vitamin-b-12 and Esophageal-Neoplasms

Several B vitamins are essential in the one-carbon metabolism pathway, which is central to DNA methylation, synthesis, and repair. Moreover, an imbalance in this pathway has been linked to certain types of cancers. Here, we performed a meta-analysis in order to investigate the relationship between the intake of four dietary one-carbon metabolism-related B vitamins (B2, B6, folate, and B12) and the risk of esophageal cancer (EC). We searched PubMed, Web of Science, and Embase for relevant studies published through 1 March 2018. The odds ratio (OR) with 95% confidence interval (CI) for the highest versus the lowest level of each dietary B vitamin was then calculated. From 21 articles reporting 26 studies including 6404 EC cases and 504,550 controls, we found an inverse correlation between the consumption of vitamin B6 and folate and the risk of EC; this association was specific to the US, Europe, and Australia, but was not found in Asia. A dose-response analysis revealed that each 100 μg/day increase in folate intake reduced the risk of EC by 12%. Moreover, each 1 mg/day increase in vitamin B6 intake decreased the risk of EC by 16%. Surprisingly, we found that each 1 μg/day increase in vitamin B12 intake increased the risk of esophageal adenocarcinoma by 2%, particularly in the US and Europe, suggesting both geographic and histological differences. Together, our results suggest that an increased intake of one-carbon metabolism-related B vitamins may protect against EC, with the exception of vitamin B12, which should be consumed in moderation.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Anticarcinogenic Agents; Diet; DNA Methylation; DNA Repair; DNA Replication; DNA, Neoplasm; Dose-Response Relationship, Drug; Esophageal Neoplasms; Female; Humans; Male; Middle Aged; Nutritional Status; Odds Ratio; Protective Factors; Recommended Dietary Allowances; Risk Assessment; Risk Factors; Risk Reduction Behavior; Vitamin B 12; Vitamin B Complex; Young Adult

Previous studies have found associations between one-carbon metabolism nutrients and risk of several cancers, but little is known regarding upper gastrointestinal tract (UGI) cancer. We analyzed prediagnostic serum concentrations of several one-carbon metabolism nutrients (vitamin B12, folate, vitamin B6, riboflavin and homocysteine) in a nested case-control study within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study of male smokers, which was undertaken in Finland between 1985 and 1988. We conducted a nested case-control study including 127 noncardia gastric adenocarcinoma (NCGA), 41 esophagogastric junctional adenocarcinoma and 60 esophageal squamous cell carcinoma incident cases identified within ATBC. Controls were matched to cases on age, date of serum collection and follow-up time. One-carbon nutrient concentrations were measured in fasting serum samples collected at baseline (up to 17 years prior to cancer diagnosis). Odds ratios and 95% confidence intervals (CI) were calculated using conditional logistic regression. Lower prediagnostic vitamin B12 concentrations at baseline were associated with a 5.8-fold increased risk of NCGA (95% CI = 2.7-12.6 for lowest compared to highest quartile, p-trend <0.001). This association remained in participants who developed cancer more than 10 years after blood collection, and after restricting the analysis to participants with clinically normal serum vitamin B12 (>300 pmol/L). In contrast, pepsinogen I, a known serologic marker of gastric atrophy, was not associated with NCGA in this population. As vitamin B12 absorption requires intact gastric mucosa to produce acid and intrinsic factor, our findings suggest vitamin B12 as a possible serologic marker for the atrophic gastritis that precedes NCGA, one more strongly associated with subsequent NCGA than pepsinogen.

Topics: Aged; alpha-Tocopherol; beta Carotene; Carcinoma, Squamous Cell; Case-Control Studies; Dietary Supplements; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Finland; Folic Acid; Homocysteine; Humans; Male; Middle Aged; Prospective Studies; Riboflavin; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

To investigate whether the use of the stomach as a substitute after oesophageal resections causes disturbances in vitamin B12 absorption due to deficient intrinsic factor (IF) production.. Eleven patients operated upon with oesophageal resection a.m. Ivor Lewis, for malignant (10) or benign (1) conditions of the oesophagus were examined with a postoperative dual isotope technique 11-41 months (mean 25 months) after operation.. In two patients the test showed abnormally low absorption of vitamin B12. One of these probably due to incomplete urine collection during the test period. However, no patient showed deficient intrinsic factor production with absorption ratios between vitamin B12 +/- IF of 0.87-1.14 (reference interval: 0.70-1.20).. Deficiency of intrinsic factor is neither an obligatory nor a common occurrence after oesophageal resection with gastric substitute. However, vitamin B12 absorption may be low due to other factors, and should be looked for in all patients surviving more than a couple of months postoperatively.

