Adenocarcinoma of the oesophagus and gastric cardia: Male preponderance in association with obesity
Adenocarcinoma of the oesophagus and gastric cardia: Male preponderance in association with obesity
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DOI：
10.1016/j.ejca.2005.12.024
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发表时间：
2006-05-01
影响因子：
8.4
通讯作者：
Reynolds, John V.
中科院分区：
文献类型：
--
作者：
Ryan, Aoife M.;Rowley, Suzanne P.;Reynolds, John V.
最近的证据表明肥胖与食管腺癌发病率的上升有关。在爱尔兰，1995年至2004年间，食管腺癌的发病率增加了38%，与此同时，肥胖症的患病率增加了67%。在这项研究中，对1994年至2004年期间到三级中心就诊的760名被诊断患有食道癌、贲门癌或胃癌的患者进行了一项前瞻性病例对照研究。数据与893名健康对照者进行了比较。根据体重指数（BMI）的四分位数，采用多变量logistic回归模型计算发生任一癌症类型的比值比（OR）。根据患病前的BMI，82%的食管腺癌患者超重或肥胖，而健康对照人群为59%（P < 0.001）。BMI与男性食管腺癌之间存在剂量依赖关系。BMI最高四分位数的男性与BMI最低四分位数的男性相比，调整后的比值比为4.3（95%CL 2.3-7.9）（趋势P < 0.001）。使用BMI的共同截止点，BMI > 30 kg/m2的个体发生食管下段腺癌的OR比BMI < 22 kg/m2的个体高11.3倍（95% CI：3.5-36.4）（趋势P < 0.001）。对于贲门腺癌，BMI最高四分位数的男性与最低四分位数的男性相比，OR为3.5（95% CI：1.3-9.4）（趋势P = 0.03）。BMI与食管鳞癌呈显著负相关（P < 0.001），食管腺癌、食管胃交界处腺癌和贲门腺癌的比值比（OR）分别为0.001、0.001和0.001。随着BMI的增加而显著增加。对于食管下端的肿瘤，肥胖使风险增加了10.9倍。仅在男性中风险显著增加。(c)2006爱思唯尔有限公司保留所有权利。
Recent evidence links obesity with the rising incidence of oesophageal adenocarcinoma. In Ireland between 1995 and 2004 the incidence of oesophageal adenocarcinoma increased by 38%, and this coincided with a 67% increase in the prevalence of obesity. in this study, a prospective case-control study was undertaken in 760 patients presenting to a tertiary centre between 1994 and 2004 diagnosed with cancer of the oesophagus, gastric cardia or stomach. Data were compared with 893 healthy controls. Multivariate logistic regression models were used to calculate the odds ratio (OR) of developing either cancer type according to quartiles of body mass index (BMI). Based on pre-illness BMI, 82% of patients who developed adenocarcinoma of the oesophagus were either overweight or obese compared with 59% of the healthy control population (P < 0.001). A dose-dependent relationship existed between BMI and oesophageal adenocarcinoma in males. The adjusted odds ratio was 4.3 (95% CL 2.3-7.9) among males in the highest BMI quartile compared with males in the lowest quartile (P < 0.001 for trend). Using common cut-off points for BMI, the OR of adenocarcinoma of the lower oesophagus was 11.3 times higher (95% CI: 3.5-36.4) for individuals with a BMI > 30 kg/m(2) versus individuals with a BMI < 22 kg/m(2) (P < 0.001 for trend). For adenocarcinoma of the gastric cardia, males in the top quartile of BMI had an OR of 3.5 (95% CI: 1.3-9.4) compared with the lowest quartile (P = 0.03 for trend). A significant (P < 0.001) inverse relationship between BMI and oesophageal SCC was observed.The odds ratio for adenocarcinoma of the oesophagus, the oesophago-gastric junction and gastric cardia. rose significantly with increasing BMI. For tumours of the lower oesophagus, obesity increased the risk 10.9-fold. The increased risk is significant in males only. (c) 2006 Elsevier Ltd. All rights reserved.