一天一杯牛奶或可致癌？

      根据本月25号在《国际流行病学杂志》上发表的一篇研究表示，牛奶的摄入量的多少或可导致患乳腺癌的概率上升。

牛奶

      以下是原文；“Dairy, soy, and risk of breast cancer: those confounded milks

Background

Associations between soy, dairy intakes and breast cancer risk are inconsistent. No studies exist with large numbers of dairy consumers and soy consumers to assess mutual confounding.

Methods

The study cohort contains 52 795 North American women, initially free of cancer, followed for 7.9years (29.7% were Black). Dietary intakes were estimated from food frequency questionnaires and, for 1011 calibration study subjects, from six structured 24-h dietary recalls. Incident invasive breast cancers were detected mainly by matching with cancer registries. Analyses used multivariable proportional hazards regression.

Results

The participants (mean age of 57.1years) experienced 1057 new breast cancer cases during follow-up. No clear associations were found between soy products and breast cancer, independently of dairy. However, higher intakes of dairy calories and dairy milk were associated with hazard ratios (HRs) of 1.22 [95% confidence interval (CI): 1.05–1.40] and 1.50 (95% CI 1.22–1.84), respectively, comparing 90th to 10th percentiles of intakes. Full fat and reduced fat milks produced similar results. No important associations were noted with cheese and yogurt. Substituting median intakes of dairy milk users by those of soy milk consumers was associated with HR of 0.68 (95% CI: 0.55–0.85). Similar-sized associations were found among pre- and post-menopausal cases, with CIs also excluding the null in estrogen receptor (ER+, ER-), and progesterone receptor (PR+) cancers. Less biased calibrated measurement-error adjusted regressions demonstrated yet stronger, but less precise, HRs and CIs that still excluded the null. ConclusionsHigher intakes of dairy milk were associated with greater risk of breast cancer, when adjusted for soy intake. Current guidelines for dairy milk consumption could be viewed with some caution.”

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          该研究的作者是加里·弗雷泽博士（Gary E Fraser），就职于美国加利福尼亚州洛马琳达大学公共卫生学院营养、健康生活方式和疾病预防中心。此前也曾参与研究了“卵巢癌的风险随着排卵周期的增加而增加”以及发现了“每天喝一杯酒，相关风险高达50%，而对于每天喝两到三杯的人，患病的风险进一步增加到70%—80%”。

        该研究追踪观察了52795名北美女性，她们最初都没有癌症。历时7.9年得出研究结果，截止至研究结束，受试者（平均年龄57.1岁）新发乳腺癌1057例，约占实验总人数的2%。不过该研究也指出大豆制品与乳腺癌之间没有明显的关联。全脂牛奶和低脂牛奶产生了类似的结果。没有发现奶酪和酸奶有重要的关联。

各癌症人数分布

        我国国内每年确诊乳腺癌人数约30.4万，是女性死于癌症的第一大原因，著名歌手姚贝娜便是因为这种无情的病症而不幸离世的。而四十岁以上发病率将会快速上升，这意味乳腺癌是女性的一生中所要面临的风险。

男女性癌症发病人数前十位

          不过乳腺癌患者可能将会有其他的可选择性。Puma Biotechnology是一家专注于开发和商业化创新产品以加强癌症护理的生物制药公司。近日，该公司宣布，美国食品和药物管理局（FDA）已批准一份补充新药申请（sNDA）：将靶向抗癌药Nerlynx（neratinib）联合卡培他滨（capecitabine），用于既往已接受2种或2种以上HER2靶向疗法治疗失败（三线疾病）的HER2阳性转移性乳腺癌患者*。III期研究结果显示，与Tykerb（lapatinib，拉帕替尼）+卡培他滨组合方案相比，Nerlynx+卡培他滨组合方案三线HER2阳性转移性乳腺癌显著延长了疾病无进展生存期。（注：HER2阳性转移性乳腺癌是一种侵袭性癌症，可以迅速生长和分裂，占乳腺癌总数的20%~30%）

        同时对于HER2阳性乳腺癌晚期患者，新药妥卡替尼预计下半年完成上市，妥卡替尼是一种有效的，选择性ATP竞争性口服给药的HER2小分子抑制剂。届时乳腺癌的治疗或许会有新突破。