饮食补钙对人食管上皮癌前病变的影响：双盲干预试验研究

A randomized double blind intervention trial was carried out in Huixian County Henan Province, a high risk area for esophageal cancer, to observe the effect of oral calcium supplementation on esophageal precancerous lesions. Two hundred and fourteen cases with basal cell hyperplasia and 40 with dysplasia of the esophagus aged 25-75 randomly received daily oral supplementation of 600 mg calcium or placebo for 7 months. In the calcium supplementation group, the basal cell hyperplasia and dysplasia of the esophagus were significantly improved and the profile of esophageal epithelial proliferation cells labeled with 3H-TdR approached that of the normal subjects in low risk area for esophageal cancer. The results indicate that calcium supplementation can inhibit basal cell hyperplasia and dysplasia of the esophageal epithelium in high risk area for esophageal cancer. The mechanism of interruption of esophageal precancerous lesions by calcium is discussed.     

Plant-based dietary patterns and risk of esophageal cancer:A prospective cohort study spanning 17 years

Objective: Plant-based diets have multiple health benefits for cancers; however, little is known about the association between plant-based dietary patterns and esophageal cancer(EC).This study presents an investigation of the prospective associations among three predefined indices of plant-based dietary patterns and the risk of EC.Methods: We performed endoscopic screening for 15,709 participants aged 40-69 years from two high-risk areas of China from January 2005 to December 2009 and followed t...     

食管癌危险因素的病例对照研究

目的:探讨食管癌高发区--淮安市楚州区居民的食管癌危险因素.方法:采用以人群为基础的1:2匹配的病例对照研究方法,用专门设计的调查表对207例食管癌病例及414例正常对照者进行1对1的询问调查,采用条件logistic回归分析法对所获得的调查资料进行统计学分析.结果:人均月收入低、体质指数(body mass index,BMI)偏低、既往食管病变、不按时就餐、10年前喜食辣食、10年前喜食烫食、喜食肥肉、不食大蒜和肿瘤家族史等可能是食管癌的危险因素.结论:饮食习惯、人均月收入、既往食管病变等因素可影响食管癌的发生,应针对相关危险因素采取相应的预防措施.     

盐亭县核黄素强化盐干预试验人群食管癌前病变与转归的研究

目的:研究核黄素强化盐对食管癌高发人群食管癌前状态的影响.方法:用食管脱落细胞学检查方法,比较分析在食管癌高发区四川盐亭县开展核黄素强化营养盐干预5年的前后,试验组与对照组食管上皮增生的检出率、食管正常者的进展率和食管增生者的逆转率,评价核黄素强化盐对人群的食管癌前病变的干预效果.结果:干预试验前,试验组和对照组的食管上皮增生检出率,男性分别为19.6%(47/240)和10.9%(24/222),女性分别为15.5%(36/233)和13.6%(29/213);干预5年后,试验组男性和女性食管上皮增生检出率分别为12.5%(30/240)和12.9%(30/233),比对照组分别降低49/6%(X2=11.55,P<0.01)和57.0%(X219.68,P<0.01).与对照相比,试验组男性和女性食管增生转归的比数比分别为3.8(95%CI为1.1～13.2,P<0.05)和10.0(95%CI为2.6～37.9,P<0.01);而在正常人群中,试验组男性和女性食管向癌变进展的比数比分别为0.42(95%CI为0.24～0.76,P<0.01)和0.38(95%CI为0.21～0.68,P<0.01).结论:在食管癌高发区人群中实施核黄素强化营养盐的干预措施能延缓和逆转食管癌前病变的发展进程,有益于降低食管癌的发病率.     

A prospective study of dietary calcium, dairy products and prostate cancer risk (Finland)

