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

作者：Fujii Takuma^*; Takatsuka Naoyoshi; Nagata Chisato; Matsumoto Koji; Oki Akinori; Furuta Reiko; Maeda Hiroo; Yasugi Toshiharu; Kawana Kei; Mitsuhashi Akira; Hirai Yasuo; Iwasaka Tsuyoshi; Yaegashi Nobuo; Watanabe Yoh; Nagai Yutaka; Kitagawa Tomoyuki; Yoshikawa Hiroyuki

来源：International Journal of Clinical Oncology, 2013, 18(6): 1091-1101.

DOI：10.1007/s10147-012-0486-5

• Human papillomavirus
• Cervical intraepithelial neoplasia
• Low-grade squamous intraepithelial lesion
• Micronutrients
• Carotenoids

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. %26lt;br%26gt;In a prospective cohort study of 391 patients with cervical intraepithelial neoplasia (CIN) grade 1-2 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. %26lt;br%26gt;In non-smoking regression subjects, regression was significantly associated with serum levels of zeaxanthin/lutein (HR 1.25, 0.78-2.01, 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) 0.11-0.71, p = 0.007), although any protective effect from a higher level of serum beta-carotene was weaker or abolished (HR 0.52, 95 % CI 0.24-1.13, p = 0.098). Increasing beta-carotene intake did not show a protective effect (HR 2.30, 95 % CI 0.97-5.42, p = 0.058). %26lt;br%26gt;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.

• 出版日期2013-12
• 单位中国医学科学院肿瘤医院