Dietary factors and the risks of oesophageal adenocarcinoma and Barrett's oesophagus.
Dietary factors and the risks of oesophageal adenocarcinoma and Barrett's oesophagus.
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DOI：
10.1017/s0954422410000132
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发表时间：
2010-12
影响因子：
5.7
通讯作者：
Kaur, Rubinder
中科院分区：
文献类型：
--
作者：
Kubo, Ai;Corley, Douglas A.;Jensen, Christopher D.;Kaur, Rubinder
在过去的几十年中，食管腺癌的发病率增加了500%以上，但没有明确的原因。胃食管反流病（GERD）、肥胖和吸烟已被确定为风险因素，尽管这些风险因素的人口统计学分布与食管腺癌的人口统计学分布不一致，食管腺癌在白人和男性中比任何其他人口统计学群体更常见。许多流行病学研究表明饮食因素与食管腺癌及其前体Barrett食管的风险之间存在关联，但缺乏全面的综述。本综述的主要目的是考虑饮食因素与食管腺癌、Barrett食管以及Barrett食管向食管腺癌进展风险之间的关系。现有的流行病学证据最有力地表明，维生素C、β-胡萝卜素、水果和蔬菜（特别是生水果和蔬菜以及深绿色、多叶和十字花科蔬菜）、碳水化合物、纤维和铁的摄入量与食道腺癌和巴雷特食管的风险呈负相关。巴雷特食管和食管腺癌风险较高的患者可能会从增加水果和蔬菜的摄入量以及减少红肉和其他加工食品的摄入量中受益。需要进一步的研究来评估饮食与Barrett食管向食管腺癌进展之间的关系。来自队列研究的证据将有助于确定是否有必要进行随机化学预防试验，用于一级预防巴雷特食管或其进展为癌症。
Incidence rates for esophageal adenocarcinoma have increased by over 500% during the past few decades without clear reasons. Gastroesophageal reflux disease (GERD), obesity, and smoking have been identified as risk factors, although the demographic distribution of these risk factors is not consistent with the demographic distribution of esophageal adenocarcinoma, which is substantially more common among whites and males than any other demographic groups. Numerous epidemiological studies have suggested associations between dietary factors and the risks of esophageal adenocarcinoma and its precursor, Barrett’s esophagus, though a comprehensive review is lacking. The main aim of the present review is to consider the evidence linking dietary factors with the risks of esophageal adenocarcinoma, Barrett’s esophagus, and the progression from Barrett’s esophagus to esophageal adenocarcinoma. The existing epidemiological evidence is strongest for an inverse relationship between intake of vitamin C, β-carotene, fruits and vegetables, particularly raw fruits and vegetables and dark-green, leafy and cruciferous vegetables, carbohydrates, fiber and iron and the risk of esophageal adenocarcinoma and Barrett’s esophagus. Patients at higher risk for Barrett’s esophagus and esophageal adenocarcinoma may benefit from increasing their consumption of fruits and vegetables and reducing their intake of red meat and other processed food items. Further research is needed to evaluate the relationship between diet and the progression of Barrett’s esophagus to esophageal adenocarcinoma. Evidence from cohort studies will help determine whether randomized chemoprevention trials are warranted for the primary prevention of Barrett’s esophagus or its progression to cancer.