High dietary intakes of calcium and dairy products have been hypothesized to enhance prostate cancer risk, but available prospective data regarding these associations are inconsistent. We examined dietary intakes of calcium and dairy products in relation to risk of prostate cancer in the Alpha-Tocopherol, Beta-Carotene (ATBC) Cancer Prevention Study, a cohort of 29,133 male smokers aged 50-69 years at study entry. Dietary intake was assessed at baseline using a validated 276-item food use questionnaire. Cox proportional hazards regression was used to adjust for known or suspected risk factors for prostate cancer. During 17 years of follow-up, we ascertained 1,267 incident cases of prostate cancer. High versus low intake of dietary calcium was associated with a marked increase in prostate cancer risk. The multivariate relative risk (RR) of prostate cancer for > or =2,000 mg/day compared to <1,000 mg/day of calcium intake was 1.63 (95% confidence interval (CI), 1.27-2.10; p trend < 0.0001). Total dairy intake was also positively associated with risk of prostate cancer. The multivariate RR of prostate cancer comparing extreme quintiles of intake was 1.26 (95% CI, 1.04-1.51; p trend = 0.03). However, no association with total dairy intake remained after we adjusted for calcium (p trend = 0.17). Findings were similar by stage and grade of prostate cancer. The results from this large prospective study suggest that intake of calcium or some related component contained in dairy foods is associated with increased prostate cancer risk.     

Promoter DNA hypermethylation in gastric biopsies from subjects at high and low risk for gastric cancer

Gene promoter CpG island hypermethylation is associated with Helicobacter pylori (H. pylori) infection and may be an important initiator of gastric carcinogenesis. To examine factors influencing methylation, we utilized bisulfite Pyrosequencing® technology for quantitative analysis of promoter DNA methylation in RPRM, APC, MGMT and TWIST1 genes using DNA from 86 gastric biopsies from Colombian residents of areas with high and low incidence of gastric cancer. H. pylori colonies were cultured from the same subjects, and gastric pathology was evaluated. Virulence factors cagA (including segments of the 3′ end, encoding EPIYA polymorphisms) and vacA s and m regions were characterized in the H. pylori strains. Using univariate analysis, we found significantly elevated levels of RPRM and TWIST1 promoter DNA methylation in biopsies from residents of the high‐risk region compared to those from residents of the low‐risk region. The presence of cagA and vacA s1m1 alleles were independently associated with elevated levels of promoter DNA methylation of RPRM and MGMT. Using multivariate analysis, DNA methylation of RPRM was associated with location of residence, cagA and vacA s1m1 status and methylation of TWIST1. We conclude that cagA and vacA virulence determinants are significantly associated with quantitative differences in promoter DNA methylation in these populations, but that other as yet undefined factors that differ between the populations may also contribute to variation in methylation status.     

磁县居民食管癌危险因素病例对照研究

目的：探索食管癌发病危险因素。方法：选择河北磁县３５０例食管癌患者为病例组，对照组选取其同性别、年龄上下不超过５岁的邻居，进行１：１病例对照研究，采用统一调查表，由专业人员入户进行回顾性调查，所获资料用ＥｐｉＩｎｆｏｘ软件录入微机统计处理。结果：从２０个因素中筛选出９个有显著意义的国素，酸菜（ＯＲ＝３．４０）、咸菜（ＯＲ＝２．５９）、烫烫食（ＯＲ＝３．１１）、禽蛋（ＯＲ＝４．２２）、精神因素（ＯＲ     

A case-control study of dietary and nondietary risk factors for breast cancer in Shanghai

A case-control study of breast cancer (186 cases, 186 population, and 186 hospital controls) was conducted in Shanghai, China, between 1982 and 1984. This population has a high daily caloric intake (population control mean, 2394 kcal) and low percentage of calories from fat (22.7%) compared to Western populations. Cases have a significantly greater daily caloric intake than controls, primarily because of increased consumption of monounsaturated fat for which the relative risk is 1.89 for the highest compared to the lowest quintile (P = 0.02). This finding requires cautious interpretation but seems worthy of further study in populations with similar dietary practices.     

A randomized trial of dietary intervention for breast cancer prevention

Epidemiologic data and animal experiments suggest that dietary fat may influence risk of breast cancer. To determine whether intervention with a low-fat, high-carbohydrate diet would reduce breast cancer incidence in women at increased risk of the disease, we carried out a randomized controlled trial in Canada. We recruited 4,690 women with extensive mammographic density and randomized them to an intervention group or a comparison group. The intervention group received intensive dietary counseling to reduce fat intake to a target of 15% of calories and increase carbohydrate to 65% of calories. Dietary intakes were assessed throughout using food records. Subjects were followed for at least 7 years and for an average of 10 years. The main outcome was invasive breast cancer. Percentage of calories from fat in the intervention group decreased from 30% at baseline to 20% after randomization and remained 9% to 10% lower than the comparison group throughout. There were 118 invasive breast cancers in the intervention group and 102 in the comparison group [adjusted hazard ratio = 1.19 (95% CI: 0.91-1.55)]. Analysis of food records showed that fat intake at baseline and after randomization was not associated with total breast cancer incidence. Greater weight and lower carbohydrate intake at baseline and after randomization were associated with an increased risk of estrogen receptor (ER)-positive breast cancer. Our findings suggest that a sustained reduction in dietary fat intake did not reduce risk of breast cancer in women with extensive mammographic density. Weight and carbohydrate intakes were associated with risk of ER-positive breast cancer.     

