Vegetable consumption, serum retinol level, and risk of hepatocellular carcinoma.

A cohort of 8436 men in Taiwan was recruited with personal interview and blood sample collection between 1984 and 1986. During the 5-year follow-up period, 50 incident cases of hepatocellular carcinoma (HCC) were identified. Retinol levels were measured for 35 HCC patients whose serum samples were available and 140 matched controls randomly selected from cohort members without HCC. Lower vegetable intake was significantly associated with an increased risk of HCC after adjustment for other HCC risk factors (P = 0.006). The effect of low vegetable intake on HCC risk was limited to hepatitis B virus chronic carriers and cigarette smokers. As compared with subjects who had a weekly vegetable consumption frequency of six or more meals, the multivariate-adjusted relative risk of HCC for subjects who had a frequency of less than six meals was 4.7 (95% confidence interval, 2.0-11.1; P = 0.0004) among chronic hepatitis B virus carriers and 3.8 (95% confidence interval, 1.7-8.5; P = 0.001) among cigarette smokers. There was an inverse dose-response relationship between the prediagnostic serum retinol level and the development of HCC (trend test, P = 0.003). The odds ratio of HCC for men with a retinol level in the lowest tertile was 9.0 (95% confidence interval, 2.1-39.1) compared with those with a level in the highest tertile. The relation remained after multivariate adjustment for cigarette smoking, habitual alcohol drinking, and either the seropositivity of hepatitis B virus surface antigen and/or anti-hepatitis C virus antibody or the past history of liver diseases through conditional logistic regression analysis. The association was more striking for men 55 years or younger and for those who smoked 10 or more cigarettes/day. There was a significant synergistic effect of hepatitis B virus surface antigen carrier status and low serum retinol level on the development of HCC. These data suggest a potential role of retinol in the chemoprevention of HCC.

[1]  C. J. Chen,et al.  Hepatitis B and C viruses in the development of hepatocellular carcinoma. , 1994, Critical reviews in oncology/hematology.

[2]  C. J. Chen,et al.  Correlations of chronic hepatitis B virus infection and cigarette smoking with elevated expression of neu oncoprotein in the development of hepatocellular carcinoma. , 1994, Cancer research.

[3]  C. J. Chen,et al.  A nested case‐control study on association between hepatitis C virus antibodies and primary liver cancer in a cohort of 9,775 men in Taiwan , 1994, Journal of medical virology.

[4]  W. Blaner,et al.  Influence of vitamins A, C, and E and β‐carotene on aflatoxin B1 binding to DNA in woodchuck hepatocytes , 1994, Cancer.

[5]  J. Potter,et al.  Vegetables, fruit, and colon cancer in the Iowa Women's Health Study. , 1994, American journal of epidemiology.

[6]  G. Stoner,et al.  Cancer chemoprevention: principles and prospects. , 1993, Carcinogenesis.

[7]  J. Manson,et al.  A prospective study of the intake of vitamins C, E, and A and the risk of breast cancer. , 1993, The New England journal of medicine.

[8]  C. Y. Wang,et al.  Vitamin A, Vitamin E or beta-carotene status and hepatitis B-related hepatocellular carcinoma. , 1993, Annals of epidemiology.

[9]  C. J. Chen,et al.  Elevated serum testosterone levels and risk of hepatocellular carcinoma. , 1993, Cancer research.

[10]  D. Ong,et al.  Retinoid metabolism during intestinal absorption. , 1993, The Journal of nutrition.

[11]  C‐J. Chen,et al.  Multiple risk factors of hepatocellular carcinoma: A cohort study of 13 737 male adults in Taiwan , 1993 .

[12]  Chien-Jen Chen,et al.  Aflatoxin B1 DNA adducts in smeared tumor tissue from patients with hepatocellular carcinoma , 1992, Hepatology.

[13]  B. Henderson,et al.  Urinary aflatoxin biomarkers and risk of hepatocellular carcinoma , 1992, The Lancet.

[14]  G W Comstock,et al.  Serum retinol, beta-carotene, vitamin E, and selenium as related to subsequent cancer of specific sites. , 1992, American journal of epidemiology.

[15]  B. Henderson,et al.  Nonviral risk factors for hepatocellular carcinoma in a low-risk population, the non-Asians of Los Angeles County, California. , 1991, Journal of the National Cancer Institute.

[16]  C. J. Chen,et al.  Association between hepatitis C virus antibodies and hepatocellular carcinoma in Taiwan. , 1991, Cancer research.

[17]  M. Alaoui-Jamali,et al.  Metabolism, sister chromatid exchanges, and DNA single-strand breaks induced by 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone and their modulation by vitamin A in vitro. , 1991, Cancer research.

[18]  U. Nair,et al.  Carcinogenicity studies of tobacco extract in vitamin A-deficient Sprague-Dawley rats. , 1991, Cancer research.

[19]  Chien-Jen Chen,et al.  Effects of hepatitis B virus, alcohol drinking, cigarette smoking and familial tendency on hepatocellular carcinoma , 1991, Hepatology.

[20]  K. Prasad,et al.  Expressions of some molecular cancer risk factors and their modification by vitamins. , 1990, Journal of the American College of Nutrition.

[21]  Chien-Jen Chen,et al.  Epidemiologic Characteristics of Malignant Neoplasms in Taiwan: III. Stomach Cancer , 1988 .

[22]  C. Lindamood,et al.  Effects of retinoids on metabolizing enzymes and on binding of benzo(a)pyrene to rat tissue DNA. , 1987, Cancer research.

[23]  L. Kolonel,et al.  Rationale and strategies for chemoprevention of cancer in humans. , 1987, Cancer research.

[24]  F. Berrino,et al.  Carrots, green vegetables and lung cancer: a case-control study. , 1986, International journal of epidemiology.

[25]  H. Moriwaki,et al.  Antitumor activity of vitamin A and its derivatives. , 1984, Journal of the National Cancer Institute.

[26]  K. Miller,et al.  Simultaneous determination of plasma retinol, α-tocopherol, lycopene, α-carotene, and β-carotene by high-performance liquid chromatography , 1984 .

[27]  L. Kolonel,et al.  Dietary vitamin A, carotene, vitamin C and risk of lung cancer in Hawaii. , 1984, American journal of epidemiology.

[28]  M. Sporn,et al.  Role of retinoids in differentiation and carcinogenesis. , 1983, Cancer research.

[29]  Jeremiah Stamler,et al.  DIETARY VITAMIN A AND RISK OF CANCER IN THE WESTERN ELECTRIC STUDY , 1981, The Lancet.

[30]  P. Gullino,et al.  Effect of retinyl acetate on the incidence of mammary carcinomas and hepatomas in mice. , 1980, Journal of the National Cancer Institute.