Anatomical subsite discrepancy in relation to the impact of the consumption of alcohol, tobacco and betel quid on esophageal cancer
Anatomical subsite discrepancy in relation to the impact of the consumption of alcohol, tobacco and betel quid on esophageal cancer
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DOI：
10.1002/ijc.22324
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发表时间：
2007-04-15
影响因子：
6.4
通讯作者：
Wu, Ming-Tsang
中科院分区：
文献类型：
--
作者：
Lee, Chien-Hung;Wu, Deng-Chyang;Wu, Ming-Tsang
风险因素对食管癌（EC）的致癌影响可能因肿瘤发生的食管部分而异。目前尚不清楚为什么更多的食管鳞状细胞癌（SCC）发生在中间位置。我们在台湾进行了一项多中心病例对照研究，以评估这种肿瘤的解剖亚部位风险差异，关于消费酒精，烟草和槟榔。通过无序多分类logistic回归分析了447例经病理证实的食管SCC患者（107例为上三分之一[U/3-EC]，199例为中三分之一[M/3-EC]，141例为下三分之一[L/3-EC]）以及1，022例性别、年龄和研究医院匹配的对照。三种物质的所有消费量均与EC的每个子位点的发展有关，M/3-EC中发现当前吸烟者（调整后的比值比（AOR）= 6.2）和当前咀嚼者（U/3-EC（AOR = 4.9））的风险均较高。饮酒和吸烟的联合风险的合同较低的三分之二EC似乎显着超过一个倍增的相互作用模型估计。同时暴露于这两种药物使所有三个亚位点的EC风险高达10至23.9倍，额外的无烟草槟榔块为30.3至75.0倍。总之，肿瘤亚部位差异风险与长期暴露于烟草和槟榔与花序。酒精与烟草在食管中部以更强的超倍增方式相互作用，这可能解释了为什么食管SCC在该解剖位置更常见。(c)2007 Wiley-Liss，Inc.
The carcinogenetic impact of risk factors on esophageal cancer (EC) may differ according to the portion of the esophagus where the tumor occurs. It is unclear why more esophageal squamous cell carcinomas (SCC) developed in the middle location. We carried out a multicenter case-control study in Taiwan to assess anatomical subsite risk discrepancy for this neoplasm in regard to the consumption of alcohol, tobacco and betel quid. Four hundred forty seven incident patients with pathology-proven SCC of the esophagus (107 were upper-third [U/3-EC], 199 middle-third [M/3-EC] and 141 lower-third [L/3-EC] cases), as well as 1,022 gender, age and study hospital matched controls were analyzed by unordered polytomous logistic regression. All consumption of the three substances was related to the development of each subsite of EC, with a heterogeneously higher risk for current smokers (adjusted odds ratio (AOR) = 6.2) found in M/3-EC and for current chewers, in U/3-EC (AOR = 4.9). The joint risk of contracting lower two-third EC for drinking and smoking appeared to significantly surpass those estimated by a multiplicative interaction model. Concomitant exposure to these two agents brought the risks of EC at all three subsites up to 10- to 23.9-fold an additional tobacco-free betel quid to a 30.3- to 75.0-fold. In conclusion, tumor subsite discrepancy risk is related to prolonged exposure to tobacco and betel quid with inflorescence. Alcohol interacts with tobacco in a stronger supra-multiplicative way in the middle portion of the esophagus, probably explaining why esophageal SCC occurs more commonly at this anatomical location. (c) 2007 Wiley-Liss, Inc.