Topics: Absorption; Aged; Esophageal Neoplasms; Esophagectomy; Female; Gastric Fundus; Humans; Intrinsic Factor; Male; Middle Aged; Parietal Cells, Gastric; Prognosis; Risk Assessment; Vitamin B 12

B vitamins and methionine are essential substrates in the one-carbon metabolism pathway involved in DNA synthesis and methylation. They may have essential roles in cancer development. We aimed to evaluate the associations of dietary intakes of vitamin B12, vitamin B6, folate, and methionine with the risk of esophageal cancer (EC) using data from the Japan Public Health Center-based Prospective Study.. We included 87,053 Japanese individuals who completed a food frequency questionnaire and were followed up from 1995-1998 to 2013 and 2015. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by Cox proportional-hazard regression across quintiles of dietary intakes of B vitamins and methionine.. After 1,456,678 person-years of follow-up, 427 EC cases were documented. The multivariable HR (95% CI) of incident EC in the highest versus lowest quintile of dietary intake of vitamin B12 was 1.75 (1.13-2.71; p-trend=0.01). Stratification analysis based on alcohol consumption showed that higher dietary intakes of vitamin B12 and methionine were associated with an increased risk of EC among never-drinkers; HRs (95% CIs) were 2.82 (1.18-6.74; p-trend=0.009; p-interaction=0.18) and 3.45 (1.32-9.06; p-trend=0.003; p-interaction 0.02) for vitamin B12 and methionine, respectively. Meanwhile, there was no association between vitamin B12 and methionine intake with the risk of EC among drinkers. There were no associations between dietary intake of folate or vitamin B6 and the risk of EC.. Dietary intake of vitamin B12 was positively associated with the risk of EC in the Japanese population.

Topics: Aged; Alcohol Drinking; Eating; Esophageal Neoplasms; Female; Folic Acid; Follow-Up Studies; Humans; Japan; Male; Methionine; Middle Aged; Prognosis; Prospective Studies; Public Health; Risk Factors; Vitamin B 12; Vitamin B 6; Vitamins

The aim of this study is to determine the prevalence and incidence of vitamin B12 deficiency after esophagectomy for cancer. It is unknown if patients after esophagectomy with gastric tube reconstruction are at an increased risk for vitamin B12 deficiency. A cross-sectional cohort (group A) and a prospective cohort (group B) of patients who underwent esophagectomy for cancer in two tertiary referral centers in the Netherlands were included. Serum levels of holo-transcobalamin (Holo-TC) and methyl malonic acid (MMA) were determined. Vitamin B12 deficiency was defined as Holo-TC < 21 pmol/L and/or MMA > 0.45 μmol/L. Vitamin B12 status was assessed in group A at a single time point between one and three years postoperatively and before and every three months after resection in group B. Ninety-nine patients were analyzed in group A. The median time between surgery and analysis of vitamin B12 deficiency was 19.3 months. In 11 of 99 (11%) patients, vitamin B12 deficiency was detected. In group B, 5 of 88 (5.6%) patients had vitamin B12 deficiency preoperatively, and another 9 (10.2%) patients developed vitamin B12 deficiency after the operation at a median time of 6 months postoperatively. The estimated one-year incidence of vitamin B12 deficiency was 18.2%. None of the patients with vitamin B12 deficiency had a megaloblastic anemia. Vitamin B12 deficiency can be anticipated in 18% of patients after esophagectomy with gastric tube reconstruction for cancer. During follow-up, Holo-TC and MMA levels should be measured to detect vitamin B12 deficiency and commence treatment timely.

