乳腺癌患者血清肿瘤标志物水平与预后关系

目的 探讨血清肿瘤标志物癌胚抗原(CEA)、糖类抗原153(CA153)、组织多肽特异性抗原(TPS)与乳腺癌预后的关系。方法 选择经病理诊断的乳腺癌原发病例患者187例,收集临床病例资料及检测清肿瘤标志物CEA、CA153、TPS,并对病例进行随访,分析乳腺癌患者CEA、CA153、TPS的表达与乳腺癌临床病理因素及预后的关系。结果 乳腺癌患者TNM分期、淋巴结有无转移对乳腺癌患者血清CEA、CA153阳性率有影响(P<0.05),乳腺癌患者TNM分期、淋巴结有无转移、分化程度对乳腺癌患者血清TPS阳性率有影响(P<0.05);术前CEA、CA153、TPS表达单阳性或三阳性病例的生存时间明显缩短(均P<0.05)。结论 乳腺癌术前血清CEA、CA153和TPS水平升高可预测预后不良,血清CA153、血清TPS和分化程度可作为预测乳腺癌预后的因素。     

Prospective evaluation of associations between hearing sensitivity and selected cardiovascular risk factors

The prospective decline of hearing sensitivity was evaluated in an occupational cohort of university blue collar workers in relation to age, gender, occupational and nonoccu-pational noise exposure, smoking, blood pressure, and cholesterol. Each of these were associated with loss of hearing sensitivity univariately. When controlling for age and historical noise exposure in a multiple regression model, systolic blood pressure and cholesterol level were independently associated with decline in auditory sensitivity.     

Dietary factors of one-carbon metabolism and prostate cancer risk

BACKGROUND: Folate is hypothesized to be inversely associated with the risk of several cancers, but such a potential association has not been well studied for prostate cancer. Vitamin B-6, vitamin B-12, methionine, and alcohol can influence folate-related metabolism. OBJECTIVE: The objective was to investigate the associations between dietary factors of one-carbon metabolism and prostate cancer risk within the alpha-Tocopherol, beta-Carotene Cancer Prevention Study. DESIGN: Of the cohort's 27 111 Finnish male smokers aged 50-69 y who had complete dietary data, 1270 had a diagnosis of incident prostate cancer between 1985 and 2002. Folate, vitamin B-6, vitamin B-12, methionine, and alcohol intakes were estimated from a 276-item modified dietary history questionnaire. Cox proportional hazard models, adjusted for age and vitamin supplement use, estimated relative risks (RR) and 95% CIs. RESULTS: Vitamin B-6 intake was inversely associated with prostate cancer risk (RR for highest versus lowest quintile: 0.88; 95% CI: 0.72, 1.07; P for trend = 0.045), whereas vitamin B-12 intake was associated with significantly increased risk (RR = 1.36; 95% CI: 1.14, 1.96; P for trend = 0.01). No association between folate or alcohol intake and prostate cancer risk was observed. No differences were found in the above associations according to stage of disease or subgroups of several potential effect modifiers. CONCLUSIONS: We found no convincing evidence for a protective role of one-carbon metabolism against prostate cancer, although these observations can be generalized only to smokers. The possible modest protective association with vitamin B-6 and the significantly elevated risk with vitamin B-12 intake warrant further investigation.     

N-acetyltransferase 2 polymorphisms, tobacco smoking, and breast cancer risk in the breast and prostate cancer cohort consortium

Common polymorphisms in the N-acetyltransferase 2 gene (NAT2) modify the association between cigarette smoking and bladder cancer and have been hypothesized to determine whether active cigarette smoking increases breast cancer risk. The authors sought to replicate the latter hypothesis in a prospective analysis of 6,900 breast cancer cases and 9,903 matched controls drawn from 6 cohorts (1989-2006) in the National Cancer Institute's Breast and Prostate Cancer Cohort Consortium. Standardized methods were used to genotype the 3 most common polymorphisms that define NAT2 acetylation phenotype (rs1799930, rs1799931, and rs1801280). In unconditional logistic regression analyses, breast cancer risk was higher in women with more than 20 pack-years of active cigarette smoking than in never smokers (odds ratio (OR) = 1.28, 95% confidence interval (CI): 1.17, 1.39), after controlling for established risk factors other than alcohol consumption and physical inactivity. However, associations were similar for the slow (OR = 1.25, 95% CI: 1.11, 1.39) and rapid/intermediate (OR = 1.24, 95% CI: 1.08, 1.42) acetylation phenotypes, with no evidence of interaction (P = 0.87). These results provide some support for the hypothesis that long-term cigarette smoking may be causally associated with breast cancer risk but underscore the need for caution when interpreting sparse data on gene-environment interactions.     

