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【JAMA Oncol】维生素D水平与乳腺癌生存率的关系

2016年11月24日

来源：肿瘤资讯

一项新的研究显示对于诊断为乳腺癌患者，如果高血清维生素D水平可能有更好的生存，乳腺癌的恶性程度更低。

虽然这项新研究支持以前对维生素D和乳腺癌的研究，但它不能证明促进维生素D水平会改善乳腺癌妇女的预后。

该研究的主要研究者Song Yao说，“总体而言，我们发现在诊断时与维生素D水平相关的全因死亡率降低30％，”纽约州布法罗的Roswell Park癌症研究所。

研究人员使用了2006年开始的加利福尼亚妇女正在进行的研究的数据。妇女大多在两个月内被诊断患有浸润性乳腺癌。患者平均年龄为59岁。他们在进入研究后定期进行随访。

基于患者的血清水平25-羟基维生素D（25OHD）水平将妇女分为三个组，每组约有520名患者，。

研究人员发现，25OHD水平较低的患者疾病更晚期，最低水平的女性还没有进入更年期，很多是三阴性癌症，这些患者比其他类型的乳腺癌预后更差。

在平均7年的随访中，维生素D水平最低组约100名的妇女死亡，而维生素D水平最高则有76名的妇女死亡。

研究人员在JAMA Oncology于11月10日在线报道了该结果，在考虑肿瘤特征和其他因素后，最高维生素D水平的患者在研究期间比具有最低维生素D水平的妇女死亡率低28％。绝经前妇女的联系更强。

波士顿Dana-Farber癌症研究所的乳腺癌专家Wendy Chen博士指出，需要进行进一步的临床研究才能说有二者之间有直接联系。

Vitamin D Levels Tied to Breast Cancer Survival

(Reuters Health) - For women diagnosed with breast cancer, high serum vitamin D levels may be tied to better odds of surviving and having tumors with less deadly characteristics, suggests a new study.

While the new study supports previous research on vitamin D and breast cancer, it can't prove that boosting vitamin D levels will improve outcomes for women with breast cancer.

"Overall, we found a 30 percent reduction of all-cause mortality associated with vitamin D levels at the time of diagnosis," said the study's lead author Song Yao, of the Roswell Park Cancer Institute in Buffalo, New York.

The researchers used data from an ongoing study of California women started in 2006. Women were usually enrolled within two months of being diagnosed with invasive breast cancer. Participants' average age was about 59. They were evaluated when they entered the study and periodically afterward.

The women were split into three roughly equally-sized groups, with about 520 participants each, based on their serum levels of 25-hydroxyvitamin D (25OHD).

The researchers found low levels among women with more advanced cancers. The lowest levels were in women who had not yet entered menopause and were diagnosed with triple-negative cancer, which tends to have worse outcomes than other types of breast cancers.

Over an average of seven years of follow-up, about 100 women with the lowest vitamin D levels died, compared to 76 women with the highest level of vitamin D.

Women with the highest vitamin D levels were 28 percent less likely to die of any cause during the study than women with the lowest vitamin D levels, after accounting for tumor characteristics and other factors, the researchers report in JAMA Oncology, online November 10.

The link was stronger among premenopausal women. In that group, high vitamin D levels were also tied to a better chance of not having breast cancer recur, and not dying from it.

Yao told Reuters Health it would take a randomized controlled trial to examine whether high vitamin D causes women with breast cancer to live longer.

Dr. Wendy Chen, a breast cancer specialist at the Dana-Farber Cancer Institute in Boston, agreed that a trial would be needed to say there is a direct link.

"I would not be able to derive a causal relationship from this data, because of all the things that are related to vitamin D and survival," said Chen, who was not involved with the new research.

For example, she told Reuters Health, obesity can influence vitamin D levels and breast cancer prognosis.

Chen said women with breast cancer who currently take low-dose vitamin D supplements should be able to continue during treatment.

People should get 600 international units (IU) of vitamin D each day from ages 1 through 70, according to the Institute of Medicine. Older people should get 800 IU of the vitamin each day.

SOURCE: http://bit.ly/2fIPw4y

JAMA Oncol 2016.