堅果可以顯著降低腸癌風險並延長病人生存期

09-24

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最近耶魯大學醫學院的研究團隊在八百多名3期腸癌患者中開展了食用堅果對病人生存期和癌症複發影響的臨床試驗，結果今年4月發表在臨床腫瘤學雜誌上，摘要如下：

J Clin Oncol. 2018 Apr 10;36(11):1112-1120. doi: 10.1200/JCO.2017.75.5413. Epub 2018 Feb 28.

Nut Consumption and Survival in Patients With Stage III Colon Cancer: Results From CALGB89803 (Alliance).

Fadelu T1, Zhang S1, Niedzwiecki D1, Ye X1, Saltz LB1, Mayer RJ1, Mowat RB1, Whittom R1, Hantel A1, Benson AB1, Atienza DM1, Messino M1, Kindler HL1, Venook A1, Ogino S1, Ng K1, Wu K1, Willett W1, Giovannucci E1, Meyerhardt J1, Bao Y1, Fuchs CS1.

Author information

Abstract

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.

研究的結論是食用堅果可以顯著降低腸癌複發和病人死亡率。

耶魯大學校報對此結果有專文報道，鏈接如下：

Nut consumption may aid colon cancer survival?

news.yale.edu

上面這篇文章針對的是3期腸癌患者，廣大讀者更關心的是食用堅果是否可以幫助普通人降低腸癌風險。

對於這個問題，韓國研究組得出結果是，食用堅果確實可以降低腸癌風險，論文發表在今年4月的營養學雜誌上：

RESULTS:

High nut consumption was strongly associated with reduced risk of colorectal cancer among women (adjusted ORs: 0.30, 95%CI: 0.15-0.60 for the ≥3 servings per week group vs. none). A similar inverse association was observed for men (adjusted ORs: 0.28, 95% CI: 0.17-0.47). In sub-site analyses, adjusted ORs (95% CIs) comparing the ≥3 servings per week group vs none were 0.25 (0.09-0.70) for proximal colon cancer, 0.39 (0.19-0.80) for distal colon cancer, and 0.23 (0.12-0.46) for rectal cancer among men. An inverse association was also found among women for distal colon cancer (OR: 0.13, 95% CI: 0.04-0.48) and rectal cancer (OR: 0.40, 95% CI: 0.17-0.95).

CONCLUSIONS:

We found a statistically significant association between high frequency of nut consumption and reduced risk of colorectal cancer. This association was observed for all sub-sites of the colon and rectum among both men and women, with the exception of proximal colon cancer for women.

相比耶魯大學的研究，來自東亞鄰國的研究更有參考意義。為了降低腸癌風險，大家平時多吃一點堅果吧！