Alcohol drinking, cigarette smoking, and the development of squamous cell carcinoma of the esophagus
Alcohol drinking, cigarette smoking, and the development of squamous cell carcinoma of the esophagus
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饮酒、吸烟与食管鳞状细胞癌的发生
DOI：
10.1007/s10147-010-0055-8
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发表时间：
2010
影响因子：
3.3
通讯作者：
Y. Maehara
中科院分区：
文献类型：
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作者：
Y. Maehara
食管癌是一种极具侵袭性的癌症，手术治疗极具侵入性。在日本，由于肿瘤诊断、手术技术、围手术期管理和放化疗的进步，患者预后显著改善；然而，大约一半的患者即使在食管切除术后也无法治愈[1,2]。因此，早期发现和预防对于避免食管癌死亡非常重要。吸烟和饮酒都是食管鳞状细胞癌（ESCC）的危险因素。据报道，这两个因素在ESCC风险方面存在剂量关系和协同效应[3-5]。此外，大量暴露于这些因素与上呼吸道消化道（UADT） SCC的多发发生密切相关，包括食道和头颈部区域[6]。此外，个体的癌症易感性因代谢酶的多态性而不同[7,8]。对于UADT中的SCC，乙醛脱氢酶2 （ALDH2）多态性被报道不仅对癌症的发展很重要，而且对多中心癌变也很重要。在ESCC中已经研究了多种遗传异常，包括癌基因的激活和抑癌基因的失活，并且存在大量关于食管癌发生[10]的知识。然而，几乎没有直接证据表明饮酒和吸烟与ESCC中观察到的遗传异常之间存在因果关系。此外，对烟酒联合作用的分子机制尚未作详细的评述。在此背景下，Morita博士及其同事回顾了烟草和酒精作为ESCC危险因素的临床意义，Toh博士及其同事讨论了烟草和酒精诱导食道癌变的分子机制。
Esophageal cancer is a highly aggressive cancer and the surgical treatment is extremely invasive. In Japan, the patient prognosis has improved remarkably due to advances in tumor diagnosis, operative techniques, perioperative management, and chemoradiotherapy; however, approximately half of the patients cannot be cured even after an esophagectomy [1, 2]. Early detection, as well as prevention, is therefore important to avoid esophageal cancer deaths. Both cigarette smoking and alcohol drinking are wellestablished risk factors for esophageal squamous cell carcinoma (ESCC). A dose relationship and a synergistic effect of these two factors have been reported regarding the risk for ESCC [3–5]. Also, heavy exposure to these factors is closely related to multiple occurrences of SCC in the upper aerodigestive tract (UADT), including the esophagus and head and neck regions [6]. Furthermore, individual cancer susceptibility differs due to polymorphisms of metabolic enzymes [7, 8]. Regarding SCC in the UADT, a polymorphism of acetaldehyde dehydrogenase 2 (ALDH2) has been reported to be important not only for the development of cancer but also for multicentric carcinogenesis [9]. Various kinds of genetic abnormalities have been investigated in ESCC, including the activation of oncogenes and inactivation of tumor-suppressor genes, and a large body of knowledge exists concerning esophageal carcinogenesis [10]. However, there is little direct evidence showing a causal relationship between alcohol consumption and cigarette smoking and the genetic abnormalities observed in ESCC. Furthermore, the molecular mechanism of the joint effect of tobacco and alcohol has not been reviewed in detail. Against this background, Dr. Morita and colleagues review the clinical significance of tobacco and alcohol as risk factors for ESCC, and Dr. Toh and colleagues discuss the molecular mechanism of tobaccoand alcohol-inducing carcinogenesis of the esophagus.