2016年5月16日，美国癌症学会官方期刊《癌症》在线发表美国范德堡大学和上海市疾病预防控制中心的研究报告，发现在三阴性乳腺癌诊断前的长期大豆食用史，可能导致乳腺肿瘤组织的肿瘤抑制基因表达增加、癌基因（尤其癌细胞生长相关基因）表达减少。该研究从基因水平进一步证实了大豆与三阴性乳腺癌的关系。
2009年12月9日，美国范德堡大学和上海市疾病预防控制中心在《美国医学会杂志》已经发表的研究表明：在中国，罹患乳腺癌并使用较多大豆的女性其相关死亡及乳腺癌复发风险较低。该研究对大豆异黄酮摄取与乳腺癌复发和患者生存率之间的相关性进行了检测，对5000多例中国女性乳腺癌生存情况进行了调查，发现那些大豆蛋白摄取量最多者与大豆蛋白摄取量最少者相比，死亡风险降低了29%，而乳腺癌复发风险则下降了32%。研究提示，大豆的摄取是安全的，并与乳腺癌患者的死亡率和复发的减少具有相关性，可能对罹患乳腺癌的女性有益。
Cancer. 2016 May 16. [Epub ahead of print]
Long-term soy consumption and tumor tissue MicroRNA and gene expression in triple-negative breast cancer.
Guo X, Cai Q, Bao P, Wu J, Wen W, Ye F, Zheng W, Zheng Y, Shu XO.
Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee; Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China.
BACKGROUND: Soy food intake may have protective effects against the risk for breast cancer, including estrogen receptor (ER)-negative breast cancer. However, the underlying molecular mechanisms remain unclear.
METHODS: To evaluate the association of soy intake with the expression of microRNAs (miRNAs) and genes in the tumor tissue of patients with triple-negative breast cancer (TNBC; ie, breast cancer lacking expression of ER, progesterone receptor, and human epidermal growth factor receptor 2), the expression of 800 miRNAs and 302 genes were measured with NanoString nCounter assays in formalin-fixed, paraffin-embedded tumor tissue from 272 TNBC patients. Soy intake during the 1-year period before the cancer diagnosis was assessed with a validated food-frequency questionnaire. The association of soy intake with the expression of miRNAs and genes was evaluated via linear regression analysis with adjustments for patient age and TNM stage.
RESULTS: A total of 14 miRNAs and 24 genes were significantly associated with soy food intake (P < .05): Thirteen of the 14 miRNAs (92.9%) and 9 of the 24 genes (37.5%), including tumor suppressors miR-29a-3p and IGF1R, showed overexpression for those women with high soy intake, whereas the remaining miRNAs and genes, including oncogenes KRAS and FGFR4, showed underexpression. Furthermore, cell growth-related genes showed a predominantly underexpression pattern according to a comparison of tumor samples from women with high soy food intake and samples from women with lower soy food intake.
CONCLUSIONS: This study suggests that long-term prediagnosis soy intake may lead to increased expression of tumor suppressors and decreased expression of oncogenes, especially cell growth-related genes, in breast tumor tissues.
KEYWORDS: gene expression; microRNA (miRNA) expression; soy consumption; triple-negative breast cancer
PMID: 27183356
DOI: 10.1002/cncr.29981
JAMA. 2009 Dec 9;302(22):2437-43.
Soy food intake and breast cancer survival.
Shu XO, Zheng Y, Cai H, Gu K, Chen Z, Zheng W, Lu W.
Vanderbilt Epidemiology Center, 2525 West End Ave, Ste 600, Nashville, TN 37203-1738, USA; Shanghai Institute of Preventive Medicine, Shanghai, China.
CONTEXT: Soy foods are rich in isoflavones, a major group of phytoestrogens that have been hypothesized to reduce the risk of breast cancer. However, the estrogen-like effect of isoflavones and the potential interaction between isoflavones and tamoxifen have led to concern about soy food consumption among breast cancer patients.
OBJECTIVE: To evaluate the association of soy food intake after diagnosis of breast cancer with total mortality and cancer recurrence.
DESIGN, SETTING, AND PARTICIPANTS: The Shanghai Breast Cancer Survival Study, a large, population-based cohort study of 5042 female breast cancer survivors in China. Women aged 20 to 75 years with diagnoses between March 2002 and April 2006 were recruited and followed up through June 2009. Information on cancer diagnosis and treatment, lifestyle exposures after cancer diagnosis, and disease progression was collected at approximately 6 months after cancer diagnosis and was reassessed at 3 follow-up interviews conducted at 18, 36, and 60 months after diagnosis. Annual record linkage with the Shanghai Vital Statistics Registry database was carried out to obtain survival information for participants who were lost to follow-up. Medical charts were reviewed to verify disease and treatment information.
MAIN OUTCOME MEASURES: Total mortality and breast cancer recurrence or breast cancer-related deaths. Cox regression analysis was carried out with adjustment for known clinical predictors and other lifestyle factors. Soy food intake was treated as a time-dependent variable.
RESULTS: During the median follow-up of 3.9 years (range, 0.5-6.2 years), 444 deaths and 534 recurrences or breast cancer-related deaths were documented in 5033 surgically treated breast cancer patients. Soy food intake, as measured by either soy protein or soy isoflavone intake, was inversely associated with mortality and recurrence. The hazard ratio associated with the highest quartile of soy protein intake was 0.71 (95% confidence interval [CI], 0.54-0.92) for total mortality and 0.68 (95% CI, 0.54-0.87) for recurrence compared with the lowest quartile of intake. The multivariate-adjusted 4-year mortality rates were 10.3% and 7.4%, and the 4-year recurrence rates were 11.2% and 8.0%, respectively, for women in the lowest and highest quartiles of soy protein intake. The inverse association was evident among women with either estrogen receptor-positive or -negative breast cancer and was present in both users and nonusers of tamoxifen.
CONCLUSION: Among women with breast cancer, soy food consumption was significantly associated with decreased risk of death and recurrence.
PMID: 19996398
PMCID: PMC2874068
DOI: 10.1001/jama.2009.1783
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