Adenocarcinomas of the esophagus and gastric cardia: medical conditions, tobacco, alcohol, and socioeconomic factors.
Adenocarcinomas of the esophagus and gastric cardia: medical conditions, tobacco, alcohol, and socioeconomic factors.
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发表时间：
1996-10
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通讯作者：
Zuo‐Feng Zhang;R. Kurtz;M. Sun;M. Karpeh;Guo-Pei Yu;N. Gargon;J. S. Fein;S. Georgopoulos;S. Harlap
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作者：
Zuo‐Feng Zhang;R. Kurtz;M. Sun;M. Karpeh;Guo-Pei Yu;N. Gargon;J. S. Fein;S. Georgopoulos;S. Harlap
在过去的10-15年里，西方国家的食道腺癌和贲门腺癌的发病率有所增加。发病率上升的原因尚不清楚。我们的研究旨在调查食道腺癌和贲门腺癌的潜在危险因素，并比较一组患有这种癌症的患者和那些患有远端胃癌的患者的风险概况。我们研究了95例经病理诊断的食管腺癌和贲门腺癌，67例远端胃腺癌和132例无癌对照。1992年11月1日至1994年11月1日期间，患者在纪念斯隆-凯特琳癌症中心就诊。流行病学数据是通过修改的国家癌症研究所健康习惯历史问卷收集的。危险因素分析采用Mantel-Haenszel方法和Logistic回归模型。在控制了年龄、性别、种族、教育程度、吸烟年限、饮酒、体重指数和饮食总卡路里摄入量后，高血压与食道腺癌和贲门腺癌的风险增加了2倍。食管腺癌和贲门腺癌的风险增加与年龄、男性性别和高加索人种有关。吸烟与患食管腺癌和贲门腺癌的风险较小。相比之下，远端胃癌的风险与胃溃疡和多年吸烟有关。缺铁与食道腺癌和贲门腺癌以及远端胃腺癌的风险增加显著相关。没有发现明显的职业暴露、癌症家族史和体力活动之间的关联。这项研究表明，高血压和缺铁等医疗条件可能与食道腺癌和贲门腺癌的风险有关，并证实了与吸烟相关的中等风险。我们的结果表明，在食道腺癌、胃门腺癌和远端胃腺癌的危险因素方面存在病因学上的异质性。
Adenocarcinomas of the esophagus and gastric cardia have increased in incidence over the past 10-15 years in Western countries. The cause for this increase in incidence is still unknown. Our study was designed to investigate potential risk factors for adenocarcinomas of the esophagus and gastric cardia and to compare the risk profiles of a group of patients with this cancer with those having distal stomach cancer. We studied 95 incident cases with the pathological diagnosis of adenocarcinomas of the esophagus and gastric cardia, 67 patients with adenocarcinomas of the distal stomach, and 132 cancerfree controls. Patients were seen at Memorial Sloan-Kettering Cancer Center from November 1, 1992 to November 1, 1994. Epidemiological data were collected by a modified National Cancer Institute Health Habits History Questionnaire. Risk factors were analyzed using Mantel-Haenszel methods and a logistic regression model. Hypertension was associated with a 2-fold increased risk of adenocarcinomas of esophagus and gastric cardia after controlling for age, sex, race, education, pack-years of smoking, alcohol use, body mass index, and total dietary intake of calories. Increased risk of adenocarcinomas of esophagus and gastric cardia was associated with age, male gender, and Caucasian race. Tobacco smoking was related to a modest risk of adenocarcinomas of esophagus and gastric cardia. In contrast, the risk of distal stomach cancer was associated with stomach ulcers and pack-years of cigarette smoking. Iron deficiency was significantly associated with increased risk of both adenocarcinomas of the esophagus and gastric cardia and adenocarcinomas of the distal stomach. No obvious associations were identified for occupational exposures, family history of cancer, and physical activities. This study suggests that medical conditions such as hypertension and iron deficiency may be related to the risk of adenocarcinomas of esophagus and gastric cardia and confirms the moderate risk associated with tobacco smoking. Our results indicated an etiological heterogeneity with respect to risk factors identified between adenocarcinomas of esophagus and gastric cardia and those of the distal stomach.