Association between carotenoids and outcome of cervical intraepithelial neoplasia: a prospective cohort study

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• 作者：Takuma Fujii (1)
  Naoyoshi Takatsuka (2)
  Chisato Nagata (2)
  Koji Matsumoto (3)
  Akinori Oki (3)
  Reiko Furuta (4)
  Hiroo Maeda (5)
  Toshiharu Yasugi (6)
  Kei Kawana (6)
  Akira Mitsuhashi (7)
  Yasuo Hirai (8)
  Tsuyoshi Iwasaka (9)
  Nobuo Yaegashi (10)
  Yoh Watanabe (11)
  Yutaka Nagai (12)
  Tomoyuki Kitagawa (4)
  Hiroyuki Yoshikawa (3)
  
• 关键词：Human papillomavirus ; Cervical intraepithelial neoplasia ; Low ; grade squamous intraepithelial lesion ; Micronutrients ; Carotenoids
• 刊名：International Journal of Clinical Oncology
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：18
• 期：6
• 页码：1091-1101
• 全文大小：
• 作者单位：Takuma Fujii (1)
  Naoyoshi Takatsuka (2)
  Chisato Nagata (2)
  Koji Matsumoto (3)
  Akinori Oki (3)
  Reiko Furuta (4)
  Hiroo Maeda (5)
  Toshiharu Yasugi (6)
  Kei Kawana (6)
  Akira Mitsuhashi (7)
  Yasuo Hirai (8)
  Tsuyoshi Iwasaka (9)
  Nobuo Yaegashi (10)
  Yoh Watanabe (11)
  Yutaka Nagai (12)
  Tomoyuki Kitagawa (4)
  Hiroyuki Yoshikawa (3)
  
  1. Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
  2. Department of Epidemiology and Preventive Medicine, Gifu University, Graduate School of Medicine, Yanagito 1-1, Gifu, Gifu, 501-1194, Japan
  3. Department of Obstetrics and Gynecology, Graduate School of Comprehensive Human Science, University of Tsukuba, 1-1, 1-chome, Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
  4. Department of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, 8-31, 3-chome, Ariake, Kouto-ku, Tokyo, 135-8550, Japan
  5. Department of Transfusion Medicine and Cell Therapy, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
  6. Department of Obstetrics and Gynecology, The University of Tokyo, 3-1, 7-chome, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
  7. Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, 8-1, 1-chome, Inohana, Chuo-ku, Chiba, 260-8670, Japan
  8. Department of Gynecology and Cytopathology, The Cancer Institute Hospital, Japanese Foundation of Cancer Research, 8-31, 3-chome, Ariake, Kouto-ku, Tokyo, 135-8550, Japan
  9. Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, 1-1, 5-chome, Nabeshima, Saga, Saga, 849-8501, Japan
  10. Department of Obstetrics and Gynecology, Tohoku University School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
  11. Department of Obstetrics and Gynecology, Kinki University, School of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 589-8511, Japan
  12. Department of Obstetrics and Gynecology, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagamigun, Okinawa, 903-0215, Japan
  
• ISSN：1437-7772

文摘

Background It has been suggested that micronutrients such as alpha-tocopherol, retinol, lutein, cryptoxanthin, lycopene, and alpha- and beta-carotene may help in the prevention of cervical cancer. Our aim was to investigate whether serum concentrations and/or dietary intake of micronutrients influence the regression or progression of low-grade cervical abnormalities. Methods In a prospective cohort study of 391 patients with cervical intraepithelial neoplasia (CIN) grade 1 lesions, we measured serum micronutrient concentrations in addition to a self-administered questionnaire about dietary intake. We evaluated the hazard ratio (HR) adjusted for CIN grade, human papillomavirus genotype, total energy intake and smoking status. Results In non-smoking regression subjects, regression was significantly associated with serum levels of zeaxanthin/lutein (HR 1.25, 0.78.01, p=0.024). This benefit was abolished in current smokers. Regression was inhibited by high serum levels of alpha-tocopherol in smokers (p=0.042). In progression subjects, a significant protective effect against progression to CIN3 was observed in individuals with a medium level of serum beta-carotene [HR 0.28, 95% confidence interval (CI) 0.11.71, p=0.007), although any protective effect from a higher level of serum beta-carotene was weaker or abolished (HR 0.52, 95% CI 0.24.13, p=0.098). Increasing beta-carotene intake did not show a protective effect (HR 2.30, 95% CI 0.97.42, p=0.058). Conclusions Measurements of serum levels of carotenoids suggest that regression is modulated by smoking status. Maintaining a medium serum level of beta-carotene has a protective effect for progression; however, carotene intake is not correlated with serum levels of carotenoids.