类胡萝卜素摄入量与雌激素受体和孕激素受体状态定义的乳腺癌风险：18 项前瞻性队列研究的汇总分析。
Carotenoid intakes and risk of breast cancer defined by estrogen receptor and progesterone receptor status: a pooled analysis of 18 prospective cohort studies.
机构信息
Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
出版信息
Am J Clin Nutr. 2012 Mar;95(3):713-25. doi: 10.3945/ajcn.111.014415. Epub 2012 Jan 25.
BACKGROUND
Epidemiologic studies examining associations between carotenoid intakes and risk of breast cancer by estrogen receptor (ER) and progesterone receptor (PR) status are limited.
OBJECTIVE
We investigated these associations in a pooled analysis of 18 cohort studies.
DESIGN
Of 1,028,438 participants followed for a maximum follow-up of 26 y across studies, 33,380 incident invasive breast cancers were identified. Study-specific RRs and 95% CIs were estimated by using Cox proportional hazards regression and then pooled by using a random-effects model.
RESULTS
α-Carotene, β-carotene, and lutein/zeaxanthin intakes were inversely associated with the risk of ER-negative (ER-) breast cancer (pooled multivariable RRs of the comparison between the highest and lowest quintiles): α-carotene (0.87; 95% CI: 0.78, 0.97), β-carotene (0.84; 95% CI: 0.77, 0.93), and lutein/zeaxanthin (0.87; 95% CI: 0.79, 0.95). These variables were not inversely associated with the risk of ER-positive (ER+) breast cancer (pooled multivariable RRs for the same comparison): α-carotene (1.04; 95% CI: 0.99, 1.09), β-carotene (1.04; 95% CI: 0.98, 1.10), and lutein/zeaxanthin (1.00; 95% CI: 0.93, 1.07). Although the pooled RRs for quintile 5 for β-cryptoxanthin were not significant, inverse trends were observed for ER- and ER+ breast cancer (P-trend ≤ 0.05). Nonsignificant associations were observed for lycopene intake. The associations were largely not appreciably modified by several breast cancer risk factors. Nonsignificant associations were observed for PR-positive and PR-negative breast cancer.
CONCLUSIONS
Intakes of α-carotene, β-carotene, and lutein/zeaxanthin were inversely associated with risk of ER-, but not ER+, breast cancer. However, the results need to be interpreted with caution because it is unclear whether the observed association is real or due to other constituents in the same food sources.
背景
有关类胡萝卜素摄入量与雌激素受体（ER）和孕激素受体（PR）状态下乳腺癌风险之间关联的流行病学研究有限。
目的
我们对 18 项队列研究进行了汇总分析，以研究这些关联。
设计
在研究期间最长随访 26 年的 1028438 名参与者中，共发现 33380 例侵袭性乳腺癌新发病例。采用 Cox 比例风险回归估计研究特异性相对危险度（RR）和 95%置信区间（CI），然后采用随机效应模型进行汇总。
结果
α-胡萝卜素、β-胡萝卜素和叶黄素/玉米黄质的摄入量与 ER 阴性（ER-）乳腺癌的风险呈负相关（最高和最低五分位数之间比较的汇总多变量 RR）：α-胡萝卜素（0.87；95%CI：0.78，0.97）、β-胡萝卜素（0.84；95%CI：0.77，0.93）和叶黄素/玉米黄质（0.87；95%CI：0.79，0.95）。这些变量与 ER 阳性（ER+）乳腺癌的风险无负相关（相同比较的汇总多变量 RR）：α-胡萝卜素（1.04；95%CI：0.99，1.09）、β-胡萝卜素（1.04；95%CI：0.98，1.10）和叶黄素/玉米黄质（1.00；95%CI：0.93，1.07）。β-隐黄质五分位 5 的汇总 RR 虽无统计学意义，但 ER-和 ER+乳腺癌呈负相关趋势（P 趋势≤0.05）。番茄红素摄入量无显著相关性。这些关联在很大程度上不受多种乳腺癌危险因素的显著影响。PR 阳性和 PR 阴性乳腺癌的相关性无统计学意义。
结论
α-胡萝卜素、β-胡萝卜素和叶黄素/玉米黄质的摄入量与 ER-乳腺癌的风险呈负相关，但与 ER+乳腺癌的风险无关。然而，由于不清楚观察到的相关性是真实的还是由于同一食物来源中的其他成分所致，因此需要谨慎解释这些结果。
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