鎳、硒可抗胰臟癌


【24drs.com】根據線上發表於12月19日Gut期刊的一篇研究,體內鎳、硒含量高者發生外分泌腺胰臟癌的風險比較低;相同研究也發現,體內鉛、砷、鎘含量高會增加發病風險。
  
  西班牙馬德里西班牙國立癌症研究中心基因與分子流行病學小組Andre F.S. Amaral醫師等人分析了趾甲中的12種微量元素,評估微量元素值和外分泌腺胰臟癌(EPC)風險的關係。
  
  研究者搜集與分析了1992-1995年間在西班牙5間醫院參與「Multicentre Prospective Study on the Role of the K-ras and other Genetic Alterations in the Diagnosis, Prognosis and Etiology of Pancreatic and Biliary Diseases (PANKRAS II)」研究的118名EPC病患的趾甲樣本,也對參與「Spanish Bladder Cancer/EPICURO」研究的399名對照組進行類似的檢測;兩篇研究約是在相同時期進行,在地理位置上相近。
  
  Amaral醫師等人校正了抽菸、糖尿病、過重和教育程度(高或低)等可能的干擾變項。
  
  根據期刊的新聞稿,趾甲砷、鎘值最高者發生胰臟癌的風險是最低值者的2到3.5倍。他們指出,鉛值最高者發生疾病的風險更是超過6倍。
  
  分析最高的四分之一和最低的四分之一這兩組後,研究者發現,EPC風險增加與鉛(風險比[OR],6.26;95%信心區間[CI],2.71 - 14.47;趨勢P = 3 × 10-5)、鎘(校正OR,3.58;95% CI,1.86 - 6.88;趨勢P = 5 × 7-6)和砷(校正OR,2.02;95% CI,1.08 - 3.78;趨勢P = .009)有關。
  
  含較多鎳(OR,0.27;95% CI,0.12 - 0.59;趨勢P = 2 × 10-4)與硒(OR,0.05;95% CI,0.02 - 0.15;趨勢P = 8 × 10-11)則與發生EPC風險降低有關。其他微量元素則與EPC沒有統計上的顯著關係。
  
  研究限制包括,屬於回溯設計、小樣本、案例組和對照組的納入期間有所差異。
  
  作者們寫道,這是首次有研究顯示,EPC風險和趾甲鉛、鎳、硒含量有顯著關聯,也確認了砷、鎘的關聯,這在以往少有研究提及。重要的是,每種關聯都發現到劑量反應效應。
  
  作者們結論指出,其研究結果需要其他研究驗證,也需後續研究證實微量元素在胰臟癌病理的角色。
  
  資料來源:http://www.24drs.com/professional/list/content.asp?x_idno=6688&x_classno=0&x_chkdelpoint=Y
  

Nickel, Selenium May Protect Against Pancreatic Cancer

By Troy Brown
Medscape Medical News

December 21, 2011 — People with high bodily levels of nickel and selenium may have a lower risk of developing exocrine pancreatic cancer, according to a recent study published online December 19 in Gut. The same study also found that high bodily levels of lead, arsenic, and cadmium appear to increase the risk of developing the disease.

Andre F.S. Amaral, MD, from the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre, Madrid, Spain, and colleagues analyzed toenails for 12 trace elements to assess the relationship between trace element levels and exocrine pancreatic cancer (EPC) risk.

The researchers collected and analyzed toenail samples from 118 patients with EPC enrolled in the Multicentre Prospective Study on the Role of the K-ras and other Genetic Alterations in the Diagnosis, Prognosis and Etiology of Pancreatic and Biliary Diseases (PANKRAS II) Study from 1992 to 1995 at 5 hospitals in Spain. Similar testing was performed on toenail samples from 399 hospital-based controls recruited from the Spanish Bladder Cancer/EPICURO Study. Both studies were conducted around the same time, and in close geographic proximity.

Dr. Amaral and colleagues adjusted for potential confounders including smoking, diabetes, overweight, and educational level (high vs low).

"Patients with the highest levels of arsenic and cadmium in their nails were between two and 3.5 times more likely to have pancreatic cancer than those with the lowest levels," according to a journal news release. "[T]hose with the highest levels of lead were more than six times as likely to have the disease," they add.

After studying levels in the highest quartile vs the lowest quartile, the researchers found that an increased risk of having EPC was associated with lead (odds ratio [OR], 6.26; 95% confidence interval [CI], 2.71 - 14.47; P-trend = 3 × 10?5), cadmium (adjusted OR, 3.58; 95% CI, 1.86 - 6.88; P-trend = 5 × 7?6), and arsenic (adjusted OR, 2.02; 95% CI, 1.08 - 3.78; P-trend = .009).

High levels of nickel (OR, 0.27; 95% CI, 0.12 - 0.59; P-trend = 2 × 10?4) and selenium (OR, 0.05; 95% CI, 0.02 - 0.15; P-trend = 8 × 10?11) were associated with decreased risk of having EPC.

None of the other trace elements had statistically significant associations with EPC.

Limitations of the study include the retrospective design, small sample size, and difference in recruitment period between case and control patients.

"The study shows, for the first time, highly significant associations between EPC risk and toenail concentrations of lead, selenium and nickel, and confirms associations with cadmium and arsenic exposure, previously reported by a few studies. Importantly, a dose–response effect was observed for each of these associations," the authors write.

"While our findings need to be replicated in independent studies, they suggest a role of trace elements in pancreatic cancer pathogenesis, and justify further research," the authors conclude.

The study was supported by the Association for International Cancer Research, Fondo de Investigacion Sanitaria, Spain, Red Tematica de Investigacion Cooperativa en Cancer and CIBER de Epidemiologia y Salud Publica), Instituto de Salud Carlos III, Ministry of Health, Spain, Fundacion Cient?fica de la Asociacion Espanola Contra el Cancer and the Intramural Research Program of the Division of Cancer Epidemiology and Genetics, National Cancer Institute. The Dartmouth Trace Element Core is partly supported by the National Institute of Environmental Health Sciences. The authors have disclosed no relevant financial relationships.

Gut. Published online December 19, 2011.

    
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