부산대학교 도서관

Given previous biologic evidence of immunomodulatory effects of coffee, we hypothesized that the association between coffee intake of colorectal cancer patients and survival differs by immune responses. Using a molecular pathologic epidemiology database of 4465 incident colorectal cancer cases, including 1262 cases with molecular data, in the Nurses' Health Study and the Health Professionals Follow-up Study, we examined the association between coffee intake of colorectal cancer patients and survival in strata of levels of histopathologic lymphocytic reaction and T- cell infiltrates in tumor tissue. We did not observe a significant association of coffee intake with colorectal cancer--specific mortality (multivariable-adjusted hazard ratio [HR] for 1-cup increase of coffee intake per day, 0.93; 95% Cl, 0.84 to 1.03). Although statistical significance was not reached at the stringent level ([alpha]=.005), the association of coffee intake with colorectal cancer-- specific mortality differed by Crohn disease--like lymphoid reaction ([P.sub.interaction]=-007). Coffee intake was associated with lower colorectal cancer--specific mortality in patients with high Crohn disease--like reaction (multivariable HR for 1cup increase of coffee intake per day, 0.55; 95% Cl, 0.37 to 0.81; [P.sub.trend]=- 002) but not in patients with intermediate Crohn disease--like reaction (the corresponding HR, 1.02; 95% Cl, 0.72 to 1.44) or negative/low Crohn disease--like reaction (the corresponding HR, 0.95; 95% Cl, 0.83 to 1.07). The associations of coffee intake with colorectal cancer--specific mortality did not significantly differ by levels of other lymphocytic reaction or any T-cell subset ([P.sub.interaction]>-18). There is suggestive evidence for differential prognostic effects of coffee intake by Crohn disease--like lymphoid reaction in colorectal cancer.
The biologic importance of the immune system in colorectal cancer is well supported by previous studies. (1) For example, a high-level immune response featuring cytotoxic and memory T cells in [...]