Evaluation of polygenic risk scores for predicting breast and prostate cancer risk

Recently, polygenic risk scores (PRS) have been shown to be associated with certain complex diseases. The approach has been based on the contribution of counting multiple alleles associated with disease across independent loci, without requiring compelling evidence that every locus had already achieved definitive genome-wide statistical significance. Whether PRS assist in the prediction of risk of common cancers is unknown. We built PRS from lists of genetic markers prioritized by their association with breast cancer (BCa) or prostate cancer (PCa) in a training data set and evaluated whether these scores could improve current genetic prediction of these specific cancers in independent test samples. We used genome-wide association data on 1,145 BCa cases and 1,142 controls from the Nurses' Health Study and 1,164 PCa cases and 1,113 controls from the Prostate Lung Colorectal and Ovarian Cancer Screening Trial. Ten-fold cross validation was used to build and evaluate PRS with 10 to 60,000 independent single nucleotide polymorphisms (SNPs). For both BCa and PCa, the models that included only published risk alleles maximized the cross-validation estimate of the area under the ROC curve (0.53 for breast and 0.57 for prostate). We found no significant evidence that PRS using common variants improved risk prediction for BCa and PCa over replicated SNP scores.     

Statin use and the risk of breast and prostate cancer

BACKGROUND: Laboratory data suggest that the cholesterol-lowering "statin" drugs may have chemopreventive potential against cancer at various sites, including breast and prostate. However, in one trial of pravastatin there was a significant excess of breast cancer in the treatment group. In the present study, we assessed the relation of statin use to the risk of breast and prostate cancer in our hospital-based Case-Control Surveillance Study of Drugs and Serious Illnesses. METHODS: Cases were 1,132 women with breast cancer and 1,009 men with prostate cancer; controls were 1,331 women and 1,387 men admitted for conditions unrelated to statin use. We used multivariate unconditional logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for use of statins compared with no use. RESULTS: The OR for breast cancer among statin users was 1.5 (95% CI = 1.0-2.3), largely accounted for by an OR of 1.8 (95% CI = 0.9-3.6) among cases with carcinoma in situ. Among invasive cases, the OR was 1.2 (95% CI = 0.7-2.0). The odds ratio for prostate cancer overall was 1.2 (95% CI = 0.8-1.7), and it was 1.4 (95% CI = 0.7-2.5) for Stage A. CONCLUSIONS: The data from the present study do not support a protective effect of statins against breast or prostate cancer. Detection bias is a possible explanation for the higher ORs observed for carcinoma in situ or early-stage cancer as compared with more invasive cancer.     

脂代谢相关指标和肥胖与血尿酸关系

目的 研究脂代谢相关指标及肥胖与血尿酸(SUA)的关系.方法 2007年1月～7月随机抽取新疆医科大学附属中医医院住院病人466例为研究对象,血清检测血尿酸(SUA)及血脂相关生化指标,同时测量并计算体脂相关指标.结果 高尿酸组生化各指标中除高密度脂蛋白(HDL-C)外,SUA、甘油三酯(TG)、极低密度脂蛋白(VLDL-C)均高于正常组;体脂肪相关指标中体重、腰围、臀围、腰围/身高比(WHTR)、腰臀比(WHR)、体质指数(BMI)均为高尿酸组高于正常组,差异有统计学意义(P＜0.05);＞30岁男性体脂肪含量(BF%)高尿酸组高于正常组;相关性分析中除HDL-C外TG、VLDL-C、体重、腰围、臀围、WHTR、BMI与血尿酸呈正相关;＞30岁男性和女性的血尿酸与体脂百分含量呈正相关;按几种肥胖判定方法将研究对象分组,组间血尿酸差异均有统计学意义(P＜0.01).结论 高尿酸血症与脂代谢紊乱、肥胖有相关性,而肥胖与血尿酸相关的机制可能与内脏脂肪含量有关,利用BF%、WHTR、BMI、WHR等对肥胖分组并了解脂肪分布,对与血脂相关的高尿酸血症危险性的预测有积极意义.     

