Potischman N
Environmental Studies Section, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.
J Nutr. 1993 Feb;123(2 Suppl):424-9. doi: 10.1093/jn/123.suppl_2.424.
There appears to be a natural progression of some preinvasive cervical lesions to more advanced lesions. Although research has evaluated the associations between nutrients and particular preinvasive lesions or invasive disease, little work has been done to compare results across the spectrum of lesions in the progression to invasive disease. This review compiles studies that have evaluated the relation between nutrients and cervical neoplasia and evaluates the general consistency of the literature across stage of disease. Preformed vitamin A does not appear to be related to risk of any preinvasive or invasive lesions, whereas vitamin C has been associated with a reduced risk for dysplasia, in situ cancer, and invasive disease, particularly among smokers. There was evidence of reduced risks associated with various carotenoids and vitamin E at all stages of the disease process, although these studies were inconsistent and further work is needed. Folate was the only nutrient that appeared to be protective for dysplastic lesions and not related to risk of in situ or invasive disease. Red blood cell folate was a better predictor of dysplasia than were serum or dietary folate, and further investigation using this marker of folate status is warranted. Research is needed across a spectrum of lesions within one study, with particular attention to interactions between nutrients and other risk factors for disease.
一些宫颈原位病变似乎会自然发展为更严重的病变。尽管已有研究评估了营养素与特定原位病变或浸润性疾病之间的关联，但在比较病变进展至浸润性疾病全过程中不同病变阶段的研究结果方面，所做的工作很少。本综述汇编了评估营养素与宫颈肿瘤形成之间关系的研究，并评估了疾病各阶段文献的总体一致性。预形成的维生素A似乎与任何原位或浸润性病变的风险均无关联，而维生素C与发育异常、原位癌和浸润性疾病风险降低有关，尤其是在吸烟者中。有证据表明，在疾病过程的各个阶段，各种类胡萝卜素和维生素E与风险降低相关，尽管这些研究结果并不一致，仍需进一步研究。叶酸是唯一一种似乎对发育异常性病变有保护作用且与原位或浸润性疾病风险无关的营养素。红细胞叶酸比血清或膳食叶酸更能预测发育异常，因此有必要使用这种叶酸状态标志物进行进一步研究。需要在一项研究中对一系列病变进行研究，尤其要关注营养素与其他疾病风险因素之间的相互作用。
