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ABSTRACT
Riboflavin is an essential micronutrient for normal cellular activity, and deficiency may result in disease, such as cancer. We performed a case-control study to explore the association of riboflavin levels with risk and prognosis of esophageal squamous cell carcinoma (ESCC). Plasma riboflavin levels, as measured by enzyme-linked immunosorbent assay (ELISA), in ESCC patients were significantly lower than in those of healthy controls (7.04 ± 6.34 ng/ml vs. 9.32 ± 12.40 ng/ml; P < 0.05). Moreover, there was an inverse relationship between riboflavin level and risk of ESCC (odds ratio (OR) = 0.97, 95% confidence interval (CI) = 0.95–0.99, P = 0.02). The 5-year relapse-free and overall survival rates were significantly lower when riboflavin levels were ≤0.8 ng/ml than >0.8 ng/ml (relapse-free survival rate: 29.4% vs. 54.8%; overall survival rate: 28.6% vs. 55.6%). Plasma riboflavin level was an independent protective factor for both relapse-free (hazard ratio (HR) = 0.325, 95% CI = 0.161–0.657, P = 0.002) and overall survival of ESCC patients (HR = 0.382, 95% CI = 0.190–0.768, P = 0.007). In conclusion, plasma riboflavin levels are significantly related to risk and prognosis of ESCC patients, suggesting that moderate supplementation of riboflavin will decrease risk and prevent recurrence of ESCC and also improve prognosis of ESCC patients.
Acknowledgments
The authors thank Dr. Stanley Li Lin from the Department of Cell Biology and Genetics of Shantou University Medical College for assistance in revising the manuscript. The authors' responsibilities were as follows—SSL, LYX, and EML: conceived and designed the study. SSL, YWX, JYW, HZT, and ZYW: contributed to data acquisition. SSL and JJZ: performed data analysis. SSL: wrote the paper.
Funding
This work was supported by grants from the Natural Science Foundation of China Guangdong Joint Fund (No. U1301227) and the Key Laboratory Project for College and University of Guangdong Province (grant KLB11009), and the Department of Education, Guangdong Government under the Top-tier University Development Scheme for Research and Control of Infectious Diseases.
Conflict of interest
The authors confirm that there are no conflicts of interest.