-carotene, the precursor of vitamin A has been shown to induce regression of precancerous lesions and 13-cis retinoic acid has a preventive effect on the development of a second cancer in patients with epidermoid cancer of the buccal cavity, the pharynx or the larynx although no effect has been observed on the primary cancer. Current research also suggests vitamin C has a potential anticancer effect, particularly for cancer of the stomach, the rectum and the cervix. For vitamin E, epidemiological data give less conclusive results. Several prospective studies suggest the absence of any correlation between vitamin E intake and general risk of cancer. A Chinese trial has shown a decreased incidence of oesophageal and gastric carcinoma while a Finnish trial revealed increased incidence of cancer among smokers treated by beta-carotene and vitamin E. Selenium and zinc intake, based on geographical correlations, has also been suggested to affect cancer incidence, but the results of prospective studies are conflicting. For example in 10 such trials analyzing blood selenium levels and risk of cancer, 4 have demonstrated a significant correlation. Further research is needed but is hindered by the absence of an adequate animal model and the difficulty in conducting large clinical trials. Nevertheless, positive data collected to date must be validated to determine the real effect of dietary preventive measures in the fight against cancer.
癌症是一种基因组疾病,自由基会损害基因组DNA,因此人们对维生素和矿物质潜在的抗氧化保护作用产生了兴趣。事实上,大多数回顾性研究结果表明,富含水果和蔬菜的饮食对癌症具有保护作用。然而,前瞻性随机试验给出了相互矛盾的结果。维生素A的前体β-胡萝卜素已被证明可使癌前病变消退,13-顺式维甲酸对颊腔、咽部或喉部表皮样癌患者的二次癌症发生具有预防作用,尽管对原发性癌症未观察到效果。目前的研究还表明,维生素C具有潜在的抗癌作用,特别是对胃癌、直肠癌和宫颈癌。对于维生素E,流行病学数据给出的结果不太确凿。几项前瞻性研究表明,维生素E摄入量与总体癌症风险之间不存在任何关联。一项中国试验显示食管癌和胃癌的发病率有所下降,而一项芬兰试验则显示,接受β-胡萝卜素和维生素E治疗的吸烟者中癌症发病率有所上升。基于地理相关性,硒和锌的摄入量也被认为会影响癌症发病率,但前瞻性研究的结果相互矛盾。例如,在10项分析血硒水平与癌症风险的此类试验中,有4项显示出显著相关性。需要进一步研究,但由于缺乏合适的动物模型以及进行大型临床试验的困难而受到阻碍。尽管如此,迄今收集到的阳性数据必须得到验证,以确定饮食预防措施在抗癌斗争中的实际效果。