Tobacco,alcohol intake,and diet in relation to adenocarcinoma of the esophagus and gastric cardia

Little is known about the etiology of adenocarcinoma of the distal esophagus/cardia, a cancer which has increased in incidence in the United States over the last two decades. We analyzed data on smoking, alcohol use, dietary intake, and other factors obtained from 173 hospitalized males with adenocarcinoma of the distal esophagus/cardia (cases) and 4,544 hospitalized males with diseases not related to smoking and of other organ systems than the gastrointestinal tract (controls). Cases of squamous cell carcinoma of the esophagus (n=136) and adenocarcinoma of the distal stomach (n=122) were included as separate case groups. All subjects were interviewed in 28 hospitals in eight cities in the US between 1981 and 1990. After adjustment for covariates, the odds ratio (OR) for adenocarcinoma of the distal esophagus/cardia for current smokers was 2.3 (95 percent confidence interval [CI]=1.4–3.9) and that for ex-smokers was 1.9 (CI=1.2–3.0) relative to never-smokers. The OR for drinkers of four or more ounces of whiskey-equivalents of alcohol per day (relative to those consuming less than one drink per week) was 2.3 (CI=1.3–4.3). Intakes of total fat and vitamin A from animal sources were significant risk factors and fiber intake was associated inversely with adenocarcinoma of the distal esophagus/cardia. Although the number of female cases of adenocarcinoma of the distal esophagus/cardia was small (n=21), significant associations were observed for smoking and alcohol.Dr Kabat is in the Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA. At the time of this work be was with the Division of Epidemiology, American Health Foundation, New York, NY. Drs Ng and Wynder are with the Division of Epidemiology, American Health Foundation. Address correspondence to Dr Kabat, Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Belfer Bldg, Rm 1302, 1300 Morris Park Avenue, Bronx, NY 10461, USA. Supported by National Cancer Institute Program Project grant CA32617 and Center grant CA17613.     

Occupational exposures and risk of esophageal and gastric cardia cancers among male Swedish construction workers

Objective: The rising incidence and the strong male predominance among patients with esophageal and gastric cardia adenocarcinoma remain unexplained. We hypothesized that occupational airborne exposures in a traditional male dominated industry might contribute to these observations.Methods: A prospective, large cohort study of Swedish construction workers was linked to the Swedish population-based registers of Cancer, Causes of Death and Total Population. 260,052 men were followed from 1971 through 2000. Industrial hygienists assessed specific exposures for 200 job titles, and occupational airborne exposures were analyzed separately and combined. Incidence rate ratios (IRR), with 95% confidence intervals (CI), were estimated in multivariable Cox regression models adjusted for attained age, calendar period, smoking status and body mass.Results: We found positive associations between high exposure to asbestos (IRR 4.5 [95% CI 1.4–14.3]) and cement dust (IRR 3.8 [95% CI 1.5–9.6]) and risk of esophageal adenocarcinoma. Associations were seen between high exposure to asphalt fumes (IRR 2.3 [95% CI 1.0–5.3]) and wood dust (IRR 4.8 [95% CI 1.2–19.4]) and risk of cardia adenocarcinoma. No consistent associations regarding esophageal squamous-cell carcinoma were found.Conclusions: Exposure to asbestos and cement dust may be risk factors for esophageal adenocarcinoma, and exposure to asphalt fumes and wood dust may increase the risk of cardia adenocarcinoma. However, these associations cannot explain the major sex differences or the increasing incidence trends of these tumors.     

