The effect of folic acid on the development of stomach and other gastrointestinal cancers

作     者：朱舜时 施尧 胡运彪 李蓉蓉 汪敏 周怡和 金冠球 谢宇野Shanghai Navy Hospital Shanghai 200081 China 邬桂泉 夏德凰Shanghai Putuo People's Hospital 钱珍华 宋海连Shanghai Traditional and Western Medical Integrated Hospital 屠伯强 张丽冬 萧树东 

作者机构：Department of Gastroenterology The Renji Hospital and Shanghai Institute of Digestive Disease Shanghai First People's Hospital Shanghai Navy Hospital Shanghai Post and Telecommunication Hospital Tongji University Railway Hospital Shanghai Traditional and Western Medical Integrated Hospital Human Nutrition Research Center on Aging 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2003年第116卷第1期

页      面：15-19页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：ThisresearchwaspartlysupportedbytheNationalNaturalScienceFoundationofChina (No 39370 332 ) 

主　　题：Adult Aged Anticarcinogenic Agents Double-Blind Method Female Folic Acid Gastric Mucosa Gastrointestinal Neoplasms Humans Male Middle Aged Patient Compliance Research Support, Non-U.S. Gov't Stomach Neoplasms beta Carotene 

摘      要：OBJECTIVE: To evaluate the roles of folic acid and beta-carotene in the chemoprevention of gastric and other gastrointestinal (GI) cancers. METHODS: In a randomized, double-blind, placebo-controlled trial, a total of 216 patients with atrophic gastritis were randomly assigned to one of the four groups: (1) folate (FA, 20 mg per day plus vitamin B(12) 1 mg, intramuscularly, per month for one year, then 20 mg two times a week plus 1 mg per three months for the next year); (2) natural beta-carotene (N-betaC, 30 mg per day for first year, then 30 mg two times a week for the next); (3) synthetic beta-carotene (S-betaC, administered as in N-betaC); and (4) placebo. Follow-ups continued from 1994 to 2001. RESULTS: A total of 7 new cases of gastrointestinal cancers were diagnosed with 3 stomach, 1 colon and 1 esophageal cancers occurring in the placebo group; 1 stomach cancer in both of the N-betaC and S-betaC groups, and no cancer occurring in FA group. In terms of GI cancers, there was a significant reduction in the FA group, compared with the placebo group (P = 0.04). A similar trend was observed in both N-betaC and S-betaC groups (P = 0.07 - 0.08). Taken together, the three intervention groups displayed a highly significant decrease in occurrence (P = 0.004, vs placebo), and a lower risk for GI cancers (OR = 0.12; 95% confidence interval, 0.03 - 0.51). For development of gastric cancer, any one of the three active-treated groups did not reach statistically significant reduction. The FA group showed obvious improvement of the gastric mucosal lesions with more patients displaying lesions reversed or stable atrophy and inflammation (P = 0.04), reversed intestinal metaplasia (P = 0.06) at the end of follow-up, and reversed displasia (P = 0.017) at 12 months. Two cases of false jaundice were found in beta-carotene groups with no influence on administration, and no side-effects were reported in FA group. CONCLUSIONS: This trial revealed the interventional effect of folic acid