Decreased incidence of prostate cancer with selenium supplementation: results of a double-blind cancer prevention trial.
Decreased incidence of prostate cancer with selenium supplementation: results of a double-blind cancer prevention trial.
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DOI：
10.1046/j.1464-410x.1998.00630.x
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发表时间：
1998-05
期刊：
影响因子：
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通讯作者：
L. Clark;Bruce L. Dalkin;A. Krongrad;G. Combs;B. Turnbull;E. Slate;R. Witherington;Herlong Jh
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文献类型：
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作者：
L. Clark;Bruce L. Dalkin;A. Krongrad;G. Combs;B. Turnbull;E. Slate;R. Witherington;Herlong Jh
目的：研究膳食中补充硒是否与前列腺癌发病率的变化有关。患者和方法共有974名有基底细胞癌或鳞状细胞癌病史的男性被随机分配到每日补充200微克硒或安慰剂组。患者平均治疗4.5年，平均随访6.5年。结果1983 - 93年期间，硒治疗与前列腺癌发病率的次要终点显著降低（63%）相关。硒治疗组有13例前列腺癌病例，安慰剂组有35例前列腺癌病例（相对危险度，RR = 0.37，P = 0.002）。将分析限制在843例最初前列腺特异性抗原水平正常（≤ 4 ng/mL）的患者中，在2年治疗滞后后，硒治疗组中仅4例被诊断，安慰剂组中16例被诊断（RR = 0.26 P = 0.009）。对于其他次要终点，即总癌症死亡率以及总肺癌和结直肠癌的发病率，也有显著的健康益处。皮肤基底细胞癌和鳞状细胞癌的主要终点发生率无显著变化。鉴于这些结果，本试验的"设盲"阶段提前停止。结论：虽然硒对皮肤鳞状细胞癌和基底细胞癌的主要终点没有保护作用，但硒治疗组的前列腺癌发病率、总癌症发病率和死亡率显著降低，这需要在对照良好的预防试验中进一步评估。
OBJECTIVE To test if supplemental dietary selenium is associated with changes in the incidence of prostate cancer. PATIENTS AND METHOD A total of 974 men with a history of either a basal cell or squamous cell carcinoma were randomized to either a daily supplement of 200 microg of selenium or a placebo. Patients were treated for a mean of 4.5 years and followed for a mean of 6.5 years. RESULTS Selenium treatment was associated with a significant (63%) reduction in the secondary endpoint of prostate cancer incidence during 1983-93. There were 13 prostate cancer cases in the selenium-treated group and 35 cases in the placebo group (relative risk, RR=0.37, P=0.002). Restricting the analysis to the 843 patients with initially normal levels of prostate-specific antigen (< or = 4 ng/mL), only four cases were diagnosed in the selenium-treated group and 16 cases were diagnosed in the placebo group after a 2 year treatment lag, (RR=0.26 P=0.009). There were significant health benefits also for the other secondary endpoints of total cancer mortality, and the incidence of total, lung and colorectal cancer. There was no significant change in incidence for the primary endpoints of basal and squamous cell carcinoma of the skin. In light of these results, the 'blinded' phase of this trial was stopped early. CONCLUSIONS Although selenium shows no protective effects against the primary endpoint of squamous and basal cell carcinomas of the skin, the selenium-treated group had substantial reductions in the incidence of prostate cancer, and total cancer incidence and mortality that demand further evaluation in well-controlled prevention trials.