性别与贲门腺癌术后患者预后相关性研究

目的目前,国内外关于性别与贲门腺癌(gastric cardia adenocarcinoma,GCA)患者术后预后的研究鲜有报道。本研究探讨性别是否与GCA患者的预后有关。为GCA患者的治疗提供最优方案,延长其生存期。方法回顾性分析郑州大学第一附属医院省部共建食管癌防治国家重点实验室500×10~3例食管癌和贲门癌临床信息数据库中行贲门癌根治术的5968例GCA患者临床资料,采用Kaplan-Meier法计算患者的累积生存率,并绘制生存曲线,组间比较用Log-rank检验。多因素Cox比例风险回归模型方法分析预后主要影响因素。结果本研究5968例患者中男性中位总生存期(median overall survival,mOS)为3.871年,女性为4.274年,差异有统计学意义,χ^2=21.396,P<0.001。单因素分析显示,年龄(χ^2=47.863,P<0.001)、分化程度(χ^2=59.517,P<0.001)、切缘状况(χ^2=12.198,P<0.001)、TNM分期(χ^2=470.929,P<0.001)均是GCA患者预后的影响因素,结果显示在年龄(<55岁,χ^2=5.749,P=0.016;≥55岁,χ^2=15.462,P=0.001)、高低发区(低发区,χ^2=8.218,P=0.004;高发区,χ^2=13.462,P=0.001)、分化程度(低分化,χ^2=8.144,P=0.004;中分化,χ^2=7.060,P=0.008;高分化,χ^2=5.422,P=0.020)、切缘状况(净,χ^2=16.010,P=0.001;不净,χ^2=7.193,P=0.007)、TNM分期(Ⅱ期,χ^2=11.760,P<0.001;Ⅲ期,χ^2=13.331,P<0.001)上女性生存均优于男性。多因素分析显示,性别(OR=1.209,95%CI为1.120~1.304)、年龄(OR=1.349,95%CI为1.240~1.469)、分化程度(中分化,OR=1.174,95%CI为1.046~1.317;低分化,OR=1.093,95%CI为0.976~1.224)、切缘状况(OR=1.167,95%CI为1.048~1.299)、TNM分期(Ⅱ期,OR=1.823,95%CI为1.423~2.337;Ⅲ期,OR=3.518,95%CI为2.752~4.497)是影响GCA患者预后的独立影响因素。调整混杂因素后进一步多因素分层分析提示,年龄(OR=1.312,95%CI为1.191~1.445)、中分化(OR=1.155,95%CI为1.010~1.322)、切缘状况(OR=1.241,95%CI为1.100~1.400)、TNM分期(Ⅱ期,OR=1.832,95%CI为1.398~2.401;Ⅲ期,OR=3.535,95%CI为2.707~4.617)是男性GCA患者预后的独立影响因素;年龄(OR=1.470,95%CI为1.231~1.754)、TNM分期(Ⅲ期OR=3.692,95%CI为1.970~6.918)是女性GCA患者预后的独立影响因素。结论性别为GCA患者预后的独立影响因素,女性患者的生存期明显优于男性患者。且不同性别GCA患者预后的独立影响因素不同。     

食管癌贲门癌术后早期肠内营养的临床观察

探讨食管癌、贲门癌术后早期进行肠内营养的临床效果。将68例食管癌、贲门癌患者随机分成肠内营养组(EN)和肠外营养组(PN组)。所有病例在术前和术后第1、5、8 天各进行血清生化和免疫水平检查。临床观察营养状况、消化道症状、胃肠功能恢复、术后并发症等。结果提示治疗8 d各营养指标及免疫功能均有增高。EN组免疫水平明显高于PN组,t=2. 12,P<0. 05,临床观察EN组肛门恢复排气时间较PN组均显著缩短,t=2. 36,P<0.05,且无严重术后并发症发生。术后早期肠内营养支持是一种较肠外营养更有效的营养方式。     

Cigarette smoking,alcohol consumption and subsequent gastric cancer risk by subsite and histologic type

