Factors associated with the presence of multiple Lugol-voiding lesions in patients with esophageal squamous-cell carcinoma
Factors associated with the presence of multiple Lugol-voiding lesions in patients with esophageal squamous-cell carcinoma
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DOI：
10.1111/j.1442-2050.2012.01429.x
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发表时间：
2014-07-01
影响因子：
2.6
通讯作者：
Koizumi, W.
中科院分区：
文献类型：
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作者：
Katada, C.;Muto, M.;Koizumi, W.
食管多中心鳞状不典型增生的特征是在Lugol染色内镜下发现多个Lugol排泄性病变（LVL）。多个LVL与食管以及头颈部发生多种癌症的风险非常高相关。为了深入了解食管粘膜多发性LVL的发病机制，我们研究了76例目前或以前诊断为食管鳞状细胞癌的患者发生此类病变的危险因素。所有患者均行食管粘膜Lugol染色内镜检查。记录了吸烟和饮酒的历史。醛脱氢酶2型（ALDH 2）基因的多态性进行了鉴定，使用序列特异性引物的聚合酶链反应。分析多个LVL的相关临床因素。所有多LVL患者均为饮酒者。在单变量分析中，男性（比值比[OR] 15，95%置信区间[CI] 1.84-122.45：P = 0.011），存在ALDH 2 -2等位基因（OR 4.5，95%CI 1.55-13.24：P = 0.006）和吸烟指数>= 1000（OR 2.6，95%CI 1.02-6.6：P = 0.045）与多个LVL相关。多变量分析显示，男性（OR 10.02，95% CI 1.13-88.44：P = 0.038）和ALDH 2 -2等位基因（OR 4.56，95% CI 1.4-14.82：P = 0.012）与多发性LVL相关。在饮酒者中，每日酒精摄入量≥ 100 g纯乙醇且携带ALDH 2 -2等位基因（OR 17.5，95% CI 1.97-155.59：P = 0.01）和每日酒精摄入量≥ 100 g纯乙醇且携带ALDH 2 -2等位基因（OR 17.5，95% CI 1.97-155.59：P = 0.01）的饮酒者中，
Multicentric squamous dysplasia of the esophagus is characterized by multiple Lugol-voiding lesions (LVLs) on Lugol chromoendoscopy. Multiple LVLs are associated with a very high risk of multiple cancers arising in the esophagus as well as the head and neck. To gain insight into the pathogenesis of multiple LVLs of the esophageal mucosa, we studied risk factors for the development of such lesions in 76 patients who had a current or previous diagnosis of esophageal squamous cell carcinoma. All patients underwent Lugol chromoendoscopy of the esophageal mucosa. The history of tobacco and alcohol use was documented. Polymorphisms of the aldehyde dehydrogenase type 2 (ALDH2) gene were identified by polymerase chain reaction using sequence-specific primers. Clinical factors related to multiple LVLs were analyzed. All patients with multiple LVLs were drinkers. On univariate analysis, male sex (odds ratio [OR] 15, 95% confidence interval [CI] 1.84-122.45: P = 0.011), presence of the ALDH2-2 allele (OR 4.5, 95% CI 1.55-13.24: P = 0.006), and smoking index >= 1000 (OR 2.6, 95% CI 1.02-6.6: P = 0.045) were associated with multiple LVLs. On multivariate analysis, male sex (OR 10.02, 95% CI 1.13-88.44: P = 0.038) and presence of the ALDH2-2 allele (OR 4.56, 95% CI 1.4-14.82: P = 0.012) were associated with multiple LVLs. Among drinkers, a daily alcohol intake of >= 100 g pure ethanol with the ALDH2-2 allele (OR 17.5, 95% CI 1.97-155.59: P = 0.01) and a daily alcohol intake of