Effect of diindolylmethane supplementation on low-grade cervical cytological abnormalities: double-blind, randomised, controlled trial
Effect of diindolylmethane supplementation on low-grade cervical cytological abnormalities: double-blind, randomised, controlled trial
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DOI：
10.1038/bjc.2011.496
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发表时间：
2012-01-03
影响因子：
8.8
通讯作者：
Sasieni, P.
中科院分区：
文献类型：
--
作者：
Castanon, A.;Tristram, A.;Sasieni, P.
背景：宫颈筛查发现许多妇女低度异常。体外和体内研究表明，二吲哚甲烷（DIM）可能会阻止（宫颈）致癌作用。我们报告一项随机对照试验的影响，DIM在妇女与低度宫颈cervical cytological abnormality.METHODS：我们进行了一个务实的双盲，随机对照试验150毫克DIM（从生物反应DIM）或安慰剂每天6个月的妇女与新诊断的，低度细胞学异常。随机化比例为2（DIM）比1（安慰剂）。所有女性在6个月时均被邀请进行阴道镜检查，并对任何异常进行活检。结果：在551名可供分析的随机女性中，DIM组9%的女性和安慰剂组12%的女性在6个月后出现宫颈上皮内瘤变-2（CIN 2）或更严重的情况补充（风险比（RR）0.7（95%置信区间（CI）：0.4-1.2）），而4.6%和5.1%分别有CIN 3或更差（RR 0.9（95% CI：0.4-2.0））。在6个月时，DIM组和安慰剂组分别有27.3%和34.3%的妇女没有疾病体征（细胞学、阴道镜检查和人乳头瘤病毒（HPV）检测阴性）（RR 0.8（95% CI：0.6-1.0））。在基线时HPV阳性的患者中，DIM组69%（114/166）在6个月时为阳性，而安慰剂组为61%（43/71）：RR 1.1（95% CI：0.9-1.4）。结论：结果表明，短期补充DIM（150毫克天（-1））是耐受性良好，但不太可能有细胞学或HPV感染的影响。其对CIN 2+的影响仍不确定。英国癌症杂志（2012）106，45-52。doi：10.1038/bjc.2011.496 www.bjcancer.com在线发布2011年11月10日（C）2012英国癌症研究
BACKGROUND: Cervical screening identifies many women with low-grade abnormalities. In vitro and in vivo studies have shown that diindolylmethane (DIM) could potentially halt (cervical) carcinogenesis. We report on a randomised controlled trial of the effect of DIM in women with low-grade cervical cytological abnormalities.METHODS: We conducted a pragmatic double-blind, randomised controlled trial of 150 mg DIM (from BioResponse DIM) or placebo daily for 6 months in women with newly diagnosed, low-grade cytological abnormalities. Randomisation was in the ratio 2 (DIM) to 1 (placebo). All women were invited for colposcopy at 6 months with biopsy of any abnormality.RESULTS: Of the 551 randomised women available for analysis, 9% on DIM and 12% on placebo had cervical intraepithelial neoplasia-2 (CIN2) or worse after 6-month supplementation (risk ratio (RR) 0.7 (95% confidence interval (CI): 0.4-1.2)), whereas 4.6% and 5.1%, respectively, had CIN3 or worse (RR 0.9 (95% CI: 0.4-2.0)). A total of 27.3% of women on DIM and 34.3% on placebo had no sign of disease (negative cytology, colposcopy and human papilloma virus (HPV) tests) at 6 months (RR 0.8 (95% CI: 0.6-1.0)). Of those HPV-positive at baseline, 69% (114 out of 166) of the DIM group were positive at 6 months compared with 61% (43 out of 71) of the placebo group: RR 1.1 (95% CI: 0.9-1.4). Diindolylmethane supplementation was well tolerated.CONCLUSION: The results suggest that short-term DIM supplementation (150 mg day (-1)) is well tolerated, but is unlikely to have an effect on cytology or HPV infection. Uncertainty remains regarding its effect on CIN2 +. British Journal of Cancer (2012) 106, 45-52. doi: 10.1038/bjc.2011.496 www.bjcancer.com Published online 10 November 2011 (C) 2012 Cancer Research UK