The effect of cigarette smoking or alcohol consumption on the risk of gastric cancer has not been clarified. We investigated this relationship, considering the anatomic subsite and histologic type of gastric cancer. A total of 19,657 men (aged 40-59 years at baseline), who responded to the baseline questionnaire and reported no serious illness at that time, were followed for 10 years, from January 1990 to December 1999. Gastric cancer was confirmed histologically in 293 men. Smoking was associated with an increased risk of the differentiated type of distal gastric cancer; compared to the group who never smoked, the adjusted rate ratios (RRs) of gastric cancer for past and current smokers were 2.0 (95% CI 1.1-3.7) and 2.1 (95% CI 1.2-3.6), respectively. No association was observed between cigarette smoking and risk of the undifferentiated type of distal gastric cancer except for a suggestive association with cardia cancer. For alcohol consumption, elevated risk was suggested only for cardia cancer of all histologic types, though the relationship failed to reach significance. Among those who drank alcohol at least once per week, RRs for ethanol intake of 2.7-161.0, 162.0-322.0 and 322.5+ g/week compared to those who drank 0-3 times/month were 2.5 (95% CI 0.7-9.5), 3.3 (0.9-11.6) and 3.0 (0.8-11.1), respectively (p(trend) = 0.66). In conclusion, our results confirm that smoking is related to gastric cancer of the differentiated type. Further studies with more cases are needed to detect a positive association between cigarette smoking or alcohol consumption and cardia cancer.     

Body mass index in relation to ovarian cancer: a multi-centre nested case-control study

The incidence of ovarian cancer is up to 10 times higher in Western countries than in rural Asia and Africa. One common consequence of a Western lifestyle is the development of excessive body weight and obesity. A multi‐centre prospective study was conducted to investigate the association between body mass index (BMI) and ovarian cancer risk. A case‐control study was nested within 3 prospective cohorts in New York (USA), Umeå (Sweden) and Milan (Italy). Information on anthropometry, demographic characteristics, medical history and lifestyle was obtained at the time of subjects' recruitment in each cohort. Women diagnosed with primary, invasive epithelial ovarian cancer from the 3 cohorts (n = 122) diagnosed 12 months or later after recruitment into the respective cohort served as case subjects. For each case subject, 2 control subjects that matched the case subject on cohort, menopausal status, age and date of recruitment were randomly identified. Data were analyzed by conditional logistic regression. There was an inverse association between BMI and ovarian cancer risk. For increasing quartiles of BMI above the lowest, the ORs were 0.62 (0.32–1.21), 0.59 (0.30–1.17) and 0.46 (0.23–0.92), p = 0.03. Analyses limited to women diagnosed 3 or more years after recruitment into the cohorts did not alter these findings. When obese women (BMI > 30) were compared to lean women (BMI ≤ 23), the inverse association became stronger, with an OR of 0.38 (0.17–0.85), p < 0.02. There was some evidence of direct association of ovarian cancer with height, which was limited to cancers diagnosed before age 55. Our data suggest that increasing body weight may confer a protection against ovarian cancer. © 2002 Wiley‐Liss, Inc.     

Body mass index, tobacco chewing, alcohol drinking and the risk of oral submucous fibrosis in Kerala, India

Objective: While chewing areca nut is considered a risk factor for oral submucous fibrosis, the effects of cigarette smoking, alcohol drinking, and body mass index (BMI) have not been examined; nor are they well established. In this study we investigated the association between BMI, smoking, drinking, and the risk of oral submucous fibrosis. Methods: We conducted a case–control study within the fraåework of an ongoing randomized oral cancer screening trial in Kerala, India. Trained health workers conducted interviews with structured questionnaires and oral visual inspections to diagnose oral premalignant lesions. A total of 170 oral submucous fibrosis cases (139 women and 31 men) and 47,773 controls were identified. The odds ratios (OR) and 95% confidence intervals (CI) were calculated by logistic regression in SAS. Results: The adjusted OR for ever-tobacco chewing was 44.1 (95% CI = 22.0–88.2). An inverse dose–response relationship was seen between BMI and the risk of oral submucous fibrosis when both genders were combined (p for trend = 0.0010), with an OR of 0.5 (95% CI = 0.3–0.9) for the highest BMI quartile compared to the lowest. Alcohol drinking may possibly be associated with the risk of oral submucous fibrosis; the adjusted OR for ever drinking was 2.1 (95% CI = 1.0–4.4). Cigarette smoking did not appear to be a risk factor for women or for men. Both smoking and drinking were rare habits among women. Conclusion: This study suggested, for the first time, that BMI was inversely associated with the risk of oral submucous fibrosis for both genders when potential confounding factors were adjusted. Our results indicated that alcohol drinking might be a moderate risk factor and confirmed the previous observation that chewing tobacco was a strong risk factor for oral submucous fibrosis.     

