结直肠癌和癌前病变检出率与其危险因素关系

摘 要：［目的］ 探索结直肠癌各类危险因素与结直肠癌及其癌前病变检出率关系,为合理制定结直肠癌筛查策略与防控措施提供科学依据。［方法］ 基于海宁市2010～2012年40～74岁目标人群结直肠癌筛查信息,分析各类危险因素与结直肠癌及癌前病变检出率关系。［结果］危险因素量化评估问卷调查240 177人,筛查顺应率为88.25%,病史阳性率6.09%;两次大便隐血试验（FOBT）388 780份,阳性21 079份,阳性率5.42%,初筛确定高危人群33 624人,占筛查人数的13.85%;高危人群结肠镜检查24 046例,顺应率为76.01 %;共检出肠道病变（息肉、腺瘤、癌、溃疡）6552例（其中结直肠癌119例,进展期腺瘤1042例）,总检出率为27.25%。男性检出率明显高于女性(P<0.01);检出率随年龄增长而上升（趋势检验,P<0.01）,70岁年龄组的检出率比40岁组高出1倍左右。多因素非条件Logistic回归分析表明：年龄大(OR=1.103,95%CI：1.075～1.133,P=0.000),大便隐血试验（FOBT）阳性（OR=4.470 95%CI：2.129～9.385,P=0.000）,有慢性阑尾炎或手术史(OR=0.445,95%CI：0.199～0.996,P=0.049),结直肠息肉史（OR=0.225,95%CI：0.051～0.995,P=0.049）与结直肠癌检出率存在统计关联。［结论］ 应加强对有黏液血便、有慢性阑尾炎或手术史、结直肠息肉史、大便隐血试验阳性的老年男性的结直肠癌筛查。     

大肠癌高发区人群的大肠腺瘤危险因子分析

对大肠癌高发区人群筛检出来的86例大肠腺癌进行了配对病例对照(1:5)研究,发现便秘史、粘液血便史、阑尾炎史、阑尾切除史、精神刺激史及服导泻药史与大肠腺瘤有阳性联系,并具有显著的统计学意义.饮食习惯、烟酒嗜好、肠息肉史、慢性腹泻史等在大肠腺癌患者中有增高倾向,但与对照组相比,差异无显著意义.本研究为大肠癌的人群预防提供了流行病学依据.     

基于金昌队列的常规循环肝功能标志物与结直肠癌发病关系的巢式病例对照研究

[目的]探索常规循环肝功能标志物与结直肠癌发病风险的关系。[方法]采用巢式病例对照研究，剔除基线慢性结肠炎、肠息肉和恶性肿瘤患者及基本资料不全者，以金昌队列3次随访期间新发结直肠癌患者145例为病例组，以随访未发生结直肠癌的人群作为对照来源，根据同期随访、基线年龄±2岁和同性别进行1∶4个体匹配，获得对照组580名，最终纳入725名研究对象。通过条件Logistic回归分析探究常规循环肝功能标志物与结直肠癌发病风险的关系，计算比值比(odds ratio,OR)及其95%置信区间(confidence interval,CI)，采用限制性立方样条分析相关因素与结直肠癌发病的剂量-反应关系。[结果]研究对象平均年龄为61.24岁，男性占比71.72%。多因素条件Logistic回归分析结果显示，在调整混杂因素后，发现总胆红素第2四分位数组研究对象发生结直肠癌的风险是第1四分位数组的0.490倍(OR=0.490,95%CI:0.273～0.879)，处于白蛋白第2、3、4四分位数组的研究对象发生结直肠癌的风险分别较处于第1四分位数组的研究对象降低41.6%(OR=0.584,95%CI:...     

血脂代谢异常及肿瘤标志物水平与结直肠癌肝转移关系研究

目的探究血脂异常及肿瘤标志物水平与结直肠癌肝转移的关系, 为结直肠癌肝转移提供更高的证据支持。方法回顾分析2019年1月至2023年2月在两家医院收治均经肠镜或手术等方式获得病理诊断的结直肠癌患者115例临床资料, 其中有肝转移的24例(肝转移组), 无肝转移的91例(无肝转移组)。使用卡方检验比较肝转移组与无肝转移组患者的一般临床资料和血清中的总胆固醇、总甘油三酯、高密度脂蛋白、低密度脂蛋白、癌胚抗原、糖类抗原19-9水平。Logistic回归分析结直肠癌肝转移的危险因素。结果 Logistic单因素分析显示总胆固醇(OR=6.780)、癌胚抗原(OR=44.611)、糖类抗原19-9(OR=11.340)水平为肝转移的危险因素(均P<0.05), 多因素分析显示总胆固醇(OR=4.166)、癌胚抗原(OR=28.393)为肝转移的危险因素(均P<0.05)。结论 TC、CEA升高为结直肠癌患者发生肝转移的危险因素, 可能促进结直肠癌肝转移。     

