Japanese

Risk of Cancer in the Upper Aerodigestive Tract in Japanese Alcoholic Men with Superficial Esophageal Cancer, Esophageal Dysplasia, or Inactive Aldehyde Dehydrogenase-2:An Endoscopic Follow-up Study Akira Yokoyama 1 , Tai Omori 2 , Tetsuji Yokoyama 3 , Yasuo Sato 4 , Hirofumi Kawakubo 2 , Takeshi Mizukami 1 1National Hospital Organization Kurihama Alcoholism Center, Yokosuka, Japan 2Department of Surgery, Kawasaki Municipal Hospital, Kawasaki, Japan 3Department of Technology Assessment and Biostatistics, National Institute on Public Health, Wako, Japan 4Department of Otorhinolaryngology, Kawasaki Municipal Hospital, Kawasaki, Japan Keyword: アルコール , アルデヒド脱水素酵素 , 食道癌 , 食道異形成 , 多発重複癌 pp.1365-1374
Published Date 2007/8/25
DOI https://doi.org/10.11477/mf.1403101175
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 Japanese studies have consistently demonstrated a strong relationship between multiple development of squamous cell carcinoma(SCC)of the upper aerodigestive tract and alcohol consumption combined with inactive heterozygous aldehyde dehydrogenase-2(ALDH21/2). Japanese alcoholic men diagnosed as cancer-free by an initial endoscopic screening examination and those with esophageal SCC, which was treated by endoscopic mucosal resection(EMR), received follow-up examinations. The 6-year cumulative rates of new primary SCC in the esophagus/oropharyngolarynx were 56%/35%in EMR cases(n=84), 31%/20%in cancer-free cases with esophageal dysplasia≧5 mm(n=112), and 4%/4%in cancer-free cases without distinct iodine-unstained lesion≧5 mm(DIUL;n=616), respectively. Cox proportional hazards analysis showed that in comparison with cases without DIUL, the adjusted relative hazards for SCC in the esophagus/oropharygolarynx were 23.8(95%CI;11.4~49.5)/14.2(8.03~25.0)in EMR cases and 11.2(5.26~24.0)/6.55(3.62~11.8)in cases with esophageal dysplasia. The 6-year cumulative rates of new primary SCC in the esophagus/oropharyngolarynx were 70%/46%in ALDH21/2 EMR cases(n=44), 34%/30%in ALDH21/2 cancer-free cases(n=72), 30%/8%in ALDH21/1 EMR cases(n=40), and 5%/5%in ALDH21/1 cancer-free cases(n=484). In comparison with ALDH21/1 cancer-free cases, the adjusted relative hazards for SCC in the esophagus/oropharygolarynx were 32.6(14.3~74.2)/21.8(11.1~42.9)in ALDH21/2 EMR cases, 11.7(4.77~28.9)/11.6(5.70~23.4)in ALDH21/2 cancer-free cases, and 8.12(2.45~26.9)/7.36(2.80~19.3)in ALDH21/1 EMR cases. Japanese alcoholics after EMR for esophageal SCC have an extremely high risk of metachronous SCC in the upper aerodigestive tract, especially in ALDH21/2 heterozygotes. Cancer-free patients with esophageal dysplasia or inactive ALDH21/2 also have very high risk of the SCC. All these patients need careful long-term follow-up examinations.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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