Measures of combined antioxidant and pro-oxidant exposures and risk of overall and advanced stage prostate cancer

PurposeOxidative stress is possibly related to prostate carcinogenesis. We constructed a dietary antioxidant score, which is a measure of combined antioxidant exposures, and an oxidative balance score (OBS), which is a measure of combined antioxidant and pro-oxidant exposures. We hypothesized that both scores are inversely associated with the risk of prostate cancer (PCa).MethodsWe conducted a case–cohort study among 58,279 men in the Netherlands Cohort Study. Cohort members completed a baseline questionnaire. From 1986 to 2003, 3451 patients with PCa were identified including 1196 advanced cancers (stage III/IV). The antioxidant score and the OBS were created by summing quartile and category scores of individual score constituents, which had an equal weight. Pro-oxidants were scored in the opposite way to antioxidants.ResultsBoth the antioxidant score and OBS were not associated with risk of overall PCa or PCa subgroups on the basis of disease stage. Most score constituents were not associated with the risk of PCa. Total catechin intake was associated with a decreased risk of stage IV PCa (greatest vs. lowest quartile: hazard ratio, 0.76; 95% confidence interval, 0.59–0.98).ConclusionsThe antioxidant score and OBS were not associated with risk of overall and advanced-stage PCa.     

妊娠期糖尿病患者血清鸢尾素水平与糖脂代谢、妊娠结局的相关性

目的探讨妊娠期糖尿病(GDM)患者血清鸢尾素水平与糖脂代谢、妊娠结局的相关性。方法选取2017年4月-2019年4月接受产检并确诊为GDM的孕妇90例为GDM组,根据血清鸢尾素水平分为高鸢尾素组、低鸢尾素组,每组45例。选取同期进行产检的健康孕妇100例为对照组。采用酶联免疫吸附法检测血清鸢尾素水平。检测糖代谢指标、脂代谢指标水平。比较高鸢尾素组、低鸢尾素组孕妇的妊娠结局和胎儿/新生儿结局。结果 GDM组孕妇血清鸢尾素水平为(6. 59±0. 82) ng/ml,显著高于对照组孕妇[(4. 11±0. 56) ng/ml](P <0. 05)。GDM组孕妇血清空腹血糖(FPG)、空腹胰岛素(Fins)、糖化血红蛋白(Hb A1c)水平均高于对照组,高鸢尾素组孕妇血清FPG、Fins、Hb A1c水平均高于低鸢尾素组,差异均有统计学意义(P<0. 05)。GDM组与对照组孕妇血清脂代谢指标水平比较差异有统计学意义,高鸢尾素组和低鸢尾素组孕妇血清脂代谢指标水平比较差异有统计学意义(P<0. 05)。高鸢尾素组和低鸢尾素组孕妇剖宫产率比较差异有统计学意义(P<0. 05)。高鸢尾素组巨大儿和新生儿窒息发生率均高于低鸢尾素组(P<0. 05)。结论 GDM患者血清鸢尾素水平与病情严重程度存在直接相关关系,对妊娠结局也有一定预测价值。     

Serum lycopene,other serum carotenoids,and risk of prostate cancer in US Blacks and Whites

Epidemiologic studies investigating the relation between individual carotenoids and risk of prostate cancer have produced inconsistent results. To further explore these associations and to search for reasons prostate cancer incidence is over 50% higher in US Blacks than Whites, the authors analyzed the serum levels of individual carotenoids in 209 cases and 228 controls in a US multicenter, population-based case-control study (1986-1989) that included comparable numbers of Black men and White men aged 40-79 years. Lycopene was inversely associated with prostate cancer risk (comparing highest with lowest quartiles, odds ratio (OR) = 0.65, 95% confidence interval (CI): 0.36, 1.15; test for trend, p = 0.09), particularly for aggressive disease (comparing extreme quartiles, OR = 0.37, 95% CI: 0.15, 0.94; test for trend, p = 0.04). Other carotenoids were positively associated with risk. For all carotenoids, patterns were similar for Blacks and Whites. However, in both the controls and the Third National Health and Nutrition Examination Survey, serum lycopene concentrations were significantly lower in Blacks than in Whites, raising the possibility that differences in lycopene exposure may contribute to the racial disparity in incidence. In conclusion, the results, though not statistically significant, suggest that serum lycopene is inversely related to prostate cancer risk in US Blacks and Whites.     