结直肠息肉摘除术后患者结肠镜复诊的依从性分析

目的 探讨结直肠息肉摘除术后患者结肠镜复诊依从性及其影响因素.方法 统计1 108例结直肠息肉摘除术后患者结肠镜复诊情况,并对可能影响依从性的因素进行统计学分析.结果 依从性好者354例(31.9％),依从性差者754例(68.1％).经统计学分析,依从行为与结直肠癌术史、操作医师资质有关,差异有统计学意义(P＜0.05);性别、年龄差异无统计学意义(P＞0.05).结论 此次调查结直肠息肉摘除术后结肠镜复诊依从性不高.有过结直肠癌术史,选择高年资医师手术者依从性相对较高.做好结直肠息肉术后患者的宣教工作,提升医师个人素养及威望,提高肠镜操作技巧及推广舒适内镜是提高结直肠息肉摘除术后复诊依从性的关键.     

可切除结直肠癌肺转移的预后因素分析

目的 探讨结直肠癌肺转移根治性切除术后的预后影响因素.方法 回顾性分析行根治性切除术的60例结直肠癌肺转移患者的临床资料.结果 全组患者肺转移瘤切除术后和结直肠癌切除术后的5年生存率分别为43.7%和74.0%.单因素分析结果显示,肺转移瘤数目和无瘤间期与结直肠癌术后患者的总生存率有关(均P＜0.05),肺转移瘤切除前癌胚抗原(CEA)水平、肺转移瘸数目、有无肺门和纵隔淋巴结转移与肺转移瘤切除术后患者的生存率有关(均P＜0.05).多因素分析结果显示,肺转移瘤数目和无瘤间期是结直肠癌术后患者预后的独立影响因素(OR=2.691,95% CI为1.072～6.754;OR=0.979,95% CI为0.963～0.994),肺转移瘤数目、有无肺门和纵隔淋巴结转移是肺转移瘤切除术后患者预后的独立影响因素(OR=3.319,95% CI为1.274～8.648;OR=3.414,95% CI为1.340～8.695).结论 经过严格选择的结直肠癌肺转移患者,尤其是单发肺转移及无肺门和纵隔淋巴结转移的患者,行根治性切除术后可获得长期生存.     

APC基因3'-非编码区rs1804197多态性与结直肠癌易感性的关系

目的 探讨结肠腺瘤性息肉病(APC)基因3'-非编码区rs1804197多态性与结直肠癌易感性的关系.方法 收集573例结直肠癌病例及588例对照外周静脉血标本,提取外周血DNA,使用实时荧光定量PCR进行基因分型,通过病例-对照研究方法分析rs1804197多态性位点不同基因型与结直肠癌易感性的关系.结果 结直肠癌病例组中rs1804197位点CC型387例(67.5％),AC型153例(26.7％),AA型33例(5.8％);对照组中CC型427例(72.6％),AC型144例(24.5％),AA型17例(2.9％);病例组与对照组中AA基因型比例差异有统计学意义(OR=2.14,95％ CI为1.17 ～3.91,P=0.011),A等位基因频率差异有统计学意义(P=0.011).进一步亚组分析显示,男性人群和不饮酒的人群中,病例组和对照组之间rs18041797位点基因型的频率分布差异具有统计学意义(P男性=0.048,P不饮酒=0.020);在男性人群中,携带A等位基因的个体罹患结直肠癌的风险增加了0.41倍(OR=1.41,95％ CI为1.01 ～ 1.98);在不饮酒的人群中,携带A等位基因的个体罹患结直肠癌的风险增加了0.22倍,但该结果并无统计学意义(OR=1.22,95％ CI为0.91 ～1.64).结论 APC基因3'-非编码区的rs1804197多态性与结直肠癌易感性相关,AA基因型可能增加部分人群中结直肠癌的易感性.     

