Risk of multiple squamous cell carcinomas both in the esophagus and the head and neck region
Risk of multiple squamous cell carcinomas both in the esophagus and the head and neck region
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DOI：
10.1093/carcin/bgi035
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发表时间：
2005-05-01
期刊：
影响因子：
4.7
通讯作者：
Esumi, H
中科院分区：
文献类型：
--
作者：
Muto, M;Takahashi, M;Esumi, H
虽然多发性鳞状细胞癌经常在食管和头颈部观察到，并使我们对有利的治疗感到困惑，但一些患者更有可能发展为多种癌症的原因仍然不清楚。本文对203例新诊断的鳞状细胞癌患者的临床因素进行统计分析，以评估其发生多种癌症的危险性，为建立有效的预防和筛查方案提供依据。广泛的上皮致癌性改变被评估为多发性Lugol排泄病变（多发性LVL）使用Lugol色素内镜。采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）分析方法，检测乙醇脱氢酶3型（ADH 3）和乙醛脱氢酶2型（ALDH 2）基因多态性。40例患者同时患有多个癌症，其余163例为孤立性癌症。多个LVL的存在是多种癌症的唯一独立危险因素[相对危险度（RR）= 67; 95%CI，15-310]。多个LVL只在吸烟饮酒者中观察到。多因素分析显示，ALDH 2缺乏等位基因（RR = 5.7; 95%CI，2.8-11.6）和ADH 3代谢缓慢等位基因（RR = 1.9; 95%CI，1.1-7.9）是多发性LVL的独立危险因素。这些等位基因的组合导致多发性LVL的风险增加。总之，多发性LVL发作是食管和头颈部多发性癌症的显著高风险。饮酒和ALDH 2缺乏等位基因之间的相互作用增加了风险。此外，缓慢代谢的ADH 3等位基因增加了风险。强烈建议这些人禁止使用酒精和早期发现癌症。
While multiple squamous cell carcinomas are often observed in the esophagus and the head and neck region and confound us about the favorable treatments, the reason why some patients are more likely to develop multiple cancers remains obscure. We statistically analyzed clinical factors in 203 patients with newly diagnosed squamous cell carcinoma, to assess the risk of multiple cancers for the establishment of an effective prevention and screening programs. Widespread epithelial oncogenic alterations were assessed as multiple lugol-voiding lesions (multiple LVL) using lugol chromoendoscopy. Genetic polymorphisms of alcohol dehydrogenase type 3 (ADH3) and aldehyde dehydrogenase type 2 (ALDH2) were identified by PCR-restriction fragment length polymorphism analysis. Forty patients had synchronous multiple cancers and the remaining 163 had solitary cancer. Presence of multiple LVL was the only independent risk factor for multiple cancers [relative risk (RR) = 67; 95%CI, 15-310]. Multiple LVL was observed in only smoking drinkers. Among them, a multivariate analysis demonstrated that the ALDH2 deficiency allele (RR = 5.7; 95%CI, 2.8-11.6) and the slow metabolizing ADH3 allele (RR = 1.9; 95%CI, 1.1-7.9) were the independent risk factors for multiple LVL. Combination of these alleles lead to increase the risk of multiple LVL. In conclusion, an episode of multiple LVL is a remarkable high risk for multiple cancers both at the esophagus and the head and neck region. The interaction between drinking and the ALDH2 deficiency allele increases the risk. In addition, the slow metabolizing ADH3 allele enhances the risk. Prohibiting the use of alcohol and early detection of cancer are strongly recommended for such individuals.