Topics: Adult; Aged; Cross-Sectional Studies; Esophageal Neoplasms; Esophagectomy; Female; Gastroplasty; Humans; Incidence; Male; Methylmalonic Acid; Middle Aged; Postoperative Complications; Postoperative Period; Prospective Studies; Time Factors; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

B vitamins play an essential role in DNA synthesis and methylation, and may protect against oesophageal and gastric cancers. In this case-cohort study, subjects were enrolled from the General Population Nutrition Intervention Trial in Linxian, China. Subjects included 498 oesophageal squamous cell carcinomas (OSCCs), 255 gastric cardia adenocarcinomas (GCAs), and an age- and sex-matched sub-cohort of 947 individuals. Baseline serum riboflavin, pyridoxal phosphate (PLP), folate, vitamin B12, and flavin mononucleotide (FMN) were measured for all subjects. We estimated the associations with Cox proportional hazard models, with adjustment for potential confounders. Compared to those in the lowest quartile of serum riboflavin, those in the highest had a 44% lower risk of OSCC (HR: 0.56, 95% CI: 0.41 to 0.75). Serum vitamin B12 as a continuous variable was observed to be significantly inversely associated with OSCC (HR: 0.95, 95% CI: 0.89 to 1.01, P for score test = 0.041). Higher serum FMN levels were significantly associated with increased risk of OSCC (HR: 1.08, 95% CI: 1.01 to 1.16) and GCA (HR: 1.09, 95% CI: 1.00 to 1.20). Our study prompted that B vitamins have the potential role as chemopreventive agents for upper gastrointestinal cancers.

Topics: Adenocarcinoma; Adult; Aged; Carcinoma, Squamous Cell; Cardia; China; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Female; Flavin Mononucleotide; Folic Acid; Humans; Male; Middle Aged; Niacin; Proportional Hazards Models; Prospective Studies; Pyridoxal Phosphate; Riboflavin; Stomach Neoplasms; Vitamin B 12; Vitamin B Complex

Evidence is accumulating regarding a role of micronutrients in folate metabolism in cancer risk. We investigated the associations of plasma folate, vitamin B12, and homocysteine with upper gastrointestinal (GI) cancers in a population-based case-control study in Taixing City, China. With informed consent, we recruited cases with cancers of esophagus (n = 218), stomach (n = 206), and liver (n = 204), and one common healthy control group (n = 405). A standardized epidemiologic questionnaire was used in face-to-face interviews, and blood samples were collected during interviews. We observed an inverse association between plasma folate levels and liver cancer. The adjusted odds ratio (aOR) was 0.46 [95% confidence interval (CI) = 0.24-0.88] comparing individuals in the highest quartile to those in the lowest. We found a positive association between plasma vitamin B12 levels and all three cancers. The aORs for those in the highest quartile were 2.80 (95% CI = 1.51-5.18) for esophageal cancer, 2.17 (1.21-3.89) for stomach cancer, and 9.97 (4.82-20.60) for liver cancer, comparing to those in the lowest quartile. We further observed interaction between plasma folate and vitamin B12 on these cancers. Our data indicated associations between plasma folate and vitamin B12 with upper GI cancers in Chinese population. Further research is warranted considering the debate over the necessity of food fortification.

Topics: Adult; Aged; Case-Control Studies; China; Esophageal Neoplasms; Female; Folic Acid; Homocysteine; Humans; Liver Neoplasms; Male; Middle Aged; Odds Ratio; Risk Factors; Stomach Neoplasms; Surveys and Questionnaires; Vitamin B 12

Nutrients in the one-carbon metabolism pathway may be involved in carcinogenesis. Few cohort studies have investigated the intakes of folate and related nutrients in relation to gastric and esophageal cancer.. We prospectively examined the association between self-reported intakes of folate, methionine, vitamin B6, and vitamin B12 and gastric and esophageal cancer in 492,293 men and women.. We observed an elevated risk of esophageal squamous cell carcinoma with low intake of folate (relative risk (95% confidence interval): Q1 vs Q3, 1.91 (1.17, 3.10)), but no association with high intake. Folate intake was not associated with esophageal adenocarcinoma, gastric cardia adenocarcinoma, or non-cardia gastric adenocarcinoma. The intakes of methionine, vitamin B6, and vitamin B12 were not associated with esophageal and gastric cancer.. Low intake of folate was associated with increased risk of esophageal squamous cell carcinoma.