基于大型数据库链接后队列的结直肠癌危险因素巢式病例对照研究

[目的]探讨我国结直肠癌发病相关影响因素及多种因素联合暴露与结直肠癌发病风险的关联。[方法]基于中国慢性病及其危险因素监测项目数据与中国肿瘤登记数据链接、匹配后的数据库开展巢式病例对照研究。共纳入结直肠癌病例755例,1∶4匹配对照共3 004例。采用条件Logistic回归模型计算各因素与结直肠癌发病风险的比值比（OR）和95%置信区间（CI）,并基于弗明汉风险评分函数计算每个个体不同因素联合暴露评分。[结果]在校正多种混杂因素后,目前吸烟(OR=1.765,95%CI:1.408～2.211)、目前饮酒(OR=1.370,95%CI:1.122～1.674)、日均静坐时长超过4 h(OR=1.843,95%CI:1.382～2.456)、体质指数(body mass index,BMI)为超重(OR=1.241,95%CI:1.027～1.501)或肥胖(OR=1.564,95%CI:1.217～2.009)、每天吃红肉类食物(OR=1.445,95%CI:1.185～1.763)、不经常吃蔬菜(OR=1.650,95%CI:1.196～2.278)、患有高血压(OR=1.634,...     

C-肽及胰岛素抵抗水平与结直肠癌发病风险的相关性研究

目的 探讨C-肽及胰岛素抵抗(insulin resistance,IR)与结直肠癌发病的相关性.方法 选取结直肠癌患者(n=50)、结直肠腺瘤患者(n=27)以及经过肠镜检查正常的对照组者(n=36),共113例,应用统计学分析比较其空腹血清胰岛素(FINS)、C-肽、空腹血糖水平以及胰岛素抵抗指数的差异.结果 结直肠癌组患者空腹血清胰岛素、胰岛素抵抗指数、C-肽、空腹血糖均高于对照组,差异有统计学意义(0＜0.01).结直肠腺瘤组患者C-肽和空腹血糖高于对照组,差异有统计学意义(P＜ 0.05).多因素Logistic回归分析发现年龄、C-肽、空腹血糖与结直肠癌发病有关;C-肽、胰岛素抵抗与结直肠息肉发病有关.结论 C-肽及胰岛素抵抗与结直肠息肉、结直肠癌发病相关.     

生长激素1基因多态性和烟酒习惯与结直肠癌易感性的关系

目的:研究生长激素1(growth hormone1,GH1)基因T1663A多态性与结直肠癌易感性的关系。方法:在江苏省进行了一个病例-对照研究(结直肠癌患者315例,人群对照439名),调查研究对象的生活习惯,抽取静脉血,提取白细胞DNA,采用PCR-RFLP检测研究对象的GH1T1663A基因型。结果:1)GH1T/T、T/A和A/A基因型分布频度在结直肠癌组分别为42.2%、46.7%和11.1%,对照组分别为38·1%、45·9%和16·0%,两组差异无统计学意义,χ2MH=3·907,P=0·142。但在调整性别、年龄、吸烟和饮酒习惯后,A/A基因型者与T/T基因型者相比,发生结直肠癌的危险性显著降低(OR=0·88,95%CI:0·78~0·99,P=0·0287)。2)多因素分析结果显示,饮酒者患结直肠癌的危险性显著增高(OR=1·96,95%CI:1·34~2·86,P=0·0005),A/A基因型与降低结直肠癌的危险性有关,而吸烟与增加或降低结直肠癌的危险性无显著相关。3)GH1基因多态与吸烟、饮酒相互作用的分层分析发现,在不吸烟者中,GH1A/A基因型者与T等位基因型者相比,发生结直肠癌的危险性显著降低(性别和年龄调整OR=0·50,95%CI:0·27~0·93);在不饮酒者中,GH1A/A基因型者发生结直肠癌的调整OR为0·56(95%CI:0·32~0·99)。结论:T1663A GH1基因的A/A基因型可降低结直肠癌易感性,特别是在不吸烟和不饮酒者中。     

胃癌低发区的病例对照研究

目的 :探寻肿瘤低发区胃癌的危险因素和保护因素。方法 :选择江苏省胃癌低发区邳州市胃癌患者 187例进行病例对照研究 ,以普通人群为对照。结果 :咸肉、熏肉、咸鱼、剩粥、油炸食物的摄入与胃癌危险性增加有关 ,前三者OR值分别为 2 36、3 4 4和 6 4 7。而新鲜蔬菜、豆类的摄入与胃癌发生的危险性呈负相关 ,OR值分别为 0 5 1和 0 5 3。多食大蒜亦趋于降低胃癌危险性。结论 :经常摄入咸肉、熏肉、咸鱼、剩粥、油炸食物是胃癌的危险因素 ,摄入新鲜蔬菜、豆类、大蒜则是胃癌的保护因素。     

