van den Brandt P A, Goldbohm R A, van 't Veer P, Bode P, Dorant E, Hermus R J, Sturmans F
Department of Epidemiology, University of Limburg, Maastricht, The Netherlands.
J Natl Cancer Inst. 1993 Feb 3;85(3):224-9. doi: 10.1093/jnci/85.3.224.
Various animal studies and ecologic studies suggest an inverse association between low dietary selenium intake and risk of various types of cancer.
The goal of this prospective cohort study was to investigate the association between toenail selenium levels and risks of stomach cancer and colorectal cancer.
Our cohort study on diet and cancer started in The Netherlands in 1986 with enrollment of 120,852 subjects aged 55-69 years. Of this number, 58,279 were men and 62,573 were women. Following the case-cohort approach for analysis of the data, we randomly selected from the cohort a subcohort of 3500 subjects (1688 men and 1812 women). After 3.3 years of follow-up, 155 incident cases of microscopically confirmed stomach cancer, 313 cases of colon cancer, and 166 cases of rectal cancer had been detected in the cohort. Toenail selenium data were available for 104 patients with stomach cancer, 234 with colon cancer, and 113 with rectal cancer and for 2459 subjects from the subcohort.
In a multivariate analysis, the relative rates (RRs) of stomach cancer for subjects in increasing quintiles of toenail selenium level were 1.00, 0.44, 0.59, 0.84, and 0.64 (trend, P = .491). For men, there was some evidence for an inverse association between toenail selenium levels and stomach cancer: The RR for those in the highest compared with the lowest quintile of toenail selenium was 0.40 (95% confidence interval = 0.17-0.96), but the trend was not statistically significant (P = .136). For stomach cancer in women, there was no negative association with toenail selenium levels. Toenail selenium level was not associated with the risk of colon or rectal cancer. After exclusion of cases diagnosed in the 1st year of follow-up, the RRs of colon cancer for increasing quintiles of toenail selenium were 1.00, 1.27, 1.17, 0.75, and 1.07 (trend, P = .544); for rectal cancer, RR estimates were 1.00, 1.73, 0.83, 1.58, and 1.12 (trend, P = .890).
These data support a suggestive but inconsistent inverse association between selenium levels and risk of stomach cancer. Our findings, like those of other studies, do not suggest an inverse association with risk of colorectal cancer.
多项动物研究和生态学研究表明，低膳食硒摄入量与各类癌症风险之间存在负相关。
这项前瞻性队列研究的目的是调查 toenail 硒水平与胃癌和结直肠癌风险之间的关联。
我们关于饮食与癌症的队列研究于1986年在荷兰启动，招募了120852名年龄在55至69岁之间的受试者。其中，男性58279名，女性62573名。按照病例队列方法对数据进行分析，我们从队列中随机选取了一个由3500名受试者组成的子队列（男性1688名，女性1812名）。经过3.3年的随访，队列中检测到155例经显微镜确诊的胃癌、313例结肠癌和166例直肠癌新发病例。有104例胃癌患者、234例结肠癌患者和113例直肠癌患者以及子队列中的2459名受试者的 toenail 硒数据。
在多变量分析中，toenail 硒水平处于递增五分位数的受试者患胃癌的相对风险（RRs）分别为1.00、0.44、0.59、0.84和0.64（趋势，P = 0.491）。对于男性，有一些证据表明 toenail 硒水平与胃癌之间存在负相关：toenail 硒处于最高五分位数与最低五分位数的受试者相比，RR为0.40（95%置信区间 = 0.17 - 0.96），但趋势无统计学意义（P = 0.136）。对于女性胃癌，与 toenail 硒水平无负相关。toenail 硒水平与结肠癌或直肠癌风险无关。排除随访第1年诊断的病例后，toenail 硒递增五分位数的受试者患结肠癌的RRs分别为1.00、1.27、1.17、0.75和1.07（趋势，P = 0.544）；对于直肠癌，RR估计值分别为1.00、1.73、0.83、1.58和1.12（趋势，P = 0.890）。
这些数据支持硒水平与胃癌风险之间存在提示性但不一致的负相关。我们的研究结果与其他研究一样，未表明与结直肠癌风险存在负相关。
