Περίληψη:
Although it appears biologically plausible for iron to be associated
with gastric carcinogenesis, the evidence is insufficient to lead to any
conclusions. To further investigate the relationship between body iron
status and gastric cancer risk, we conducted a nested case-control study
in the multicentric European Prospective Investigation into Cancer and
Nutrition (EPIC) study. The study included 456 primary incident gastric
adenocarcinoma cases and 900 matched controls that occurred during an
average of 11 years of follow-up. We measured prediagnostic serum iron,
ferritin, transferrin and C-reactive protein, and further estimated
total iron-binding capacity (TIBC) and transferrin saturation (TS). Odds
ratios (ORs) and 95% confidence intervals (CIs) for the risk of gastric
cancer by iron metrics were estimated from multivariable conditional
logistic regression models. After adjusting for relevant confounders, we
observed a statistically significant inverse association between gastric
cancer and ferritin and TS indices (ORlog2=0.80, 95% CI=0.72-0.88;
OR10%increment=0.87, 95% CI=0.78-0.97, respectively). These
associations appear to be restricted to noncardia gastric cancer
(ferritin showed a p for heterogeneity=0.04 and TS had a p for
heterogeneity=0.02), and no differences were found by histological type.
TIBC increased risk of overall gastric cancer (OR50 mu g/dl=1.13, 95%
CI=1.02-1.2) and also with noncardia gastric cancer (p for
heterogeneity=0.04). Additional analysis suggests that time between
blood draw and gastric cancer diagnosis could modify these findings. In
conclusion, our results showed a decreased risk of gastric cancer
related to higher body iron stores as measured by serum iron and
ferritin. Further investigation is needed to clarify the role of iron in
gastric carcinogenesis.
What’s new? Iron is highly reactive, iron levels in the body rise with
inflammation, and the iron-overload disorder hemochromatosis is
associated with an increased risk of gastric cancer. Thus, one might
predict that high levels of iron will increase the risk of cancer.
However, in this study from a large European population, the authors
found that increased body iron stores actually decreased the risk of
gastric cancer. These results suggest that further investigation is
needed to clarify the role of iron in gastric carcinogenesis.
Συγγραφείς:
Fonseca-Nunes, Ana
Agudo, Antonio
Aranda, Nuria
Arija,
Victoria
Cross, Amanda J.
Molina, Esther
Jose Sanchez, Maria
and Bueno-de-Mesquita, H. B(as)
Siersema, Peter
Weiderpass,
Elisabete
Krogh, Vittorio
Mattiello, Amalia
Tumino, Rosario
and Saieva, Calogero
Naccarati, Alessio
Ohlsson, Bodil and
Sjoberg, Klas
Boutron-Ruault, Marie-Christine
Cadeau, Claire and
Fagherazzi, Guy
Boeing, Heiner
Steffen, Annika
Kuehn, Tilman
and Katzke, Verena
Tjonneland, Anne
Olsen, Anja
Khaw,
Kay-Tee
Wareham, Nick
Key, Tim
Lu, Yunxia
Riboli, Elio
and Peeters, Petra H.
Gavrila, Diana
Dorronsoro, Miren
Ramon
Quiros, Jose
Barricarte, Aurelio
Jenab, Mazda
Zamora-Ros,
Raul
Freisling, Heinz
Trichopoulou, Antonia
Lagiou, Pagona
and Bamia, Christina
Jakszyn, Paula