Carcinogen metabolism genes, red meat and poultry intake, and colorectal cancer risk

Diets high in red meat are established risk factors for colorectal cancer (CRC). Carcinogenic compounds generated during meat cooking have been implicated as causal agents. We conducted a family-based case-control study to investigate the association between polymorphisms in carcinogen metabolism genes (CYP1A2 -154A>C, CYP1B1 Leu432Val, CYP2E1 -1054C>T, GSTP1 Ile105Val, PTGS2 5UTR -765, EPHX1 Tyr113His, NAT2 Ile114Thr, NAT2 Arg197Gln and NAT2 Gly286Glu) and CRC risk. We tested for gene-environment interactions using case-only analyses (N = 577) and compared statistically significant results to those obtained using case-unaffected sibling comparisons (N = 307 sibships). Our results suggested that CYP1A2 -154A>C might modify the association between intake of red meat cooked using high temperature methods and well done on the inside and CRC risk (case-only interaction OR = 1.53; 95% CI = 1.19-1.97; p = 0.0008) and the association between intake of red meat heavily browned on the outside and rectal cancer risk (case-only interaction OR = 0.65; 95% CI = 0.48-0.86; p = 0.003). We also found that GSTP1 Ile105Val might modify the association between intake of poultry cooked with high temperature methods and CRC risk (p = 0.0035), a finding that was stronger among rectal cancer cases. Our results support a role for heterocyclic amines that form in red meat as a potential explanation for the observed association between diets high in red meat and CRC. Our findings also suggest a possible role for diets high in poultry cooked at high temperatures in CRC risk.     

Risk factors for the development of colorectal carcinoma: A case control study from South India

AIM: To study the association of colorectal carcinoma (CRC) with diet, smoking, alcohol, physical activity, body mass index, family history and diabetes. METHODS: All consecutive patients with CRC confirmed by histopathology diagnosis were included. Age (± 5 years) and gender matched controls were selected among the patients admitted in surgery ward for various conditions without any co-existing malignancy. Food frequency questionnaire (FFQ) was developed and validated after pretesting by investigator trained in data collection techniques. Cases and controls were interviewed ensuring privacy, in similar interview setting, with same duration of time for both cases and controls without any leading question. Biological variables like family history of CRC in first degree relatives, history of diabetes mellitus; behavioral factors like tobacco use both smoking and smokeless form, alcohol consumption and physical activity were recorded. Dietary details were recorded using a FFQ consisting 29 food items with seven categories. Analysis was done using appropriate statistical methods. RESULTS: Ninety-four histopathologically confirmed cases of CRC and equal number of age and gender matched controls treated over a period of two years were studied. Age distribution, mean age, male to female ratio, education level and socioeconomic status were similar in cases and controls. Intake of food items was categorized into tertile due to skewed distribution of subjects as per recommended cut off for consumption of food item. On univariate analysis red meat [OR = 7.4 (2.935-18.732)], egg [OR = 5.1 (2.26-11.36)], fish, fried food and oil consumption were found to be risk factors for CRC. On multivariate analysis red meat consumption of more than 2-3 times a month (OR = 5.4; 95%CI: 1.55-19.05) and egg consumption of more than 2-3 times a week (OR = 3.67; 95%CI: 1.23-9.35) were found to be independent risk factors for the development of CRC. CONCLUSION: Egg and red meat consumption found to be independent risk factors for CRC. Smoking, alcohol, physical activity and family history were not associated with increased risk.     

NAT2, meat consumption and colorectal cancer incidence: an ecological study among 27 countries

