JNCI：蔬菜的摄入量与ER阴性乳腺癌发病率呈负相关

目前对雌激素受体（ER-）阴性的乳腺癌患者知之甚少，同时对于所能进行干预的可改变的危险因素也了解不多。因为在整个乳腺癌患者群中，ER阴性的患者仅占了15%至20%，为了精确评估水果蔬菜摄入和ER阴性的乳腺癌发病风险之间可能存在的反向联系，需要进行大型汇总分析。为了探究上述问题的答案，来自哈佛大学的Seungyoun Jung等进行了相关研究，他们的研究结果发表在JNCI 1月最新的在线期刊上。

研究者对20个队列研究进行了汇总分析，在这些研究中共有993466名女性受试者，上述研究的随访时间为11至20年，在这些受试者中，研究者发现了19869名雌激素受体阳性的乳腺癌患者以及4821名ER阴性的乳腺癌患者。研究者采用Cox风险比例回归分析法计算了研究特异性多变量相对危险度（RRs）和95%可信区间，然后使用随机效应模型结合上述结果。所有的统计检验皆为双侧。
水果蔬菜的总体摄入与ER阴性的乳腺癌发病风险呈显著负相关，但是对于乳腺癌的总体发病率或ER阳性的乳腺癌发病率则无显著相关性。在ER阴性的乳腺癌患者中发病率与蔬菜的消耗量呈负相关。比较蔬菜摄入量最多和最少的患者的汇总相对风险，在ER阴性的乳腺癌患者中为0.82(95%可信区间0.74至 0.90)，在ER阳性的乳腺癌患者中为1.04(95% 可信区间0.97至1.11)。总体水果摄入量与ER阴性乳腺癌患者的发病风险不存在显著相关性，比较摄入水果摄入量最多和最少的患者的RR为0.94（95%可信区间为0.85至1.04）。

研究结果指出，在总体水果蔬菜的摄入量和乳腺癌总体发病率之间没有存在显著相关性。然而，本研究的大型汇总分析指出，蔬菜的摄入量与ER阴性的乳腺癌发病率呈负相关。

原文链接：
Fruit and Vegetable Intake and Risk of Breast Cancer by Hormone Receptor Status.

Background Estrogen receptor–negative (ER−) breast cancer has few known or modifiable risk factors. Because ER− tumors account for only 15% to 20% of breast cancers, large pooled analyses are necessary to evaluate precisely the suspected inverse association between fruit and vegetable intake and risk of ER− breast cancer.

Methods Among 993 466 women followed for 11 to 20 years in 20 cohort studies, we documented 19 869 estrogen receptor positive (ER+) and 4821 ER− breast cancers. We calculated study-specific multivariable relative risks (RRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression analyses and then combined them using a random-effects model. All statistical tests were two-sided.

Results Total fruit and vegetable intake was statistically significantly inversely associated with risk of ER− breast cancer but not with risk of breast cancer overall or of ER+ tumors. The inverse association for ER− tumors was observed primarily for vegetable consumption. The pooled relative risks comparing the highest vs lowest quintile of total vegetable consumption were 0.82 (95% CI = 0.74 to 0.90) for ER− breast cancer and 1.04 (95% CI = 0.97 to 1.11) for ER+ breast cancer (P common-effects by ER status < .001). Total fruit consumption was non-statistically significantly associated with risk of ER− breast cancer (pooled multivariable RR comparing the highest vs lowest quintile = 0.94, 95% CI = 0.85 to 1.04).

Conclusions We observed no association between total fruit and vegetable intake and risk of overall breast cancer. However, vegetable consumption was inversely associated with risk of ER− breast cancer in our large pooled analyses.

来源：丁香园