Nutrition Intervention Trials in Linxian China

中国临县营养干预试验

• 批准号: 7733687
• 负责人: Philip Taylor
• 金额: $ 69.01万
• 依托单位: DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7733687
• 关键词: Age; Beta Carotene; Blood specimen; Cancer Death Rates; Carotenoids; Categories; China; Cohort Studies; Consumption; Cytology Histology; Data Analyses; Death Rate; Dietary Intervention; Disease; Double-Blind Method; Dysplasia; End Point; Esophageal; Etiology; Food; Fumonisins; General Population; Genetic Polymorphism; Goiter; Helicobacter pylori; Human Herpesvirus 4; Human Papillomavirus; Incidence; Intervention; Intervention Studies; Intervention Trial; Lung; Malignant Neoplasms; Malignant neoplasm of esophagus; Malignant neoplasm of lung; Micronutrients; Millet; Minerals; Nitrosamines; Numbers; Nutrient; Participant; Patient Self-Report; Persons; Placebo Control; Play; Pleura; Prevention; Randomized; Rate; Risk; Role; Selenium; Selenium/vitamin E; Serologic tests; Serum; Silicon Dioxide; Specimen; Stomach; Stomach Carcinoma; Structure of nail of toe; Study of serum; Supplementation; Testing; Tissues; Tooth Loss; Trachea and Bronchus; Trauma; Vegetables; Vitamins; Zinc; alpha Tocopherol; cancer risk; carcinogenesis; esophageal cancer prevention; malignant stomach neoplasm; mortality; stomach cardia

OBJECTIVE: The primary objective of this project is to determine if supplementation with multiple vitamin-minerals reduces the incidence and mortality of esophageal cancer, gastric cancer, and total mortality. Secondary objectives are to assess supplement effects on intermediate endpoints in carcinogenesis and to examine new hypotheses relating to the etiology and prevention of esophageal cancer and gastric cancer. BACKGROUND: Probably the highest worldwide rates of esophageal cancer occur in Linxian, China where cumulative death rates to age 75 for this cancer exceed 20%. Widespread deficiencies of multiple nutrients are considered the most likely cause, but consumption of pickled vegetables, moldy foods and nitrosamines, and physical trauma from silica fragments in ingested millet may play a role. METHODS: Two double-blind, placebo-controlled randomized intervention studies were conducted to evaluate multiple vitamins/minerals in the prevention of esophageal and other cancers. The Dysplasia Trial evaluated 3,318 persons with cytologic evidence of dysplasia supplemented for 6 years, while the General Population Trial evaluated 29,584 persons supplemented for 5 1/4 years. Biologic specimens (blood, toenails, cytology and histology specimens) were collected periodically throughout the trials. PROGRESS: TRIALS - Both trials concluded in 1991, and results showed that the combination of beta-carotene/vitamin E/selenium significantly reduced total mortality, total cancer mortality, and stomach cancer incidence and mortality. Results from endoscopic and cytologic examinations suggested that multiple vitamins/minerals may decrease proliferation and enhance cytologic reversion to nondysplasia. POST-TRIAL FOLLOW-UP - Analysis of data from 10 years of post-intervention followup (through May 2001) indicate that, for the General Population Trial, the beneficial effects of the beta-carotene/vitamin E/selenium supplementation continued after termination of the intervention, and that the benefits were greater in the younger participants. None of the four factors tested influenced lung cancer death rates. ETIOLOGY STUDIES - A number of nested case-cohort studies relating baseline serum values of micronutrients, fumonisins, Helicobacter pylori, HPV, and EBV to cancer have recently been completed. Results of recent analyses have shown: (1) an especially strong association with increased risk for esophageal cancer and gastric cardia cancer among subjects with low serum selenium levels; (2) no relation of serum carotenoids with esophageal cancer or gastric cancer; (3) a strong association for low serum alpha-tocopherol levels and esophageal cancer risk; (4) a strong association between low tissue zinc levels and increased esophageal cancer risk; (5) increased risk for H pylori exposure for gastric cancer, both cardia as well as body; (5) no relation of fumonisin exposure with esophageal cancer risk; (6) an association between tooth loss and risk of esophageal cancer and gastric cancer; (7) associations between several genetic polymorphisms and risk of esophageal cancer and gastric cardia cancer; (8) increased risk of gastric noncardia cancer in persons with self-reported goiter; and (9) no relation for HPV 16, 18, or 73 serology and esophageal cancer or gastric cancer.

