PDF(Pubmed)
Abstract：
High recurrence and progression rates are major clinical challenges for non-muscle-invasive bladder cancer (NMIBC). Dietary isothiocyanates (ITCs), phytochemicals primarily from cruciferous vegetables (CV), show strong anticancer activities in preclinical BC models, yet their effect on NMIBC prognosis remains unknown.
This study aimed to investigate the associations of dietary ITC exposure at diagnosis with NMIBC recurrence and progression.
The study analyzed 1143 participants from the Be-Well study, a prospective cohort of newly diagnosed NMIBC cases in 2015-2019 with no prior history of BC. Dietary ITC exposure was indicated by self-reported CV intake, estimated ITC intake, urinary metabolites, and plasma ITC-albumin adducts. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for recurrence and progression, and unconditional logistic regression models were used to calculate odds ratios (ORs) and 95% CIs for delayed and multiple recurrence.
Over a mean follow-up of 25 mo, 347 (30%) developed recurrence and 77 (6.7%) had disease progression. Despite no significant associations with the overall risk of recurrence, urinary ITC metabolites (OR: 1.96; 95% CI: 1.01, 4.43) and dietary ITC intake (OR: 2.13; 95% CI: 1.03, 4.50) were associated with late recurrence after 12-mo postdiagnosis compared with before 12-mo postdiagnosis. Raw CV intake was associated with reduced odds of having ≥2 recurrences compared with having one (OR: 0.34; 95% CI: 0.16, 0.68). Higher plasma concentrations of ITC-albumin adducts were associated with a reduced risk of progression, including progression to muscle-invasive disease (for benzyl ITC, HR: 0.40; 95% CI: 0.17, 0.93; for phenethyl ITC, HR: 0.40; 95% CI: 0.19, 0.86).
Our findings indicate the possible beneficial role of dietary ITCs in NMIBC prognosis. Given the compelling preclinical evidence, increasing dietary ITC exposure with CV intake could be a promising strategy to attenuate recurrence and progression risks in patients with NMIBC.
This study aimed to investigate the associations of dietary ITC exposure at diagnosis with NMIBC recurrence and progression.
The study analyzed 1143 participants from the Be-Well study, a prospective cohort of newly diagnosed NMIBC cases in 2015-2019 with no prior history of BC. Dietary ITC exposure was indicated by self-reported CV intake, estimated ITC intake, urinary metabolites, and plasma ITC-albumin adducts. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for recurrence and progression, and unconditional logistic regression models were used to calculate odds ratios (ORs) and 95% CIs for delayed and multiple recurrence.
Over a mean follow-up of 25 mo, 347 (30%) developed recurrence and 77 (6.7%) had disease progression. Despite no significant associations with the overall risk of recurrence, urinary ITC metabolites (OR: 1.96; 95% CI: 1.01, 4.43) and dietary ITC intake (OR: 2.13; 95% CI: 1.03, 4.50) were associated with late recurrence after 12-mo postdiagnosis compared with before 12-mo postdiagnosis. Raw CV intake was associated with reduced odds of having ≥2 recurrences compared with having one (OR: 0.34; 95% CI: 0.16, 0.68). Higher plasma concentrations of ITC-albumin adducts were associated with a reduced risk of progression, including progression to muscle-invasive disease (for benzyl ITC, HR: 0.40; 95% CI: 0.17, 0.93; for phenethyl ITC, HR: 0.40; 95% CI: 0.19, 0.86).
Our findings indicate the possible beneficial role of dietary ITCs in NMIBC prognosis. Given the compelling preclinical evidence, increasing dietary ITC exposure with CV intake could be a promising strategy to attenuate recurrence and progression risks in patients with NMIBC.
摘要：
背景：高复发率和进展率是非肌肉浸润性膀胱癌（NMIBC）的主要临床挑战。膳食异硫氰酸酯(ITCs)，植物化学物质主要来自十字花科蔬菜（CV），在临床前BC模型中显示出强抗癌活性，但其对NMIBC预后的影响尚不清楚.
目的：本研究旨在探讨膳食ITC暴露与NMIBC复发和进展的关系。
方法：该研究分析了Be-Well研究的1143名参与者，2015-2019年无BC病史的新诊断NMIBC病例的前瞻性队列研究.饮食ITC暴露通过自我报告的CV摄入量表示，估计ITC摄入量，尿代谢物，和血浆ITC-白蛋白加合物。Cox比例风险回归模型用于计算复发和进展的风险比(HRs)和95%置信区间(CIs)。和非条件逻辑回归模型用于计算延迟复发和多次复发的比值比(ORs)和95%CI。
结果：在平均25个月的随访中，347（30％）出现复发，77（6.7％）出现疾病进展。尽管与整体复发风险没有显著关联，与诊断后12个月前相比,尿ITC代谢物(OR:1.96;95%CI:1.01,4.43)和膳食ITC摄入量(OR:2.13;95%CI:1.03,4.50)与诊断后12个月后的晚期复发相关.与1例相比，原始CV摄入量与≥2例复发的几率降低相关(OR:0.34;95%CI:0.16,0.68)。更高的血浆浓度的ITC-白蛋白加合物与进展风险降低相关。包括进展为肌肉浸润性疾病（对于苄基ITC-HR：0.40；95％CI：0.17，0.93；对于苯乙基ITC，HR：0.40；95%CI：0.19，0.86）。
结论：我们的研究结果表明膳食ITC在NMIBC预后中可能具有有益作用。鉴于令人信服的临床前证据，在NMIBC患者中,通过CV摄入增加饮食ITC暴露可能是降低复发和进展风险的有前景的策略.
目的：本研究旨在探讨膳食ITC暴露与NMIBC复发和进展的关系。
方法：该研究分析了Be-Well研究的1143名参与者，2015-2019年无BC病史的新诊断NMIBC病例的前瞻性队列研究.饮食ITC暴露通过自我报告的CV摄入量表示，估计ITC摄入量，尿代谢物，和血浆ITC-白蛋白加合物。Cox比例风险回归模型用于计算复发和进展的风险比(HRs)和95%置信区间(CIs)。和非条件逻辑回归模型用于计算延迟复发和多次复发的比值比(ORs)和95%CI。
结果：在平均25个月的随访中，347（30％）出现复发，77（6.7％）出现疾病进展。尽管与整体复发风险没有显著关联，与诊断后12个月前相比,尿ITC代谢物(OR:1.96;95%CI:1.01,4.43)和膳食ITC摄入量(OR:2.13;95%CI:1.03,4.50)与诊断后12个月后的晚期复发相关.与1例相比，原始CV摄入量与≥2例复发的几率降低相关(OR:0.34;95%CI:0.16,0.68)。更高的血浆浓度的ITC-白蛋白加合物与进展风险降低相关。包括进展为肌肉浸润性疾病（对于苄基ITC-HR：0.40；95％CI：0.17，0.93；对于苯乙基ITC，HR：0.40；95%CI：0.19，0.86）。
结论：我们的研究结果表明膳食ITC在NMIBC预后中可能具有有益作用。鉴于令人信服的临床前证据，在NMIBC患者中,通过CV摄入增加饮食ITC暴露可能是降低复发和进展风险的有前景的策略.
