胃肠道癌症诊断后超加工食品暴露：具有叙述性综合和临床意义的范围综述
Post-diagnostic ultra-processed food exposure in gastrointestinal cancers: scoping review with narrative synthesis and clinical implications.
摘要(中文译文)
可改变的生活方式因素，包括饮食质量，与胃肠道癌症的发病率密切相关。然而，癌症诊断后超加工食品（UPF）摄入的影响仍知之甚少，证据稀缺且零散。特别是，诊断后UPF暴露在塑造生存结局和疾病进展方面的作用尚未得到系统探讨。我们开展了一项范围综述，并对现有关于诊断后UPF摄入与胃肠道癌症临床结局的文献进行了叙述性综合。纳入的研究包括成年胃肠道恶性肿瘤患者、诊断后饮食暴露评估，以及总生存期、癌症特异性死亡率、复发、进展和治疗相关结局等结局指标。直接证据极为有限。唯一一项针对结直肠癌幸存者的前瞻性研究显示，诊断后较高的UPF摄入与总死亡率或癌症特异性死亡率无关，但与心血管死亡率升高相关，凸显了竞争风险在癌症幸存者中的重要性。此外，特定的UPF亚组与结直肠癌特异性死亡率呈不良关联。支持性研究表明，治疗后饮食质量可能恶化，UPF摄入随时间增加。机制性证据支持UPF暴露、代谢功能障碍、慢性炎症、微生物群改变与生存结局之间存在生物学上合理的联系。尽管胃肠道癌症负担日益加重且超加工食品广泛消费，诊断后UPF暴露在肿瘤学研究中仍很大程度上被忽视。目前直接证据有限，且主要局限于结直肠癌幸存者，其中较高的UPF摄入与心血管死亡率相关，但与癌症特异性结局的关联并不一致。这些发现连同机制研究提供的生物学合理性，支持有必要开展前瞻性诊断后队列研究和干预试验，将标准化饮食评估纳入胃肠道癌症幸存者研究。
Abstract
Modifiable lifestyle factors, including diet quality, are strongly associated with the incidence of gastrointestinal cancers. However, the impact of ultra-processed food (UPF) consumption after cancer diagnosis remains poorly understood, with scarce and fragmented evidence. In particular, the role of post-diagnostic UPF exposure in shaping survival outcomes and disease progression has not been systematically explored. We conducted a scoping review with narrative synthesis of the available literature on post-diagnostic UPF consumption and clinical outcomes in gastrointestinal cancers. Eligible studies included adult patients with gastrointestinal malignancies, assessment of dietary exposure after diagnosis, and outcomes such as overall survival, cancer-specific mortality, recurrence, progression, and treatment-related outcomes. Direct evidence was extremely limited. The only available prospective study in colorectal cancer survivors showed that higher post-diagnostic UPF intake was not associated with overall or cancer-specific mortality but was associated with increased cardiovascular mortality, highlighting the relevance of competing risks in cancer survivorship. Furthermore, specific UPF subgroups showed adverse associations with colorectal cancer-specific mortality. Supportive studies suggested that dietary quality may deteriorate after treatment, with increasing UPF consumption over time. Mechanistic evidence supports a biologically plausible link between UPF exposure, metabolic dysfunction, chronic inflammation, microbiota alterations, and survivorship outcomes. Despite the increasing burden of gastrointestinal cancers and the widespread consumption of ultra-processed foods, post-diagnostic UPF exposure remains largely overlooked in oncologic research. Direct evidence is currently limited and mainly restricted to colorectal cancer survivors, where higher UPF intake has been associated with cardiovascular mortality but not consistently with cancer-specific outcomes. These findings, together with biological plausibility from mechanistic studies, support the need for prospective post-diagnostic cohorts and intervention trials integrating standardized dietary assessment into gastrointestinal cancer survivorship research.
如何引用
AMA
Ester Oneda, Silvia Noventa, Michela Libertini, Sara Cherri, Alessandra Manno, Fausto Meriggi, et al. Post-diagnostic ultra-processed food exposure in gastrointestinal cancers: scoping review with narrative synthesis and clinical implications.. Frontiers in nutrition. 2026; doi:10.3389/fnut.2026.1884359.
APA
Ester Oneda, Silvia Noventa, Michela Libertini, Sara Cherri, Alessandra Manno, Fausto Meriggi, et al (2026). Post-diagnostic ultra-processed food exposure in gastrointestinal cancers: scoping review with narrative synthesis and clinical implications.. Frontiers in nutrition. https://doi.org/10.3389/fnut.2026.1884359
GB/T 7714
Ester Oneda, Silvia Noventa, Michela Libertini, Sara Cherri, Alessandra Manno, Fausto Meriggi, et al. Post-diagnostic ultra-processed food exposure in gastrointestinal cancers: scoping review with narrative synthesis and clinical implications.[J]. Frontiers in nutrition, 2026 doi:10.3389/fnut.2026.1884359.
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