Red meat, family history, and increased risk of gastric cancer with microsatellite instability.
Microsatellite instability (MSI) occurs frequently in sporadic gastric cancer (GC) and may define a distinctive molecular pathway of carcinogenesis. We evaluated the role of dietary risk factors in GC according to MSI status. A large series of 382 GC cases and 561 controls were originally identified in a population-based case-control study carried out in the high-risk area around Florence, Italy; 126 GC patients were typed for MSI status. A MSI+ phenotype was detected in 43 of 126 cases (34.1%), whereas 83 cases were classified as MSI-. A multinomial logistic regression model was used to compare the two subgroups of GC classified according to MSI status in the same analysis, with all of the available population controls. A case-case approach was also used. The risk of MSI+ tumors was positively associated with high consumption of red meat and meat sauce and negatively associated with consumption of white meat. A positive association was also seen with total protein and nitrite intake, whereas no relation was found with micronutrient intake. Risk was especially high among subjects reporting both a positive GC family history and a high consumption of red meat (odds ratio, 25.7; 95% confidence interval, 6.4-102.8). For MSI- tumors, a significant protective effect was associated with frequent consumption of citrus and other fresh fruit, garlic, legumes, vegetables, and olive oil and with high intake of beta-carotene and other antioxidants and sugar, whereas positive associations were seen with protein and sodium intake. In summary, a specific dietary pattern emerged for MSI+ gastric tumors, suggesting that factors related to red meat consumption are involved in this pathway, particularly among individuals with a positive family history. In contrast, the risk of MSI- tumors was strongly reduced by the frequent consumption of fresh fruit and vegetables.
Palli
D
D
Epidemiology Unit, Centro per lo Studio e la Prevenzione Oncologica, 50135 Florence, Italy. d.palli@cspo.it
Russo
A
A
Ottini
L
L
Masala
G
G
Saieva
C
C
Amorosi
A
A
Cama
A
A
D'Amico
C
C
Falchetti
M
M
Palmirotta
R
R
Decarli
A
A
Mariani Costantini
R
R
Fraumeni
J F
JF
D000368:Aged; D000818:Animals; D016022:Case-Control Studies; D004032:Diet; D004044:Dietary Proteins / Q000008:administration & dosage; D005192:Family Health; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008460:Meat; D018895:Microsatellite Repeats / Q000235:genetics*; D008875:Middle Aged; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000209:etiology / Q000235:genetics*
D004044:Dietary Proteins