Diverse contributions of the visceral fat area to the etiology of two distinct subtypes of esophago-gastric junctional adenocarcinoma
Diverse contributions of the visceral fat area to the etiology of two distinct subtypes of esophago-gastric junctional adenocarcinoma
复制标题
内脏脂肪区域对食管胃交界腺癌两种不同亚型病因的不同贡献
DOI：
10.1080/00365521.2022.2089859
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发表时间：
2022
影响因子：
1.9
通讯作者：
Iijima Katsunori
中科院分区：
文献类型：
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作者：
Watanabe Kenta;Koizumi Shigeto;Shirane Kenji;Tsuda Hidehiko;Watanabe Hiroyuki;Tsuji Tsuyotoshi;Onochi Kengo;Yamai Kiyonori;Kusano Chika;Dohmen Takahiro;Horikawa Yohei;Ajimine Takuma;Shimodaira Yosuke;Matsuhashi Tamotsu;Iijima Katsunori
背景食管-胃结合部腺癌（EGJAC）有两种不同的病因：一种与广泛的胃粘膜萎缩（GA）有关，类似于非贲门部胃癌;另一种与胃食管反流病有关，类似于食管腺癌。在这项研究中，我们调查了内脏脂肪面积（VFA）和EGJACs之间的关联分别在两个亚型的EGJACs，根据背景GA的程度。Methods 64例连续EGJACs患者（Siewert 2型）从人口为基础的数据库在秋田县，日本，2014年至2019年。两名年龄和性别匹配的健康对照被随机分配到每个EGJAC病例。内镜下评估GA的范围，并基于计算机断层扫描图像测量VFA值。Logistic回归分析进行调查EGJACs和VFA.ResultsStudy对象之间的关联被分为2个亚组，根据内镜GA的程度：29（45.3%）没有和35（54.7%）广泛的GA。多变量回归分析显示，VFA ≥100 cm 2与无广泛GA的受试者的EGJAC显著相关[比值比（95%置信区间）：2.65（1.08-6.54）]，而在广泛GA受试者中没有这种关联[比值比（95%置信区间）：1.52（0.60-3.83）].结论VFA对EGJAC病因的贡献似乎取决于背景GA的程度而不同，在没有广泛GA的受试者中VFA与EGJAC的相关性比在有广泛GA的受试者中更显著，提供了关于EGJAC病因学异质性的进一步理论依据。
BackgroundThere are two distinct etiologies of esophago-gastric junctional adenocarcinomas (EGJACs): one associated with extensive gastric mucosal atrophy (GA), resembling non-cardiac gastric cancers; and the other related to gastro-esophageal reflux disease, resembling esophageal adenocarcinoma. In this study, we investigated the associations between the visceral fat area (VFA) and EGJACs separately in the two subtypes of EGJACs, depending on the extent of background GA.MethodsSixty-four consecutive patients with EGJACs (Siewert type 2) were enrolled from a population-based database in Akita Prefecture, Japan, between 2014 and 2019. Two age- and sex-matched healthy controls were randomly assigned to each EGJAC case. The extents of GA were evaluated endoscopically, and the VFA values were measured based on computed tomography images. Logistic regression analyses were performed to investigate the associations between EGJACs and the VFA.ResultsStudy subjects were classified into 2 subgroups depending on the extent of endoscopic GA: 29 (45.3%) without and 35 (54.7%) with extensive GA. Multivariable regression analyses revealed that a VFA of ≥100 cm2was significantly associated with EGJACs in subjects without extensive GA [odds ratio (95% confidence interval): 2.65 (1.08–6.54)], while there was no such association in subjects with extensive GA [odds ratio (95% confidence interval): 1.52 (0.60–3.83)].ConclusionsThe contribution of the VFA to the etiology of EGJACs seems to differ depending on the extent of background GA, with the VFA more prominently associated with EGJACs in subjects without extensive GA than in those with it, providing further rationale concerning the heterogeneous nature of EGJAC etiology.