| 研究课题：饮用咖啡会降低患肝癌的风险几率
供稿：流行病学、防疫隔离、统计和癌症防治，国家癌症防治中心，东京，日本
主要内容：动物实验证明了在咖啡与降低肝癌风险之间的一个关联，但对高危人群来说仍然证据不足。本公共健康部门引入了一个大规模的流行病学调查，以观察咖啡与肝癌之间的联系。方法:日本公共健康中心对新诊断病例
(250个男性和 84个女性) 进行了为期10年的追踪, 由90 452 中青年的日本公民(43 109个男性和 47
343个女性)。这些病例照咖啡的摄取量，以及被肝炎病毒感染的情况、性别，老化，饮食，生活方式因素和早先的历史分门别类。多样的风险比例（HR）和95%可信概率(CI)
依照roportional-hazards方法计算。所有的统计测试是有两面的。结果:每日饮用咖啡病例 (包括男性和女性)
的的病发症风险明显低于那些几乎从不喝咖啡的人；而且风险随饮用的量降低。 (相比不饮咖啡的人, HR 为每天饮用 2
杯时 – =0.52[95% CI=0.38 到 0.73]; 为每天 4 杯时 3 – =0.48[95% CI=0.28
到 0.83]; 为≥每天 5杯 =0.24[95% CI=0.08 到 0.77], Ptrend<.001)饮用咖啡的人几乎不存在患肝癌的风险。在这个10年的调查中，几乎从不喝的人是每
100 000 人 547.2个病例，而喝咖啡的人是每 100 000个 214.6个病例。当按受试者的生活习惯分析时，这种关系仍然存在。我们在分析C型肝炎病毒阳性患者时发现了相同的关联:HR=0.57[95%
CI=0.37 至0.86], 对 B型肝炎患者 ( HR=0.60[95% CI=0.31 到 1.18]) 和有慢性的肝病史个案，(
HR=0.45[95% CI=0.30 到 0.67])。
结论:喝咖啡能减少患肝癌的危险。
Influence
of Coffee Drinking on Subsequent Risk of Hepatocellular Carcinoma:
A Prospective Study in JapanManami Inoue,
Itsuro Yoshimi, Tomotaka Sobue, Shoichiro Tsugane (The JPHC
Study Group)
Epidemiology and Prevention Division (MI, ST) and Statistics
and Cancer Control Division (IY, TS), Research Center for
Cancer Prevention and Screening, National Cancer Center, Tokyo,
Japan
An association between coffee drinking
and reduced risk of liver cancer has been suggested by animal
studies, but epidemiologic evidence of such an association
in a high-risk population is lacking. We conducted a large-scale
population-based cohort study of the association between coffee
drinking and hepatocellular carcinoma (HCC) in a Japanese
population. Methods: Newly diagnosed case patients (250 men
and 84 women) with HCC were identified from a 10-year follow-up
of the Japan Public Health Center-based Prospective Study,
which consists of 90 452 middle-aged and elderly Japanese
subjects (43 109 men and 47 343 women). Case patients were
grouped according to coffee intake and were stratified by
hepatitis virus infection, sex, age, diet, lifestyle factors,
and previous history of liver disease. Multivariable-adjusted
hazard ratios (HR) and 95% confidence intervals (CIs) for
HCC were calculated with Cox proportional-hazards modeling.
All statistical tests were two-sided. Results: Subjects (men
and women combined) who consumed coffee on a daily or almost
daily basis had a lower HCC risk than those who almost never
drank coffee (HR = 0.49 [95% CI = 0.36 to 0.66]); risk decreased
with the amount of coffee consumed (compared with nondrinkers,
the HR for 1–2 cups per day = 0.52 [95% CI = 0.38 to 0.73];
for 3–4 cups per day = 0.48 [95% CI = 0.28 to 0.83]; for
≥5 cups per day = 0.24 [95% CI = 0.08 to 0.77], Ptrend <
.001). The risk of liver cancer in almost never drinkers in
this population was 547.2 cases per 100 000 people over 10
years, but it was 214.6 cases per 100 000 people with drinking
coffee on a daily basis. The inverse association persisted
when the participants were stratified by lifestyle factors.
Similar associations were observed when the analysis was restricted
to hepatitis C virus-positive patients (all daily drinkers
compared with nondrinkers: HR =0.57 [95% CI = 0.37 to 0.86]),
to hepatitis B virus-positive patients (HR = 0.60 [95% CI
= 0.31 to 1.18]) and to subjects with no past history of chronic
liver disease (HR = 0.45 [95% CI = 0.30 to 0.67]). Conclusions:
In the Japanese population, habitual coffee drinking may be
associated with reduced risk of HCC.
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