汉族成人脂代谢与心血管病危险因素关系

目的了解乌鲁木齐地区汉族成年人群特殊的脂代谢特点及其与其他心血管危险因素的关系.方法采用整群抽样,对2 688人进行血脂、血糖测定和血压、身高、体重、腰围、臀围的测量.结果(1)血脂水平在体质指数18.5时有显著性差异P＜0.01;男、女腰围均以70 cm,腰臀比均以0.75为界点,两组人群血脂水平有显著性差异;(2)当血压120/75mmHg为界点时血脂水平有显著性差异;(3)当空腹血糖5.5 mmol/L,餐后2 h血糖6.5 mmol/L时,血脂有显著性差异.结论乌鲁木齐地区汉族人群的血脂与心血管其他危险因素有密切关系.     

The relationship between Wolfe's classification of mammograms, accepted breast cancer risk factors, and the incidence of breast cancer

Data collected between 1973 and 1984 on 696 incident cases of breast cancer and 1,376 matched controls from four Breast Cancer Detection Demonstration Project clinics in the United States were used to assess the role of mammographic parenchymal pattern as a risk factor and its relationship with other, accepted, risk factors. The data confirm previous reports of the influence of benign breast biopsy, age at first live birth, family history of breast cancer, and duration of menstruation on the incidence of breast cancer. Height is also found to be an influential factor. Parenchymal pattern is found to be a risk factor with effects comparable in magnitude to the other factors studied. It operates separately from them, except for its relationship with height and weight. After adjustment for parenchymal pattern, weight is seen to have a significant effect on breast cancer incidence, and height is no longer needed in a model for risk. A model which simultaneously incorporates all of the risk factors considered, including parenchymal pattern, is presented. While these factors are of interest in the epidemiology of breast cancer, it is demonstrated that they are insufficient to allow reliable prediction of the disease in an individual woman.     

Prospective study of antioxidant micronutrients in the blood and the risk of developing prostate cancer

Antioxidant micronutrients may have chemopreventive effects. The authors examined the associations between prediagnostic blood levels of micronutrients and prostate cancer risk in two nested case-control studies of 9,804 and 10,456 male residents of Washington County, Maryland, who donated blood in 1974 (CLUE I) and 1989 (CLUE II), respectively. Until 1996, 182 men for whom adequate serum remained for assays in the CLUE I cohort and 142 men in the CLUE II cohort developed prostate cancer. Each case was matched with two controls by age, gender, race, and date of blood donation. In both cohorts, cases and controls had similar concentrations of alpha-carotene, beta-carotene, total carotene, beta-cryptoxanthin, lutein, lycopene, retinol, and ascorbic acid; serum alpha-tocopherol was weakly associated with prostate cancer risk. Higher retinyl palmitate concentrations were associated with a lower risk in CLUE I but not CLUE II. In CLUE I, cases had lower concentrations of gamma-tocopherol than did controls (p = 0.02), but no dose-response trend was observed. A strong inverse association between gamma-tocopherol and prostate cancer risk was observed in CLUE II. Findings do not replicate previous reports of a protective association between lycopene and prostate cancer, but they suggest potential chemopreventive effects of gamma-tocopherol on prostate cancer.     

Inverse association between dietary and serum conjugated linoleic acid and risk of breast cancer in postmenopausal women

Conjugated linoleic acid (CLA) is anticarcinogenic in experimental animal studies. We studied dietary and serum CLA in Finnish patients with breast cancer in 1992-1995. Participants were consecutive women with breast cancer (68 premenopausal and 127 postmenopausal) and population-based control women (75 premenopausal and 133 postmenopausal), matched for age and area of residence. Diet was assessed by a validated food frequency questionnaire and the fatty acid composition of serum by gas-liquid chromatography. In postmenopausal women, dietary CLA, serum CLA, myristic acid, and trans-vaccenic acid were significantly lower in cases than in controls. The odds ratio for breast cancer in the highest quintile vs. the lowest was 0.4 [95% confidence interval (CI) = 0.2-0.9]for CLA, 0.3 (95% CI = 0.1-0.7) for myristic acid, and 0.3 (95% CI = 0.1-0.7) for trans-vaccenic acid in serum. The odds ratios remained similar after adjustment for known risk factors of breast cancer. A diet composed of CLA-rich foods, particularly cheese, may protect against breast cancer in postmenopausal women, but it is impossible to assess the independent effects of CLA in this study. The findings may be of relevance for food production, inasmuch as it is possible to increase CLA and its precursor trans-vaccenic acid in foods by modifying the feeding of ruminants.     