Topics: Carcinoma, Squamous Cell; Cohort Studies; Diet; Esophageal Neoplasms; Female; Folic Acid; Humans; Male; Methionine; Middle Aged; Risk; Stomach Neoplasms; United States; Vitamin B 12; Vitamin B 6

Topics: Adenocarcinoma; Adult; Age Distribution; Age Factors; Aged; Aged, 80 and over; Aspirin; Barrett Esophagus; Clopidogrel; Drug Interactions; Drug Prescriptions; Esophageal Neoplasms; Esophagitis; Esophagoscopy; Gastroesophageal Reflux; Gastroscopy; Heartburn; Hip Fractures; Humans; Intestinal Absorption; Middle Aged; Obesity; Odds Ratio; Platelet Aggregation Inhibitors; Population Surveillance; Prevalence; Proton Pump Inhibitors; Ticlopidine; Vitamin B 12

The nutritional status of individuals from areas of South Africa that are known for having a high incidence of esophageal cancer was investigated. Our results show that individuals living in high-risk areas differ significantly from those in low-risk areas with respect to vitamins A, E, and B12 in addition to folate. These results suggest that deficiencies in these nutrients may play a significant role in the etiology of esophageal cancer.

Topics: Avitaminosis; Esophageal Neoplasms; Female; Folic Acid; Humans; Male; Methionine; Nutritional Status; Risk Factors; South Africa; Vitamin A; Vitamin B 12; Vitamin E

Topics: Adult; Aged; Esophageal Neoplasms; Esophagostomy; Female; Gastric Juice; Humans; Male; Middle Aged; Stomach; Vitamin B 12

Functions of the stomach placed in the posterior mediastinum after esophagectomy were studied in 20 esophageal carcinoma patients. Seven were long-term survivors who lived more than 5 years after operation, and five of them showed normal fasting serum gastrin levels and good or fair gastric acid secretion. Of 13 patients who had their operations within 3 years before the study, 11 showed high fasting serum gastrin levels and poor gastric acid secretion. The hepatobiliary and alimentary scintigrams with double isotopes demonstrated a time lag between the excretion of the food from the stomach and the excretion of bile into the bowels, regardless of the postoperative periods. Absorption of vitamin B12 was normal in patients who lived more than 2 years after operation. The intraluminal pressure and pH studies in long-term survivors showed that our operative technique, the posterior invagination esophagogastrostomy, was effective in preventing a gastroesophageal reflux in the anastomosis.

Topics: Adult; Aged; Carcinoma, Squamous Cell; Esophageal Neoplasms; Esophagogastric Junction; Esophagoscopy; Esophagus; Female; Gastric Acid; Gastric Emptying; Gastrins; Humans; Intestinal Absorption; Liver; Male; Middle Aged; Radionuclide Imaging; Stomach; Thorax; Vitamin B 12

Pathophysiological and nutritional conditions were compared after esophageal reconstruction in 15 patients with a gastric tube and in 12 patients with a pedicled colon segment for the treatment of esophageal cancer. There was no significant difference in the postoperative nutritional index, iron and vitamin B12 metabolisms. On the other hand, the long gastric tube from the greater curvature of the stomach used as an esophageal substitute retained some secretory functions of both exocrine and endocrine although the effect of truncal vagotomy may have to be taken into consideration.

Topics: Aged; Colon; Esophageal Neoplasms; Esophagoplasty; Female; Gastric Juice; Gastric Mucosa; Gastrins; Glucose Tolerance Test; Humans; Iron; Male; Middle Aged; Nutritional Physiological Phenomena; Postoperative Complications; Stomach; Transplantation, Autologous; Vitamin B 12

Topics: Absorption; Adult; Aged; Bone Marrow Cells; Calcium; Esophageal Neoplasms; Feces; Female; Folic Acid; Gastrectomy; Gastroscopy; Hematocrit; Hemoglobins; Humans; Iron; Lipid Metabolism; Liver Function Tests; Male; Middle Aged; Phosphorus; Schilling Test; Stomach; Stomach Neoplasms; Transferases; Vitamin B 12

Topics: Adrenocorticotropic Hormone; Corrinoids; Desoxycorticosterone; Diet; Esophageal Neoplasms; Gastrointestinal Neoplasms; Hematinics; Humans; Nandrolone; Neoplasms; Palliative Care; Stomach Neoplasms; Thiamine; Vitamin B 12