目的：该项目的主要目的是确定补充多种维生素 - 矿物质是否会降低食道癌，胃癌和总死亡率的发生率和死亡率。次要目标是评估补充对癌中间终点的影响，并检查与食管癌和胃癌的病因和预防有关的新假设。背景：全球食管癌率最高的发生率是在中国林克斯，该癌症的累积死亡率超过20％。多种营养素的普遍缺陷被认为是最有可能的原因，但是食用腌制的蔬菜，发霉的食物和硝基胺以及摄入的小米中硅片碎片的身体创伤可能起作用。方法：进行了两次双盲，安慰剂对照的随机干预研究，以评估多种维生素/矿物质，以预防食管和其他癌症。发育不良试验评估了3,318名补充了6年发育异常的细胞学证据，而一般人口试验评估了29,584名补充5 1/4年的人。在整个试验过程中，定期收集生物标本（血液，脚趾甲，细胞学和组织学标本）。进度：试验 - 两项试验均在1991年结束，结果表明，β-胡萝卜素/维生素E/硒的组合显着降低了总死亡率，总癌症死亡率以及胃癌的发病率和死亡率。内窥镜检查和细胞学检查的结果表明，多种维生素/矿物质可能会降低增殖并增强细胞学回归对非发育异常。试验后的随访 - 分析了10年的干预后随访（至2001年5月）的数据表明，对于一般人群试验，β-胡萝卜素/维生素E/硒补充剂在终止干预后的有益作用持续，并且在年轻参与者中的益处更大。测试的四个因素都没有影响肺癌死亡率。病因研究 - 最近已经完成了许多有关微量营养素，富莫诺菌素，幽门螺杆菌，HPV和EBV与癌症基线血清值的嵌套病例研究研究。最近分析的结果表明：（1）血清硒水平较低的受试者中食管癌和胃癌癌的风险增加特别牢固； （2）血清类胡萝卜素与食管癌或胃癌无关； （3）低血清α-生育酚水平和食管癌风险的牢固关联； （4）低组织锌水平与食管癌风险增加之间的密切关联； （5）胃癌幽门螺杆菌暴露的风险增加，包括心脏和身体； （5）没有烟剂暴露与食管癌风险的关系； （6）牙齿丧失与食管癌和胃癌的风险之间的关联； （7）几种遗传多态性与食管癌和胃心脏病癌的风险之间的关联； （8）自我报告的甲状腺肿的人增加了胃非心脏癌的风险； （9）HPV 16、18或73血清学和食管癌或胃癌无关。

项目成果

Prospective study of serum 25(OH)-vitamin D concentration and risk of oesophageal and gastric cancers.

• DOI: 10.1038/sj.bjc.6603834
• 发表时间: 2007-07-02
• 期刊: BRITISH JOURNAL OF CANCER
• 影响因子: 8.8
• 作者: Chen, W.;Dawsey, S. M.;Qiao, Y-L;Mark, S. D.;Dong, Z-W;Taylor, P. R.;Zhao, P.;Abnet, C. C.
• 通讯作者: Abnet, C. C.

Self-reported goiter is associated with a significantly increased risk of gastric noncardia adenocarcinoma in a large population-based Chinese cohort.

在一个大型中国人群队列中，自我报告的甲状腺肿与胃非贲门腺癌的风险显着增加相关。

• DOI: 10.1002/ijc.21993
• 发表时间: 2006
• 期刊: International journal of cancer. Journal international du cancer
• 作者: Abnet,ChristianC;Fan,Jin-Hu;Kamangar,Farin;Sun,Xiu-Di;Taylor,PhilipR;Ren,Jian-Song;Mark,StevenD;Zhao,Ping;FraumeniJr,JosephF;Qiao,You-Lin;Dawsey,SanfordM
• 通讯作者: Dawsey,SanfordM