Few favorable associations between fruit and vegetable intake and biomarkers for chronic disease risk in American adults

Using 24-hour dietary recall data from the National Health and Nutrition Examination Survey 1999 to 2006, the possible link between fruit and vegetable intake and chronic disease risk was assessed. C-reactive protein (CRP), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), fasting plasma glucose (FPG), total cholesterol, and glycosylated hemoglobin were selected as biomarkers for chronic disease risk. It is hypothesized that individuals who consume more fruits and vegetables will have reduced chronic disease risk because of the healthful benefits of these foods. The objective of this study was to examine the relationship between fruit and vegetable consumption on selected biomarkers for chronic disease risk. Although some associations were significant for FPG, HDL-C, and low-density lipoprotein cholesterol in some of the models, no trend was present. After adjusting for demographic factors, socioeconomic factors, lifestyle factors, body mass index, total energy intake, and the presence of at least 1 of our 5 predetermined comorbidities, no associations of reduced or increased risk were observed in any quartiles of combined fruit and vegetable intake. Fruit and vegetable intakes were weakly associated with an increased HDL-C level and decreased FPG, glycosylated hemoglobin, and C-reactive protein levels in some of the models; however, no association was observed in the final model. Because selected biomarkers of future disease risk remained in reference ranges at both high and low intake and no significance was observed in the final model, no protective association was observed between fruit and vegetable intake and biomarkers for chronic disease risk. However, fruit and vegetable consumption is recommended as part of an overall healthy diet and to displace other energy-dense foods for weight maintenance, which can lead to a decrease in future disease risk.     

Association between serum trans-monounsaturated fatty acids and breast cancer risk in the E3N-EPIC Study

The authors assessed the association between serum phospholipid fatty acids as biomarkers of fatty acid intake and breast cancer risk among women in the E3N Study (1989-2002), the French component of the European Prospective Investigation into Cancer and Nutrition. During an average of 7 years of follow-up, 363 cases of incident invasive breast cancer were documented among 19,934 women who, at baseline (1995-1998), had completed a diet history questionnaire and provided serum samples. Controls were randomly matched to cases by age, menopausal status at blood collection, fasting status at blood collection, date, and collection center. Serum phospholipid fatty acid composition was assessed by gas chromatography. Adjusted odds ratios for risk of breast cancer with increasing levels of fatty acids were calculated using conditional logistic regression. An increased risk of breast cancer was associated with increasing levels of the trans-monounsaturated fatty acids palmitoleic acid and elaidic acid (highest quintile vs. lowest: odds ratio = 1.75, 95% confidence interval: 1.08, 2.83; p-trend = 0.018). cis-Monounsaturated fatty acids were unrelated to breast cancer risk. A high serum level of trans-monounsaturated fatty acids, presumably reflecting a high intake of industrially processed foods, is probably one factor contributing to increased risk of invasive breast cancer in women.     

Dose-response relation between serum total cholesterol levels and overall cancer risk: evidence from 12 prospective studies involving 1,926,275 participants

This study aimed to clarify the association between serum total cholesterol (TC) levels and overall cancer risk. Study-specific relative risks (RR) and 95% confidence intervals (CI) were pooled using a random-effects model, and dose–response relation was also evaluated. Twelve prospective studies were identified with a total of 1,926,275 participants and 13,1676 cases. High levels of serum TC showed an inverse association with overall cancer risk (RR for the highest versus the lowest category: 0.87, 95% CI: 0.83?～?0.90; I²?=?52.5%). A linear dose-response relation between serum TC levels and overall cancer risk was found (p?=?.004 for Wald test; I²?=?49.6%), and the pooled RR was 0.92 (95% CI: 0.89?～?0.94) for 3?mmol/L, 0.86 (95% CI: 0.81?～?0.90) for 5?mmol/L, 0.80 (95% CI: 0.74?～?0.87) for 7?mmol/L. Our dose-response meta-analysis of 12 prospective studies indicated that higher serum TC levels were significantly associated with reduced cancer risk.