Concentration of folate in colorectal tissue biopsies predicts prevalence of adenomatous polyps.
Concentration of folate in colorectal tissue biopsies predicts prevalence of adenomatous polyps.
复制标题
结直肠组织活检中叶酸的浓度可预测腺瘤性息肉的患病率。
DOI：
10.1136/gut.2010.208074
复制
发表时间：
2011
期刊：
影响因子：
24.5
通讯作者：
Cross,AmandaJ
中科院分区：
文献类型：
--
作者：
Flood,Andrew;Mason,JoelB;Liu,Zhenhua;Cash,BrooksD;Schatzkin,Arthur;Schoenfeld,PhilipS;Cross,AmandaJ
背景和目的叶酸是结直肠癌的一个潜在的致病因子.先前的研究尚未充分利用正常结肠粘膜活检中的叶酸浓度来研究这个问题。方法使用无症状平均风险女性（40-70岁），根据组织中的叶酸浓度，使用逻辑回归模型来估计腺瘤的OR和95%CI。在结直肠癌筛查研究中。 在1 593名符合入学条件的妇女中，有1 483人（93%）参加了考试。98.7%的结肠镜检查完成至盲肠（1463/1483）的受试者，并从813（56%）这些正常的结肠组织活检，其中170人至少有一个腺瘤。在组织叶酸浓度最高五分位数的妇女中观察到远端腺瘤（OR 0.56，95% CI 0.29至1.09），但未观察到远端腺瘤（OR 1.01，95% CI 0.43至2.37）。在组织叶酸浓度最高的五分位数的妇女中观察到晚期腺瘤的风险显著降低（OR 0.24，95%CI 0.06至0.93）。定义结果为近端腺瘤性和/或增生性息肉，还观察到叶酸组织浓度与统计学显著负相关（或0.54，五分位数5与五分位数1的95% CI 0.31 - 0.95）。结论这些发现与结肠粘膜的叶酸状态是一种在确定特定疾病风险方面具有重要病因学意义的暴露的假设一致结直肠癌的分子亚型。
Background and aimsFolate has been implicated as a potential aetiological factor for colorectal cancer. Previous research has not adequately exploited concentrations of folate in normal colonic mucosal biopsies to examine the issue.MethodsLogistic regression models were used to estimate ORs and 95% CIs of adenoma according to the tissue concentration of folate using asymptomatic average-risk women (40–70 years) in a colorectal cancer screening study. Of the 1593 eligible women who were offered enrolment, 1483 (93%) participated. Colonoscopy was complete to the caecum in 98.7% (1463/1483) of the subjects, and normal colonic tissue biopsies were obtained from 813 (56%) of these, of whom 170 had at least one adenoma.ResultsA marginal reduction in risk for proximal adenomas (OR 0.56, 95% CI 0.29 to 1.09) but not distal adenomas (OR 1.01, 95% CI 0.43 to 2.37) was observed among women in the highest quintile of tissue folate concentration. A significant reduction in risk for advanced adenoma was observed for women in the highest quintile of tissue folate concentration (OR 0.24, 95% CI 0.06 to 0.93). Defining the outcome as proximal adenomatous and/or hyperplastic polyps, statistically significant inverse associations with tissue concentrations of folate were also observed (OR 0.54, 95% CI 0.31 to 0.95 for quintile 5 vs quintile 1).ConclusionsThese findings are consistent with the hypothesis that folate status of colonic mucosa is an exposure that is aetiologically important in determining the risk of particular molecular subtypes of colorectal cancer.