Body mass index and risk of colorectal carcinoma subtypes classified by tumor differentiation status.
Body mass index and risk of colorectal carcinoma subtypes classified by tumor differentiation status.
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DOI：
10.1007/s10654-017-0254-y
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发表时间：
2017-05
影响因子：
13.6
通讯作者：
Nishihara R
中科院分区：
文献类型：
--
作者：
Hanyuda A;Cao Y;Hamada T;Nowak JA;Qian ZR;Masugi Y;da Silva A;Liu L;Kosumi K;Soong TR;Jhun I;Wu K;Zhang X;Song M;Meyerhardt JA;Chan AT;Fuchs CS;Giovannucci EL;Ogino S;Nishihara R
以往的研究表明，异常的能量平衡状态可能会失调肠上皮细胞的稳态和促进结直肠癌的发生，但很少有人知道宿主的能量平衡和肥胖如何影响肠上皮细胞分化在癌变过程中。我们假设高体重指数（BMI）与结直肠癌发病率之间的关系可能因肿瘤组织病理学分化状态而异。利用护士健康研究和健康专业人员随访研究的数据库，以及重复方法考克斯比例风险模型，我们前瞻性地研究了BMI与按分化特征分类的结直肠癌亚型发病率之间的关系。120，813名参与者随访了26年或32年，记录了1，528例直肠癌和结肠癌病例，并提供了肿瘤病理学数据。BMI与结直肠癌风险之间的相关性根据低分化病灶的存在或不存在而显著不同（P异质性=0.006）。较高的BMI与无低分化病灶的结直肠癌风险较高相关（≥30.0kg/m2 vs. 18.5-22.4kg/m2：多变量校正风险比，1.87; 95%置信区间，1.49-2.34; P趋势<0.001），但与低分化病灶的癌风险无关（P趋势=0.56）。这种差异相关性在肿瘤微卫星不稳定性（MSI）或FXR表达状态的分层中似乎是一致的，尽管统计功效有限。BMI与结直肠癌风险之间的关系在肿瘤总体分化、粘液分化或印戒细胞成分方面没有显著差异（P异质性>0.03，校正α为0.01）。高BMI与不含低分化病灶的结直肠癌亚型的风险相关。我们的研究结果表明，对于在整个肿瘤区域保持更好的肠分化的肿瘤，过量能量平衡的致癌影响可能更强。
Previous studies suggest that abnormal energy balance status may dysregulate intestinal epithelial homeostasis and promote colorectal carcinogenesis, yet little is known about how host energy balance and obesity influence enterocyte differentiation during carcinogenesis. We hypothesized that the association between high body mass index (BMI) and colorectal carcinoma incidence might differ according to tumor histopathologic differentiation status. Using databases of the Nurses' Health Study and Health Professionals Follow-up Study, and duplication-method Cox proportional hazards models, we prospectively examined an association between BMI and the incidence of colorectal carcinoma subtypes classified by differentiation features. 120,813 participants were followed for 26 or 32 years and 1,528 rectal and colon cancer cases with available tumor pathological data were documented. The association between BMI and colorectal cancer risk significantly differed depending on the presence or absence of poorly-differentiated foci (Pheterogeneity=0.006). Higher BMI was associated with a higher risk of colorectal carcinoma without poorly-differentiated foci (≥30.0kg/m2 vs. 18.5-22.4kg/m2: multivariable-adjusted hazard ratio, 1.87; 95% confidence interval, 1.49-2.34; Ptrend<0.001), but not with risk of carcinoma with poorly-differentiated foci (Ptrend=0.56). This differential association appeared to be consistent in strata of tumor microsatellite instability (MSI) or FASN expression status, although the statistical power was limited. The association between BMI and colorectal carcinoma risk did not significantly differ by overall tumor differentiation, mucinous differentiation, or signet ring cell component (Pheterogeneity>0.03, with the adjusted α of 0.01). High BMI was associated with risk of colorectal cancer subtype containing no poorly-differentiated focus. Our findings suggest that carcinogenic influence of excess energy balance might be stronger for tumors that retain better intestinal differentiation throughout the tumor areas.
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影响因子：
3.4
作者：
Luis Luque-Garcia, Jose;Luis Martinez-Torrecuadrada, Jorge;Ignacio Casal, J.
通讯作者：
Ignacio Casal, J.
影响因子：
29.4
作者：
Cao Y;Nishihara R;Qian ZR;Song M;Mima K;Inamura K;Nowak JA;Drew DA;Lochhead P;Nosho K;Morikawa T;Zhang X;Wu K;Wang M;Garrett WS;Giovannucci EL;Fuchs CS;Chan AT;Ogino S
通讯作者：
Ogino S
影响因子：
6.4
作者：
Carvalho, Marco A.;Zecchin, Karina G.;Graner, Edgard
通讯作者：
Graner, Edgard
影响因子：
3.7
作者：
Ma Y;Yang Y;Wang F;Zhang P;Shi C;Zou Y;Qin H
通讯作者：
Qin H
影响因子：
29.4
作者：
Alemán JO;Eusebi LH;Ricciardiello L;Patidar K;Sanyal AJ;Holt PR
通讯作者：
Holt PR