河南林州地区贲门癌和癌旁组织中p16基因启动子甲基化及蛋白表达

目的探讨贲门癌变过程中p16基因启动子区甲基化和p16蛋白表达变化特征和规律及其相互关系。方法采用甲基化特异PCR（MSP）及免疫组化方法,检测林州地区32例贲门癌患者癌组织、癌旁不典型增生组织和正常组织p16基因启动子区甲基化状态及蛋白表达情况。结果p16基因在癌组织中表达缺失18例（56%）,不典型增生组织中表达缺失8例（73%）;26例（81%）癌组织、7例（64%）不典型增生组织和18例（67%）正常组织发生了p16基因启动子区的甲基化。贲门癌组织中p16基因甲基化与表达缺失一致率为56%。差异无统计学意义,P〉0.05。结论p16蛋白表达缺失可能是贲门癌变过程中的重要分子事件,p16基因启动子区甲基化可能是导致其蛋白表达缺失的机制之一。     

贲门腺癌中Smad4基因甲基化状态分析

目的：探讨贲门腺癌（gastric cardia adenocarcinoma,GCA）中Smad4（mothers against decapentaplegic homolog4）基因启动子区及第1外显子区的甲基化状态及其与TGF-β1蛋白表达之间的相关性。方法：取110例贲门腺癌组织及相应癌旁组织,分别采用甲基化特异性PCR（methylation specific PCR,MSP）方法检测Smad4基因的甲基化情况,RT-PCR方法检测Smad4 mRNA水平,免疫组织化学法检测Smad4和TGF-β1的蛋白表达情况。结果：贲门腺癌组织Smad4基因启动子甲基化率为5.5%（6/110）,Smad4基因第1外显子5′非翻译区的甲基化率为24.5%（27/110）,相应癌旁正常黏膜均未检测到此两个位点的甲基化,癌组Smad4基因甲基化率显著高于癌旁正常组织（P〈0.05）,且贲门腺癌中Smad4基因5′非翻译区发生甲基化的比率显并高于启动子区（P〈0.01）。贲门腺癌组织中Smad4 mRNA及蛋白表达显著低于癌旁正常组织（P〈0.05）,其甲基化与蛋白表达之间呈负相关。TGF-β1在贲门癌组织中的表达（65.5%）明显高于相应癌旁组织（15.5%）（P〈0.01）,且随肿瘤分期的增高和肿瘤分化程度的降低,TGF-β1的阳性表达率明显升高（P〈0.05）。Smad4蛋白和TGF-β1蛋白在贲门腺癌中的表达呈明显的负相关。结论：在贲门腺癌发生发展过程中Smad4基因第1外显子的5′非翻译区比启动子区更易发生高甲基化而导致基因沉默,Smad4甲基化及TGF-β1的过表达可能是贲门腺癌发生的机制之一。     

Smoking, alcohol and gastric cancer risk in Korean men: the National Health Insurance Corporation Study

We investigated the risk of gastric cancer by subsite in relation to cigarette smoking and alcohol in a large population-based cohort of 669 570 Korean men in an insurance plan followed for an average 6.5 years, yielding 3452 new cases of gastric cancer, of which 127 were cardia and upper-third gastric cancer, 2409 were distal gastric cancer and 1007 were unclassified. A moderate association was found between smoking, cardia and upper-third (adjusted relative risk (aRR) 2.2; 95% confidence interval (CI) 1.4-3.5) and distal cancers (aRR=1.4; 95% CI=1.3-1.6). We also found a positive association between alcohol consumption and distal (aRR=1.3; 95% CI=1.2-1.5) and total (aRR=1.2; 95% CI=1.1-1.4) gastric cancer. Combined exposure to high levels of tobacco and alcohol increased the risk estimates further; cardia and upper-third gastric cancers were more strongly related to smoking status than distal gastric cancer.British Journal of Cancer (2007) 97, 700-704. doi:10.1038/sj.bjc.6603893 www.bjcancer.com Published online 17 July 2007.     

