Association of multiple Lugol-voiding lesions with synchronous and metachronous esophageal squamous cell carcinoma in patients with head and neck cancer
Association of multiple Lugol-voiding lesions with synchronous and metachronous esophageal squamous cell carcinoma in patients with head and neck cancer
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DOI：
10.1067/mge.2002.128104
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发表时间：
2002-10-01
影响因子：
7.7
通讯作者：
Yoshida, S
中科院分区：
文献类型：
--
作者：
Muto, M;Hironaka, S;Yoshida, S
背景头颈部鳞状细胞癌患者第二原发性食管鳞状细胞癌的患病率很高。方法：将389例初诊的头颈部鳞状细胞癌患者分为4组：无Lugol排泄性病变组、无Lugol排泄性病变组和无Lugol排泄性病变组。几个（> 10个）小的Lugol排泄病变;许多（>10个）小的Lugol排泄病变;和许多形状不规则、多形的Lugol排泄病变。采用单因素和多因素分析研究了发生同步性第二原发食管鳞状细胞癌的相对危险度。异时第二原发性食管鳞状细胞癌也研究了227例患者超过1年后，初步examination.Results：54（14%）的389例患者被发现有同步第二原发性食管鳞状细胞癌。特别是，55%的患者有许多不规则形状的多形卢戈排尿病变同步第二原发性食管鳞状细胞癌。单因素分析显示，存在许多不规则形状的多形式的Lugol排尿病变，饮酒习惯，男性和吸烟是发生同步第二原发性食管鳞状细胞癌的重要危险因素。多因素分析还显示，多个形状不规则的多形Lugol-volding病变（比值比：21.4; p < 0.001）和饮酒习惯（比值比：3.3; p < 0.02）是独立的危险因素。在随访期间，7例患者（3%）有异时性第二原发性食管鳞状细胞癌; 6例有许多形状不规则的多形Lugol-volding病变，第7例在背景粘膜中有许多小的Lugol-volding病变。大量不规则形状的卢戈-在头颈部鳞状细胞癌患者中，排尿病变与第二原发食管鳞状细胞癌密切相关。这可以用“现场癌变”的概念来解释。“摄入酒精可能在这种现象的发生中起着重要作用。
Background. Patients with squamous cell carcinoma of the head and neck have a high prevalence of second primary esophageal squamous cell carcinomas. This study assessed the risk of developing second primary esophageal squamous cell carcinomas in patients with squamous cell carcinoma of the head and neck based on multiplicity of Lugol-voiding lesions observed by chromoendoscopy and patient characteristics.Methods: Three hundred eighty-nine patients with newly diagnosed squamous cell carcinoma of the head and neck were divided into 4 groups: no Lugol-voiding lesions; several (> 10) small Lugol-voiding lesions; many (>10) small Lugol-voiding lesions; and many irregularly shaped, multiform Lugol-voiding lesions. Relative risk for the development of synchronous second primary esophageal squamous cell carcinomas was investigated by using univariate and multivariate analysis. Metachronous second primary esophageal squamous cell carcinomas was also studied among 227 patients followed more than 1 year after initial examination.Results: Fifty-four (14%) of the 389 patients were found to have synchronous second primary esophageal squamous cell carcinomas. In particular, 55% of the patients with many irregular-shaped multiform Lugol-voiding lesions had synchronous second primary esophageal squamous cell carcinomas. Univariate analysis showed that the presence of many irregular-shaped multiform Lugol-voiding lesions, drinking habit, male gender, and smoking were significant risk factors for the development of synchronous second primary esophageal squamous cell carcinomas. Multivariate analysis also revealed that many irregular-shaped multiform Lugol-volding lesions (odds ratio: 21.4; p < 0.001) and drinking habit (odds ratio: 3.3; p < 0.02) were independent risk factors. During follow-up, 7 patients (3%) had metachronous second primary esophageal squamous cell carcinomas; 6 had many irregular-shaped multiform Lugol-volding lesions and the seventh had many small Lugol-voiding lesions in the background mucosa.Conclusions: The presence of numerous irregular-shaped multiform Lugol-voiding lesions was closely associated with second primary esophageal squamous cell carcinomas in patients with squamous cell carcinoma of the head and neck. This might be explained by the concept of "field cancerization." Ingestion of alcohol may play an important role in the occurrence of this phenomenon.