人尿液中异硫氰酸酯水平与胰腺癌关系的病例对照研究

A case-control study on the association between urinary levels of isothiocyanates and the risk of pancreatic cancer

目的 探讨人尿中异硫氰酸酯（ITC）水平与胰腺癌发病风险的关系.方法 采用病例-对照研究方法,利用新建立的“快速病例报告系统”收集2006年12月至2008年12月期间确诊的胰腺癌病例的资料和生物样本,应用高效液相色谱法对390例胰腺癌病例和414名对照者尿液中ITC代谢量进行测定,应用食物频率问卷调查十字花科蔬菜和ITC的摄人情况,采用非条件logistic回归模型分析ITC和胰腺癌的关系.结果 病例组中十字花科蔬菜摄入量、膳食ITC水平和尿液ITC代谢量的中位数（P25,P75）分别为95.0（66.9,135.8） g/d、11.0（7.1,16.0）μmol/d、0.95 （0.12,2.92） μmol/g肌酐；对照组分别为107.4（80.1,154.1）g/d、12.3（8.0,18.0） μmol/d、1.78（0.53,5.28）μmol/g肌酐；病例组均低于对照组,差异有统计学意义（t值分别为3.75、3.03、4.40,P值均＜0.01）.对照人群中尿液ITC代谢量随十字花科蔬菜、ITC摄入量增加而升高（r值分别为0.189、0.201,P值均＜0.01）.将对照组的尿液ITC代谢量划分三分位数,以最低组（＜0.825μmol/g肌酐）为参照组,调整了年龄、性别、糖尿病史、胰腺炎史等混杂因素后,发现尿液中ITC的水平与患胰腺癌的风险呈负相关,尿ITC水平较高组（0.825 ～3.342 μmol/g肌酐）、最高组（≥3.343 μmol/g肌酐）的OR（95％ CI）值分别为0.69（0.49～0.97）和0.47（0.33 ～0.68）,P趋势值＜0.01.结论 增加ITC的摄人量可能降低胰腺癌的发病风险.

Objective To investigate the association between urinary levels of isothiocyanates （ITCs） and the risk of pancreatic cancer in urban Shanghai.Methods A case-control study has been conducted in urban Shanghai.The cases （from December 2006 to December 2008） were identified through an newly established ＂instant case reporting＂ system.The high performance liquid chromatography （HPLC） method was applied to determine the urinary levels of isothiocyanates in 390 cases and 414 controls.A foodfrequency questionnaire was administered to estimate cruciferous vegetables consumption and dietary ITC exposure.Non-conditional logistic regression model was used to analyze the relationship between dietary and urinary levels of isothiocyanates and the risk of pancreatic cancer.Results The cruciferous vegetables intake and ITC consumption,urinary ITC levels （median （P25,P75）） were 95.0 （66.9,135.8） g/d,11.0 （7.1,16.0） μmol/d,0.95 （0.12,2.92） μmol/g Cr respectively in cases,all lower than those in controls,separately 107.4 （80.1,154.1） g/d,12.3 （8.0,18.0） μmol/d,1.78 （0.53,5.28） μmol/g Cr.The differences were statistically significant （t =3.75,3.03,4.40,all P values 〈 0.01）.Urinary levels of ITCs in controls were correlated with cruciferous vegetables consumption and dietary ITC exposure （r =0.189,0.201,all P values 〈0.01）.There was inverse association between urinary ITCs and the risk of pancreatic cancer after adjusting for possible confounding factors such as age,sex,history of diabetes and pancreatitis.Compared with the first tertile （〈0.825 μmol/g Cr）,the odds ratio （95% CI） for the second （0.825-3.342 μmol/g Cr） and third tertiles （≥ 3.343 μmol/g Cr） were 0.69 （0.49-0.97） and 0.47 （0.33-0.68）,respectively,Ptrend 〈 0.01.High levels of cruciferous vegetables or ITC consumption were associated with a reduced risk of pancreatic cancer （all Ptrend 〈 0.05）.Conclusion Results indicated that high levels of dietary ITC exposure might reduce the risk of pancreatic cancer.