Diabetes and risk of esophageal and gastric adenocarcinomas

Diabetes has been consistently associated with an increased risk of liver, pancreas and endometrial cancer and has been implicated as a risk factor for esophageal and gastric cancers, although this association has been less well studied. We sought to determine the role of diabetes in the etiology of esophageal, gastric cardia and distal gastric adenocarcinomas (DGAs). This analysis included patients with esophageal adenocarcinoma (EA) (n = 209), gastric cardia adenocarcinoma (GCA) (n = 257) and DGA (n = 382), and 1,309 control participants from a population-based case-control study conducted in Los Angeles County. The study included non-Hispanic whites, African Americans, Hispanics and Asian Americans. The association of diabetes with the three tumor types was estimated using polytomous logistic regression. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated. Nine percent of control participants and 13% of the case patients reported a history of diabetes. After adjustment for age, gender, race, birthplace, education, cigarette smoking status and body mass index, diabetes was associated with an increased risk of EA (OR, 1.48; 95% CI, 0.94-2.32; p = 0.089) and DGA (OR, 1.47; 95% CI, 1.01-2.15; p = 0.045), but was not associated with risk of GCA (OR, 0.96; 95% CI, 0.59-1.55; p = 0.87). However, the association between diabetes and risk of DGA was statistically significant only among patients for whom we interviewed their next of kin. Our study further investigated the association between diabetes and adenocarcinomas of the esophagus and distal stomach.     

贲门腺癌中分泌型卷曲相关蛋白4、5基因启动子区甲基化状态研究

目的：研究贲门腺癌（gastric cardia adenocarcinoma,GCA）中分泌型卷曲相关蛋白4（secreted frizzled related protein4,SFRP4）及SFRP5基因启动子区甲基化状态与贲门腺癌发生发展的关系。方法：采用甲基化特异性PCR（methylation specific PCR,MSP）方法检测94例GCA组织及47例相应癌旁正常组织中SFRP4和SFRP5基因的甲基化情况,并分析其与临床病理特征之间的关系。结果：94例GCA组织中SFRP4基因甲基化率为68．1％（64194）,显著高于癌旁正常组织中的甲基化发生率8．5％（4／47）（P〈0．01）;SFRP5基因在贲门腺癌组织中的甲基化发生率为79．8％（75／94）,显著高于癌旁正常组织中的甲基化发生率12．8％（16／47）（P〈0．01）。SFRP4基因在高、中分化腺癌组甲基化发生率为35％（14／40）,显著低于低分化腺癌组的发生率92．6％（50／54）（P〈0．01）;SFRP4基因在无淋巴结转移组的甲基化发生率为60．5％（23／38）,低于有淋巴结转移组73．2％（41／56）,但其差异无统计学意义（P〉0．05）。SFRP5基因在低分化腺癌组甲基化发生率为85．1％（46／54）,高于高、中分化腺癌组甲基化发生率72．5％（29／40）,但其差异无统计学意义（P〉0．05）;SFR巧基因甲基化发生率在无淋巴结转移组为65．8％（25／38）,显著低于有淋巴结转移组89．3％（50／56）（P〈0．05）。57例贲门腺癌组织中SFRP4和SFRP5基因同时发生甲基化者,高、中分化18例,低分化39例,两者间的差异具有统计学意义（P〈0．05）。结论：SFRP4和SFRP5基因可能参与了贲门腺癌的发生,SFRP4,SFRP5基因的高甲基化状态与贲门腺癌的恶性行为有关。     

