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首页> 外文期刊>JAMA: the Journal of the American Medical Association >Soy food intake and breast cancer survival.
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Soy food intake and breast cancer survival.

机译：大豆食物的摄入量和乳腺癌的存活率。

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CONTEXT: Soy foods are rich in isoflavones, a major group of phytoestrogens that have been hypothesized to reduce the risk of breast cancer. However, the estrogen-like effect of isoflavones and the potential interaction between isoflavones and tamoxifen have led to concern about soy food consumption among breast cancer patients. OBJECTIVE: To evaluate the association of soy food intake after diagnosis of breast cancer with total mortality and cancer recurrence. DESIGN, SETTING, AND PARTICIPANTS: The Shanghai Breast Cancer Survival Study, a large, population-based cohort study of 5042 female breast cancer survivors in China. Women aged 20 to 75 years with diagnoses between March 2002 and April 2006 were recruited and followed up through June 2009. Information on cancer diagnosis and treatment, lifestyle exposures after cancer diagnosis, and disease progression was collected at approximately 6 months after cancer diagnosis and was reassessed at 3 follow-up interviews conducted at 18, 36, and 60 months after diagnosis. Annual record linkage with the Shanghai Vital Statistics Registry database was carried out to obtain survival information for participants who were lost to follow-up. Medical charts were reviewed to verify disease and treatment information. MAIN OUTCOME MEASURES: Total mortality and breast cancer recurrence or breast cancer-related deaths. Cox regression analysis was carried out with adjustment for known clinical predictors and other lifestyle factors. Soy food intake was treated as a time-dependent variable. RESULTS: During the median follow-up of 3.9 years (range, 0.5-6.2 years), 444 deaths and 534 recurrences or breast cancer-related deaths were documented in 5033 surgically treated breast cancer patients. Soy food intake, as measured by either soy protein or soy isoflavone intake, was inversely associated with mortality and recurrence. The hazard ratio associated with the highest quartile of soy protein intake was 0.71 (95% confidence interval [CI], 0.54-0.92) for total mortality and 0.68 (95% CI, 0.54-0.87) for recurrence compared with the lowest quartile of intake. The multivariate-adjusted 4-year mortality rates were 10.3% and 7.4%, and the 4-year recurrence rates were 11.2% and 8.0%, respectively, for women in the lowest and highest quartiles of soy protein intake. The inverse association was evident among women with either estrogen receptor-positive or -negative breast cancer and was present in both users and nonusers of tamoxifen. CONCLUSION: Among women with breast cancer, soy food consumption was significantly associated with decreased risk of death and recurrence.
机译：上下文：大豆食品富含异黄酮，这是一类主要的植物雌激素，据推测可以降低​​患乳腺癌的风险。然而，异黄酮的类似雌激素的作用以及异黄酮和他莫昔芬之间的潜在相互作用已经引起了乳腺癌患者对大豆食品消费的关注。目的：评估乳腺癌诊断后摄入大豆食品与总死亡率和癌症复发之间的关系。设计，地点和参与者：《上海乳腺癌生存研究》是一项针对5042名中国女性乳腺癌幸存者的大型人群队列研究。招募了在2002年3月至2006年4月期间被诊断为20至75岁的女性，并随访至2009年6月。有关癌症诊断和治疗，癌症诊断后生活方式暴露以及疾病进展的信息是在癌症诊断后大约6个月收集的，在诊断后18个月，36个月和60个月进行了3次随访，对患者进行了重新评估。与上海生命统计登记数据库进行了年度记录链接，以获取失访者的生存信息。审查了病历表以核实疾病和治疗信息。主要观察指标：总死亡率和乳腺癌复发或与乳腺癌相关的死亡。对已知的临床预测指标和其他生活方式因素进行调整后，进行Cox回归分析。大豆食品的摄入量被视为随时间变化的变量。结果：在中位随访时间3.9年（范围0.5-6.2年）中，记录了5033例经手术治疗的乳腺癌患者的444例死亡和534例复发或与乳腺癌相关的死亡。用大豆蛋白或大豆异黄酮的摄入量来衡量，大豆食品的摄入量与死亡率和复发率成反比。与最低摄入量四分位数相比，与最高摄入四分之一大豆蛋白摄入量相关的危险比为0.71（95％置信区间[CI]，0.54-0.92）和复发率为0.68（95％CI，0.54-0.87） 。大豆蛋白摄入量最低和最高四分位数的女性，经多因素校正的4年死亡率分别为10.3％和7.4％，4年复发率分别为11.2％和8.0％。在患有雌激素受体阳性或阴性乳腺癌的女性中，这种逆向关联很明显，并且他莫昔芬的使用者和非使用者中均存在这种关联。结论：在患有乳腺癌的女性中，食用大豆食品与降低死亡和复发风险显着相关。

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