Background & Aims

Dietary patterns affect systemic and local intestinal inflammation, which have been linked to colorectal carcinogenesis. Chronic inflammation can interfere with the adaptive immune response. We investigated whether the association of a diet that promotes intestinal inflammation with risk of colorectal carcinoma was stronger for tumors with lower lymphocytic reactions than tumors with higher lymphocytic reactions.

Methods

We collected data from the molecular pathological epidemiology databases of 2 prospective cohort studies: the Nurses’ Health Study (since 1976) and the Health Professionals Follow-Up Study (since 1986). We used duplication-method time-varying Cox proportional cause-specific hazards regression to assess the association of empirical dietary inflammatory pattern (EDIP) score (derived from food frequency questionnaire data) with colorectal carcinoma subtype. Foods that contribute to high EDIP scores include red and processed meats, refined grains, carbonated beverages, and some vegetables; foods that contribute to low EDIP scores include beer, wine, coffee, tea, yellow and leafy vegetables, and fruit juice. Colorectal tissue samples were analyzed histologically for patterns of lymphocytic reactions (Crohn’s-like lymphoid reaction, peritumoral lymphocytic reaction, intratumoral periglandular reaction, and tumor-infiltrating lymphocytes).

Results

During follow-up of 124,433 participants, we documented 1311 incident colon and rectal cancer cases with available tissue data. The association between the EDIP and colorectal cancer risk was significant (P_trend = .02), and varied with degree of peritumoral lymphocytic reaction (P_{heterogeneity} < .001). Higher EDIP scores were associated with increased risk of colorectal cancer with an absent or low peritumoral lymphocytic reaction (highest vs lowest EDIP score quintile hazard ratio, 2.60; 95% confidence interval, 1.60−4.23; P_trend < .001), but not risk of tumors with intermediate or high peritumoral lymphocytic reaction (P_trend > .80).

Conclusions

In 2 prospective cohort studies, we associated inflammatory diets with a higher risk of colorectal cancer subtype that contains little or no peritumoral lymphocytic reaction. These findings suggest that diet-related inflammation might contribute to development of colorectal cancer, by suppressing the adaptive anti-tumor immune response.

中文翻译：

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炎性饮食模式与大肠癌亚型风险（按对肿瘤的免疫反应分类）之间的关联

背景与目标

饮食方式会影响全身和局部肠道炎症，这与大肠癌的发生有关。慢性炎症会干扰适应性免疫反应。我们调查了饮食，促进肠道炎症与大肠癌风险的关联是否比淋巴细胞反应高的肿瘤更强。

方法

我们从两项前瞻性队列研究的分子病理流行病学数据库中收集了数据：护士健康研究（自1976年以来）和卫生专业人员随访研究（自1986年以来）。我们使用复制方法随时间变化的Cox比例特定因果风险回归分析来评估经验性饮食炎症模式（EDIP）评分（源自食物频率问卷数据）与大肠癌亚型的关联。EDIP得分高的食品包括红色和加工肉类，精制谷物，碳酸饮料和一些蔬菜；造成EDIP分数低的食品包括啤酒，葡萄酒，咖啡，茶，黄色和多叶蔬菜以及果汁。组织学分析了大肠组织样本的淋巴细胞反应模式（克罗恩氏样淋巴样反应，

结果

在对124,433名参与者的随访中，我们记录了1311例结肠癌和直肠癌事件，并提供了可用的组织数据。EDIP与大肠癌风险之间的相关性显着（P_趋势 = .02），并随肿瘤周淋巴细胞反应程度的不同而变化（P_异质性<.001）。较高的EDIP分数与无或低的肿瘤周围淋巴细胞反应的大肠癌风险增加相关（最高与最低EDIP分数五分之一风险比为2.60; 95％置信区间为1.60-4.23; P_趋势<.001），但无风险具有中等或高肿瘤周围淋巴细胞反应的肿瘤（P_趋势> .80）。

结论

在2项前瞻性队列研究中，我们将炎症饮食与大肠癌亚型的高风险相关，该亚型几乎没有或没有肿瘤周围淋巴细胞反应。这些发现表明，饮食相关的炎症可能会通过抑制适应性抗肿瘤免疫反应来促进结直肠癌的发展。