The Alcohol Use Disorders Identification Test and the risk of metachronous cancer after endoscopic resection of esophageal cancer.
The Alcohol Use Disorders Identification Test and the risk of metachronous cancer after endoscopic resection of esophageal cancer.
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酒精使用障碍识别测试和食管癌内镜切除术后异时性癌症的风险。
DOI：
10.1093/carcin/bgaa022
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发表时间：
2020
期刊：
影响因子：
4.7
通讯作者：
Muto M.
中科院分区：
文献类型：
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作者：
Yokoyama A;Katada C;Yokoyama T;Takizawa K;Yano T;Oda I;Shimizu Y;Nakanishi H;Koike T;Hirao M;Okada H;Yoshii T;Katagiri A;Yamanouchi T;Matsuo Y;Kawakubo H;Kobayashi N;Ishikawa H;Muto M.
对因早期食管鳞状细胞癌（ESCC）接受内镜切除术（ER）的日本患者进行的随访研究报告了上呼吸消化道（UAT）异时性SCC的高患病率。这项前瞻性多中心队列研究随访了330例ESCC ER后的日本患者，中位数为49.4个月。研究登记前12个月的酒精使用障碍识别测试（AUDIT）显示高风险饮酒行为的频率较高：84例（25.4%）受试者的AUDIT评分≥15分（疑似酒精依赖），121例（36.7%）受试者的AUDIT评分为8-14分（危险饮酒）。74例受试者被异时诊断为ESCC，20例受试者被诊断为头颈部SCC（HNSCC）。AUDIT评分≥15与每100人-年HNSCC总数的增加相关（0-7为0.4，8-14为1.2，≥15为7.1;P< 0.0001）。AUDIT评分与食管Lugol排泄性病变（LVLs）的分级进行性相关，LVLs是UAT中视野癌变的预测因子。AUDIT评分≥15分和存在多个LVL均为异时性HNSCC的独立预测因素[多变量风险比（95%置信区间）分别为6.98（1.31-37.09）和3.19（1.19-8.54）]。然而，高AUDIT评分并不是异时性ESCC的预测因子。总之，高AUDIT评分在该人群中明显频繁，并增加了异时性HNSCC的风险。应将使用AUDIT评估饮酒行为和完成酒精问题的干预纳入ESCC的治疗策略。临床试验注册的名称和临床试验注册号：日本食管队列研究，UMIN 000001676。
Follow-up studies of Japanese patients who had undergone endoscopic resection (ER) for early esophageal squamous cell carcinoma (ESCC) have reported a high prevalence of metachronous SCC in the upper aerodigestive tract (UAT). This prospective multicenter cohort study followed up 330 Japanese patients after ER of ESCC for a median of 49.4 months. The Alcohol Use Disorders Identification Test (AUDIT) for the 12-month period prior to study registration revealed high frequencies of high-risk drinking behaviors: 84 (25.4%) subjects had AUDIT scores of ≥15 points (suspected alcohol dependence) and 121 (36.7%) subjects had AUDIT scores of 8–14 points (hazardous drinking). Seventy-four subjects were metachronously diagnosed with ESCC, and 20 subjects with head and neck SCC (HNSCC). AUDIT scores ≥15 were associated with increases in the total number of HNSCCs per 100 person-years (0.4 for 0–7, 1.2 for 8–14 and 7.1 for ≥15;P< 0.0001). AUDIT scores were progressively associated with the grade of esophageal Lugol-voiding lesions (LVLs), a predictor of field cancerization in the UAT. Both an AUDIT score of ≥15 points and the presence of multiple LVLs were independent predictors of metachronous HNSCC [multivariate hazard ratio (95% confidence interval) = 6.98 (1.31–37.09) and 3.19 (1.19–8.54), respectively]. However, a high AUDIT score was not a predictor of metachronous ESCC. In conclusion, high AUDIT scores were markedly frequent in this population and increased the risk of metachronous HNSCC. The assessment of drinking behavior using the AUDIT and the completion of interventions for alcohol problems should be incorporated into the treatment strategy of ESCC.The name of the clinical trial register and the clinical trial registration number: Japan Esophageal Cohort Study, UMIN000001676.