NUTRITIONAL DETERMINANTS OF BREAST CANCER RISK

尽管一系列国际人口研究和动物 实验表明，膳食脂肪可能会增加患乳房的风险 癌症，到目前为止进行的流行病学研究得出了不一致的结论 结果。然而，很少有流行病学研究测量特定的脂肪含量。 酸摄入量或已经控制了其他营养因素，特别是 抗氧化剂，这可能会改变脂肪摄取的效果。 一项病例对照研究被提出来解决一系列假设 生化等饮食摄入量指标对乳房风险的影响 绝经后妇女中的癌症。具体地说，假设 以下因素会增加患乳腺癌的风险： 1)富含特定脂肪酸的饮食，如亚油酸和反式脂肪酸 2)低硒饮食 3)高脂肪饮食 4)多不饱和脂肪酸的高摄入量与低摄入量的结合 摄入抗氧化剂(硒、维生素A和维生素E以及特定的类胡萝卜素 组分)或血浆谷胱甘肽过氧化物酶活性较低。 病例和对照将是绝经后的妇女，她们是 达纳·法伯癌症研究所乳房评估中心及其 外科手术人员。超过三年的1080名受试者-360名女性 确诊的局部或区域性乳腺癌和两名对照受试者 1例(1例无乳腺疾病需要活检，1例良性 乳房疾病)-将被登记。将测量特定的脂肪酸 毛细管柱气相色谱分离皮下脂肪 吸液标本；用中子活化法分析趾甲中的硒； 高压液体分离维生素A、E和特定类胡萝卜素 血浆层析；以及总膳食脂肪、纤维、蛋白质、维生素C 和其他营养素通过验证的半定量食物频率 问卷调查。这项研究还将提供一个机会来评估 微核试验，DNA损伤的一种可能的测量方法。 将研究特定饮食因素的影响和相互作用。 使用粗略、分层和多变量分析。研究设计 保守地提供90%的检测到亲属的概率 暴露的极端四分位数的风险为2.0。

Although a series of international population studies and animal experiments suggest that dietary fat may increase the risk of breast cancer, epidemiologic studies conducted to date have yielded inconsistent results. However, few epidemiologic studies have measured specific fatty acid intakes or have controlled for other nutritional factors, particularly antioxidants, that may modify the effect of fat intake. A case-control study is proposed to address a series of hypotheses relating biochemical and other indicators of dietary intake to the risk of breast cancer among post-menopausal women. Specifically, it is hypothesized that the following factors increase the risk of breast cancer: 1) diets high in specific fatty acids such as linoleic and trans fatty acids 2) diets low in selenium 3) diets high in total fat 4) the combination of high intake of polyunsaturated fatty acids and low intake of antioxidants (selenium, vitamins A and E and specific carotenoid fractions) or low level of plasma glutathione peroxidase activity. Cases and controls will be post-menopausal women who are patients of the Breast Evaluation Center of the Dana Farber Cancer Institute and its surgical staff. Over three years 1080 subjects - 360 women with newly diagnosed local or regional breast cancer and two control subjects for each case (one with no breast disease requiring biopsy and another with benign breast disease) - will be enrolled. Specific fatty acids will be measured by capillary column gas-liquid chromatography of fat from subcutaneous fat aspiration specimens; selenium by neutron activation analysis of toenails; vitamins A, E and specific carotenoid fractions by high-pressure liquid chromatography of plasma; and total dietary fat, fiber, protein, vitamin C and other nutrients by a validated semi-quantitative food frequency questionnaire. The study will also provide an opportunity to evaluate the micronuclei test, a possible measure of DNA damage. The effects and interactions of specific dietary factors will be studied using crude, stratified, and multivariate analyses. The study design conservatively provides a 90 percent probability of detecting relative risks of 2.0 for extreme quartiles of exposure.