美国《临床肿瘤学杂志》：树坚果可以大幅降低癌症复发和死亡风险

美国《临床肿瘤学杂志》2018年2月28日在线先发

https://doi.org/10.1200/JCO.2017.75.5413

目的

已有观察性研究报告，高胰岛素血症包括2型糖尿病、肥胖、久坐不动的生活方式和高血糖负荷饮食，有这些情况的患者结肠癌复发率和死亡率升高，食用坚果可以降低2型糖尿病、代谢综合症、胰岛素抵抗的风险，但食用坚果对结肠癌复发和生存的影响尚不知。

患者

我们对826名符合条件的III期结肠癌患者实施了一项前瞻性、观察性研究，这些患者在入组到一项随机化辅助化疗临床试验的同时，根据饮食情况问卷调查表，报告了膳食摄入量。采用Cox比例风险回归分析，我们评价了食用坚果与癌症复发、死亡的相关性。

结果

中位随访6.5年后，与不吃坚果的患者相比，每周食用≥2份坚果的患者，调校后的无病生存风险比（HR）为0.58（95%CI，0.37-0.92；趋势P=0.03）、总生存风险比为0.43（95%CI，0.25-0.74；趋势P=0.01）。在亚组分析中，明显获益仅限于食用树坚果（无病生存风险比，0.54；95%CI，0.34-0.85；趋势P=0.04。总生存的风险比，0.47；95%CI，0.27-0.82；趋势P=0.04）。即使有其它已知或疑似癌症复发、死亡风险因素，坚果总食用量与转归改善的相关性仍持续存在。

结论

在III期结肠癌患者中，高坚果食用量的饮食可能与癌症复发、死亡明显下降相关。

《壹篇》南南和北北

https://doi.org/10.1200/JCO.2017.75.5413

Purpose

Observational studies have reported increased colon cancer recurrence and mortality in patients with states of hyperinsulinemia, including type 2 diabetes, obesity, sedentary lifestyle, and high glycemic load diet. Nut intake has been associated with a lower risk of type 2 diabetes, metabolic syndrome, and insulin resistance. However, the effect of nut intake on colon cancer recurrence and survival is not known.

Patients and Methods

We conducted a prospective, observational study of 826 eligible patients with stage III colon cancer who reported dietary intake on food frequency questionnaires while enrolled onto a randomized adjuvant chemotherapy trial. Using Cox proportional hazards regression, we assessed associations of nut intake with cancer recurrence and mortality.

Results

After a median follow-up of 6.5 years, compared with patients who abstained from nuts, individuals who consumed two or more servings of nuts per week experienced an adjusted hazard ratio (HR) for disease-free survival of 0.58 (95% CI, 0.37 to 0.92; Ptrend = .03) and an HR for overall survival of 0.43 (95% CI, 0.25 to 0.74; Ptrend = .01). In subgroup analysis, the apparent benefit was confined to tree nut intake (HR for disease-free survival, 0.54; 95% CI, 0.34 to 0.85; Ptrend = .04; and HR for overall survival, 0.47; 95% CI, 0.27 to 0.82; Ptrend = .04). The association of total nut intake with improved outcomes was maintained across other known or suspected risk factors for cancer recurrence and mortality.

Conclusion

Diets with a higher consumption of nuts may be associated with a significantly reduced incidence of cancer recurrence and death in patients with stage III colon cancer.

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