中国南方沿海食管癌高发区危险因素研究:吸烟作用

目的　旨在调查吸烟、饮酒、和某些食物因素的食管癌病因学作用。方法　在中国食管癌高发区之一潮汕地区进行了一项大型的病例 -对照研究。研究包括 12 4 8例食管鳞状细胞癌病例及 12 4 8例按年龄、性别的对照。结果　观察到每日吸烟量和持续吸烟时间有明显的剂量 -效应关系。在调整了职业、居住地、经济收入以及饮酒后 ,与不吸烟者相比较 ,重度吸烟者(≥ 30支 /日 )的相对危险度为 10以上。吸烟与饮酒之间存在着相乘方式的交互作用 ,与轻度吸烟和饮酒者比较 ,重度吸烟和饮酒者的相对危险度为 32 .5。结论　戒烟有明显的保护作用 ,戒烟的时间有剂量 -效应关系。     

A case-control study of dietary factors and stomach cancer risk in Poland

We report results from a case-control study on stomach cancer conducted in 1980-81 in Cracow, Poland, where the risk of this disease is among the highest reported world-wide. One hundred and ten cases from a surgical clinic were matched by age and sex to the same number of controls from the same hospital. A matched series from a population-based health survey was also considered. After adjusting for residency, smoking and various food items, cases and hospital controls showed significant differences in consumption of fruits (RR rarely vs. daily: 3.24; 95% CI: 1.56-6.77), joint consumption of vegetables, salads and fruits (RR low vs. high: 4.23; 95% CI: 1.41-12.63), and consumption of protein-containing foods (RR low vs. high: 0.23; 95% CI: 0.08-0.61). Consumption of strong alcoholic beverages on an empty stomach (before breakfast) was associated with an RR of 2.09 (1.04-4.22). The findings are discussed in relation to the apparent urban/rural difference in stomach cancer incidence in Poland and the possible underlying etiological factors involved.     

Effects of sodium sulfate on fecal pH and proliferation of colonic mucosa in patients at high risk for colon cancer

High fecal pH level has been suggested as a risk factor for colorectal cancer. We previously demonstrated that, although sodium sulfate did not affect the proliferation rate of colonic mucosa, as indicated by thymidine-labeling index, it did lower fecal pH in subjects at average risk for colon cancer. In the current study, we evaluated the effects of sodium sulfate on fecal pH and proliferation of colonic mucosa in subjects at high risk for colon cancer. Fifty-seven patients who had had colonic polyps removed were randomly assigned to two groups to receive either sodium sulfate (27 patients) or a placebo (25 patients) at a mean dose of 4 g/day for 14 days. Age, sex, height, and weight were comparable in both groups. Before intervention, levels of fecal pH were similar in the two groups, but after intervention, fecal pH was reduced only in the sodium sulfate group (mean decrease, 0.3 U; P less than .01). Thymidine-labeling index (number of labeled cells per number of cells counted) was similar in the two groups prior to intervention and did not change significantly after intervention (mean increase, 0.9%; P = .35). Regression analysis revealed no correlation between the change in labeling index and the change in fecal pH. We conclude that high fecal pH level is only indirectly associated with the development of colon cancer and, therefore, may be a secondary, rather than a primary, measure of cancer risk.     

N-nitrosamines in gastric juice of subjects from high incidence area of esophageal cancer

A total of 353 samples of gastric juice was collected from Lin-xian subjects who were examined by endoscopy. NDMA, NDEA, NMBzA, Npyr, Npip, NSAR and other unknown compounds were detected in the fasting gastric juice. NMBzA, Npyr, Npip and NSAR can induce esophageal cancer in animals. Among the concentrations of N-Nitrosamines in gastric juice, the level of NDMA was the highest, its mean value 17.09 ppb; the level of NDEA stood next with a mean value of 6.95 ppb; the amounts of NMBzA, Npyr and Npip were 4.77, 2.45 and 1.30 ppb, respectively. A positive correlation was found between the amount of N-Nitrosamines in gastric juice and the various lesions in the esophageal epithelium of the subjects, the amount of N-Nitrosamines in gastric juice from subjects with normal esophageal epithelium was lower than that from subjects with marked dysplasia or carcinoma of esophagus. This finding lends further support to their possible involvement in esophageal cancer development.     