The polymorphic gene NAT2 is a major determinant of N-acetyltransferase activity and, thus, may be responsible for differences in one’s ability to bioactivate heterocyclic amines, a class of procarcinogens in cooked meat. An unusually marked geographic variation in enzyme activity has been described for NAT2. The present study re-examines the international direct correlation reported for meat intake and colorectal cancer (CRC) incidence, and evaluates the potential modifying effects of NAT2 phenotype and other lifestyle factors on this correlation. Country-specific CRC incidence data, per capita consumption data for meat and other dietary factors, prevalence of the rapid/intermediate NAT2 phenotype, and prevalence of smoking for 27 countries were used. Multiple linear regression models were fit and partial correlation coefficients (PCCs) were computed for men and women separately. Inclusion of the rapid/intermediate NAT2 phenotype with meat consumption improved the fit of the regression model for CRC incidence in both sexes (males—R ² = 0.78, compared to 0.70 for meat alone; p for difference in model fit—0.009; females—R ² = 0.76 compared to 0.69 for meat alone; p = 0.02). Vegetable consumption (inversely and in both sexes) and fish consumption (directly and in men only) were also weakly correlated with CRC, whereas smoking prevalence and alcohol consumption had no effects on the models. The PCC between NAT2 and CRC incidence was 0.46 in males and 0.48 in females when meat consumption was included in the model, compared to 0.14 and 0.15, respectively, when it was not. These data suggest that, in combination with meat intake, some proportion of the international variability in CRC incidence may be attributable to genetic susceptibility to heterocyclic amines, as determined by NAT2 genotype.     

Fried, well-done red meat and riskof lung cancer in women (United States)

Objective: Some epidemiological studies suggest that diets high in fat, saturated fat, or cholesterol are associated with increased risk of lung cancer. Since meat consumption is correlated with the intake of saturated fat and cholesterol, we investigated the role of meat intake and cooking practices in relation to lung cancer risk.Methods: A population-based case-control study of both non-smoking and smoking women was conducted in Missouri. A 100-item food frequency questionnaire (FFQ) with detailed questions on meat consumption was completed by 593 cases and 623 frequency matched controls. We estimated quantity of meat eaten (grams/day) according to cooking method, and doneness level. Odds ratios (ORs) and 95% confidence intervals (C.I.s) were calculated using logistic regression. Multivariate models included age, packyears of smoking, body mass index (BMI, kg/m2), education, and intake of calories, fat, fruit/fruit juices, and vegetables.Results: When comparing 90th and 10th percentiles, lung cancer risk increased for total meat consumption (OR=1.6, C.I. 1.1-2.4), red meat (OR=1.8, C.I., 1.2-2.7), well-done red meat (OR=1.5, C.I.s, 1.1-2.1) and fried red meat (OR=1.5, C.I., 1.1-2.0). The odds ratios for 5th vs. 1st quintiles using the categorical variable for well-done red meat and fried red meat were essentially the same as reported above; however, the increase in risk was associated mainly with the 5th quintile. The ORs for a 10-gram increase in consumption were, 1.04 for total meat, 1.06 for red meat, 1.08 for well done red meat, and 1.09 for fried red meat.Conclusions: Consumption of red meat, especially fried and/or well-done red meat, was associated with increased risk of lung cancer.     

Novel epidemiologic evidence for the association between fermented fish sauce and esophageal cancer in South China

Previous studies have suggested that fermented fish sauce is related to an increased risk for nasopharyngeal, thyroid and gastric cancers and has suspicious carcinogenic and promoting effects in the laboratory, but these reports have not investigated the association between this agent and esophageal cancer in population. Therefore, we investigated the relationship between esophageal cancer and consumption of fermented fish sauce, alcohol and tobacco after adjusting other risk factors using data from a large hospital-based case-control study in Chaoshan area of China. The subjects for analysis included 1,248 cases (median age 58.5 [range 29-82] years, 936 males, 312 females, some 50% with the habit of fermented fish sauce eating) with squamous cell carcinoma of the esophagus and the same amount of controls matched by sex and age. A significant increase in risk (OR 3.21; 95% CI 2.45-4.19) for eating fermented fish sauce compared to not eating and a significant dose-response relationship was found with the consumption of fermented fish sauce (p for trend < 0.001). In comparison based on the binary variables, the OR for the subjects with fermented fish sauce eating and current smoking was 15.5 with a 95% CI of 8.14-29.3, relative to those exposed to neither habit. The joint effect of fermented fish sauce (F) and smoking (S) was more than additive (F * S > F + S: 15.5 > 1 + (5.6 - 1) + (6.6 - 1)), but the effect for fermented fish sauce and alcohol was not found. It is concluded that risks of esophageal cancer in the population were substantially associated with fermented fish sauce. Further epidemiologic and experimental study are required to find a biologic causal relationship between them.     

