Cancer screening of upper aerodigestive tract in Japanese alcoholics with reference to drinking and smoking habits and aldehyde dehydrogenase‐2 genotype
Cancer screening of upper aerodigestive tract in Japanese alcoholics with reference to drinking and smoking habits and aldehyde dehydrogenase‐2 genotype
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DOI：
10.1002/(sici)1097-0215(19961104)68:3
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发表时间：
1996-11
影响因子：
6.4
通讯作者：
A. Yokoyama;T. Ohmori;T. Muramatsu;S. Higuchi;T. Yokoyama;S. Matsushita;M. Matsumoto;K. Maruyama;M. Hayashida;H. Ishii
中科院分区：
文献类型：
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作者：
A. Yokoyama;T. Ohmori;T. Muramatsu;S. Higuchi;T. Yokoyama;S. Matsushita;M. Matsumoto;K. Maruyama;M. Hayashida;H. Ishii
在这项研究中，1,000名日本男性酗酒者连续筛选上消化道内镜食管碘染色。评估了癌症检出率、饮酒和吸烟习惯以及乙醛脱氢酶-2（ALDH 2）基因型之间的关系。共有53名患者（5.3%）患有组织学确诊的癌症。36例患者被诊断为食管癌，17例患者被诊断为胃癌，9例患者被诊断为口咽癌：8例食管癌患者为多发性癌症患者，在胃和/或口咽咽区域有其他癌症。多元逻辑回归分析显示，与较轻的饮料（清酒或啤酒）相比，使用较强的酒精饮料（威士忌或烧酒）和吸烟50包年或以上增加了食管癌（比值比分别为3.2和2.8），口咽咽喉癌（分别为4.8和5.1）和多发性癌症（分别为10.5和11.8）的风险。ALDH 2的非活性形式，由基因ALDH 2 *1/2*2编码，在东方人中流行，使他们在饮酒后暴露于更高的血液乙醛水平，这是一种公认的动物致癌物。在19/36（52.8%）的食管癌患者、5/9（55.6%）的口咽癌患者和7/8（87.5%）的多发性癌症患者中检测到这种失活的ALDH 2。所有这些基因的频率远远超过了一个大的酗酒队列（80/655，12.2%）。非活性ALDH 2、烈性酒精饮料和重度吸烟的风险因素的三重组合与多发性癌症患者的相关性高于单纯食管癌患者（62.5% vs. 7.1%）。这些结果表明，这3个危险因素对日本酗酒者上呼吸消化道癌的发展很重要。对于这些高危饮酒者，似乎需要进行严格的筛查。© 1996 Wiley利斯公司
In this study, 1,000 Japanese male alcoholics were consecutively screened by upper gastrointestinal endoscopy with esophageal iodine staining. Associations among cancer‐detection rates, drinking and smoking habits, and aldehyde dehydrogenase‐2 (ALDH2) genotypes were evaluated. A total of 53 patients (5.3%) had histologically confirmed cancer. Esophageal cancer was diagnosed in 36, gastric cancer in 17, and oropharyngolaryngeal cancer in 9 patients: 8 of the esophageal‐cancer patients were multiple‐cancer patients, with additional cancer(s) in the stomach and/or oropharyngolaryngeal region. Multiple logistic regression revealed that use of stronger alcoholic beverages (whisky or shochu) in contrast with lighter beverages (sake or beer) and smoking of 50 pack‐years or more increased the risks for esophageal (odds ratio 3.2 and 2.8 respectively), oropharyngolaryngeal (4.8 and 5.1 respectively) and multiple cancer (10.5 and 11.8 respectively). The inactive form of ALDH2, encoded by the gene ALDH2*1/2*2 prevalent in Orientals, exposes them to higher blood levels of acetaldehyde, a recognized animal carcinogen, after drinking. This inactive ALDH2 was detected in 19/36 (52.8%) patients with esophageal cancer, in 5/9 (55.6%) patients with oropharyngolaryngeal cancer, and in 7/8 (87.5%) patients with multiple cancer. All of these gene frequencies far exceeded that in a large alcoholic cohort (80/655, 12.2%). The triple combination of the risk factors of the inactive ALDH2, stronger alcoholic beverages and heavy smoking was more commonly associated with multiple‐cancer patients than with patients with esophageal cancer alone (62.5% vs. 7.1%). These results show that the 3 risk factors are important for the development of upper‐aerodigestive‐tract cancer in Japanese alcoholics. For these high‐risk drinkers, regimented screening appears to be indicated. © 1996 Wiley‐Liss, Inc.