介入及化疗综合治疗高危大肠癌

目的　观察介入方法综合治疗高危大肠癌的远期疗效。方法　大肠癌根治术及再次根治术 ;术中门脉置管及手术前后选择性肝动脉 ,肠系膜上或肠系膜下动脉 ,髂内动脉或腹壁下动脉插管化疗 ;术后腹腔灌注化疗 ;全身辅助化疗 ;局部辅助放疗 ;中医中药和免疫治疗等有机综合治疗方法随机性治疗 2 2例高危大肠癌 ,并与常规综合治疗 2 5例对照 ,观察其 1.5年及 2 .5年无瘤生存率。结果　治疗组 1.5年无瘤生存率 90 .9% ,对照组 72 .0 % ,两者比较无显著性差异 (P >0 .0 5 ) ,治疗组 2 .5年无瘤生存率 76 .9% ,对照组为 42 .9% ,两者比较差异显著 (P <0 .0 5 )。治疗组的毒副反应及并发症均较对照组减轻。结论　有机溶入介入疗法及中医中药的综合治疗方法 ,可提高高危大肠癌病人 1.5年及2 .5年无瘤生存率 ,且治疗的毒副反应及并发症均较轻。     

Metabolic syndrome after risk-reducing salpingo-oophorectomy in women at high risk for hereditary breast ovarian cancer: A controlled observational study

Surgical menopause may increase the risk of cardiovascular diseases (CVDs). The aim of this study was to determine the risk of metabolic syndrome in women who had undergone risk-reducing salpingo-oophorectomy (RRSO) because of increased risk of hereditary breast ovarian cancer (HBOC).A sample of 326 (65% of invited) women at risk of HBOC who had undergone RRSO was compared to 679 women from the general population. Mean follow-up after surgery was 6.5 years (standard deviations [SD] 4.4). RRSO was significantly associated with metabolic syndrome according to the 2005 National Cholesterol Education Program Adult Treatment Panel III criteria (odds ratio [OR] 2.46 [95% confidence interval (CI) 1.63, 3.73]) and according to the International Diabetes Federation criteria (OR 2.49 [CI 1.60, 3.88]), as were increasing age and body mass index (BMI).RRSO in women at risk of HBOC is significantly associated with the metabolic syndrome, and the follow-up after RRSO should take these findings into consideration.     

食管癌高发区上消化道恶性肿瘤死亡趋势分析

目的分析河北省食管癌高发区磁县、涉县29年（1974-2002年）上消化道恶性肿瘤的死亡情况,为肿瘤防治提供依据。方法对比分析磁县、涉县同时期20世纪70年代（1974-1976年）、90年代（1990-1992年）、21世纪初（2000-2002年）全人群肿瘤登记的食管癌、贲门癌、非贲门胃癌的死亡率。结果自20世纪70年代到21世纪初,磁县、涉县食管癌粗死率均呈现明显下降趋势,磁县食管癌粗死率下降了40.96/10万,下降了32.21%;而同时期涉县下降了65.74/10万,下降了50.06%。磁县贲门癌和非贲门胃癌的粗死率呈现曲线波动,变化不大,20世纪70年代贲门癌死亡占上消化道恶性肿瘤死亡的5.67%,到90年代占4.58%,21世纪初占8.15%。而涉县贲门癌呈现明显上升趋势,非贲门胃癌呈现明显下降趋势,发现贲门癌在上消化道恶性肿瘤死亡中所占比重越来越大,由20世纪70年代的6.28%上升到新世纪的30.17%。磁县、涉县人群中男性贲门癌的死亡率高于女性。磁县山区贲门癌死亡率高于丘陵和平原,年平均死亡率达到11.61/10万,且有上升趋势。结论29年来磁县、涉县食管癌死亡呈显著下降趋势,磁县贲门癌、非贲门胃癌死亡均呈曲线波动;涉县贲门癌死亡率呈明显上升趋势,非贲门胃癌死亡率呈下降趋势。