Food groups and laryngeal cancer risk: a case-control study from Italy and Switzerland

Besides tobacco and alcohol, diet has been thought to be associated with laryngeal cancer risk. We thus analyzed the role of various food groups, as well as specific seasoning fats, in a case-control study conducted in Northern Italy and the Swiss Canton of Vaud from 1992 to 2000. Our study included 527 incident, histologically confirmed cases and 1,297 frequency-matched controls, selected among patients admitted to the same hospitals as cases for acute, nonneoplastic conditions, unrelated to smoking, alcohol consumption and long-term modifications of diet. The subjects' usual diet was investigated through a validated food frequency questionnaire, including 78 foods and beverages. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional multiple logistic regression models. After adjustment for major confounding factors, a significant trend of increasing risk was observed for eggs (OR = 1.7 for the highest compared to the lowest quintile), red meat (OR = 3.1), processed meat (OR = 1.7), fish (OR = 1.6) and sugars (OR = 1.6). Significant inverse associations were observed for pulses (OR = 0.7), raw vegetables (OR = 0.2), cooked vegetables (OR = 0.3), citrus fruit (OR = 0.6) and other fruit (OR = 0.5). In regard to seasoning fats, a significant reduction of cancer risk was observed for olive oil (OR = 0.4) and specific seed oils (OR = 0.6), while mixed seed oils were directly associated with laryngeal cancer risk (OR = 2.2). Our study suggests that increasing vegetables and fruit, decreasing meat consumption and perhaps substituting olive oil or specific seed oils for other types of seasoning lipids might help reduce laryngeal cancer risk.     

Meat intake and bladder cancer risk in a Swedish prospective cohort

Background  High meat consumption could potentially increase the risk of bladder cancer, but findings from epidemiologic studies are inconsistent. We prospectively examined the association between meat intake and bladder cancer risk in a population-based cohort study. Methods  We prospectively followed 82,002 Swedish women and men who were free from cancer and completed a food-frequency questionnaire in 1997. Incident cases of bladder cancer were identified in the Swedish cancer registries. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI), adjusted for age, sex, education, smoking status, pack-years of smoking, and total energy intake. Results  During a mean follow-up of 9.4 years, 485 incident cases of bladder cancer (76 women and 409 men) were ascertained in the cohort. We observed no association between the intake of total or any specific type of meat and the risk of bladder cancer. The multivariate HRs (95% CIs) comparing the highest and the lowest category of intake were 1.05 (0.71–1.55) for total meat, 1.00 (0.71–1.41) for red meat, 1.01 (0.80–1.28) for processed meats, 0.96 (0.70–1.30) for chicken/poultry, and 0.92 (0.65–1.30) for fried meats/fish. The associations did not vary by sex or smoking status. Conclusions  These results do not support the hypothesis that intake of red meat, processed meat, poultry, or fried meats/fish is associated with the risk of developing bladder cancer.     

幽门螺旋杆菌感染等因素与大肠癌关系的病例对照研究

目的：探讨幽门螺旋杆菌感染等因素与大肠癌发生的关系。方法：用配对病例对照方法研究大肠癌的危险因素,按性别、年龄、城乡分布进行1：1配对。资料分析使用单因素及多因素Logistic回归。结果：多因素分析显示,Hp感染与大肠癌无相关性。有肿瘤家族史、细粮摄入量高以及常吃红烧鱼增加了患大肠癌的危险,其OR值分别为3.259、3.067、1.838;而体力劳动、有非类固醇类抗炎药用药史、淡水鱼摄入量高可能是大肠癌发病的保护性因素,其OR值分别为0.164、0.232、0.543。结论：Hp感染与大肠癌的形成无相关性。有肿瘤家族史、细粮摄入量高以及常吃红烧鱼可能是大肠癌的危险因素,而从事适当的体力劳动、有非类固醇类抗炎药用药史、摄入淡水鱼较多可能是大肠癌的保护因素。     

Prospective study of NAT1 and NAT2 polymorphisms, tobacco smoking and meat consumption and risk of colorectal cancer

Heterocyclic amines in tobacco smoke and fried meat are activated or detoxified by N-acetyltransferases (NAT1 and NAT2). We identified 379 cases with colorectal cancer (CRC) and 769 sub-cohort members among a cohort of 57,000 members. There were no statistically significant associations between tobacco smoking, consumption of meat (red, processed and fried) and CRC risk. Preference for brown-dark pan-fried meat increased the CRC risk. NAT1 fast acetylators had a significantly higher risk of CRC than NAT1 slow acetylators, whereas NAT2 acetylator status did not affect the CRC risk. There were no statistically significant interactions between tobacco smoking and either NAT1 or NAT2 acetylator status in relation to CRC risk. However, smoking intensity increased CRC risk among carriers of both NAT1 and NAT2 fast. This indicates that N-acetylator status affects the relationship between smoking and CRC risk.