食管癌和贲门癌切除机械吻合术后早期并发症及死因分析

为探讨食管癌和贲门癌切除机械吻合术后早期并发症,并对发生原因及死亡原因进行分析。行食管癌和贲门癌切除410例,均行食管与胃机械吻合。结果示,术后发生吻合口瘘5例(1·2%),其中3例死亡,2例保守治愈;术后乳糜胸3例(0·7%),其中1例行开胸探查结扎胸导管治愈,另2例保守治愈;胸腔内出血3例(0·7%),均经积极地二次开胸探查止血治愈;肺部感染26例(6·3%),其中1例感染严重死亡,另25例治疗后痊愈;吻合口狭窄1例(0·2%),经胃镜下食管扩张治愈。     

A multiethnic population-based study of smoking, alcohol and body size and risk of adenocarcinomas of the stomach and esophagus (United States)

Objectives: Since the 1970s incidence rates for esophageal and gastric cardia adenocarcinomas have risen substantially, particularly among white males in the United States. Reasons for the increase of these tumor types are not well understood. We sought to determine the role of smoking, alcohol use, and body size characteristics in the etiology of esophageal, gastric cardia, and distal gastric adenocarcinomas. Materials and methods: A population-based case–control study that included Whites, African-Americans, Latinos and Asian-Americans diagnosed with incident esophageal (n = 222), gastric cardia (n = 277), and distal gastric adenocarcinomas (n = 443), and 1356 control subjects was conducted in Los Angeles County. Unconditional logistic regression was used to calculate odds ratios (ORs), as an estimate of the relative risk, and corresponding 95% confidence intervals (CIs) for the three tumor types of interest. Results: After adjustment for age, gender, race, birthplace, and education, current cigarette smoking was a significant risk factor for all tumor types; the association was strongest for esophageal adenocarcinomas (OR = 2.80, 95% CI = 1.8–4.3), intermediate for gastric cardia adenocarcinomas (OR = 2.12, 95% CI = 1.5–3.1), and weaker for distal gastric adenocarcinomas (OR = 1.50, 95% CI = 1.1–2.1). For esophageal adenocarcinomas only, cigarette smoking had a long-lasting deleterious effect, even 20 years after smoking cessation. Alcohol use was not associated with an increased risk of these tumor types. Risks of esophageal and gastric cardia adenocarcinomas also increased statistically significantly in a dose-dependent manner with increasing body mass index measured at ages 20 and 40 years and recently. The positive associations with smoking and body mass index were generally consistent when evaluated separately for Whites, non-Whites, males, and females. Conclusions: Cigarette smoking and high body mass index are significant, independent risk factors for esophageal and gastric cardia adenocarcinomas. Studies designed to understand the mechanisms whereby smoking and high body mass influence these tumor types are needed.     

Consumption of alcohol,coffee, and tobacco,and gastric cancer in Spain

A case-control study on gastric cancer was carried out between 1987 and 1989 in four regions of Spain. Three hundred and fifty-four cases of histologically confirmed adenocarcinoma were included (235 men and 119 women). For each case, a control was selected, matched by sex, age, and area of residence, from the same hospital as the case. No association was observed with smoking, nor with the consumption of coffee or tea. The usual consumption of alcohol was associated with gastric cancer in men (odds ratio = 1.54, 95 percent confidence interval = 1.03–2.31), but there was no dose-response relationship. No association was observed in women. All estimations were carried out taking into account the effect of the dietary factors associated with gastric cancer. In accordance with previous evidence, the association observed between gastric cancer and alcohol appears not to be causal.Drs Agudo and González are with the Unit of Epidemiology, Hospital de Mataró, Mataró, Spain. Dr Marcos is with the Department of Preventive Medicine, Hospital Clínico, Zaragoza, Spain. Dr Sanz is with the Department of Pathology, Hospital del INSALUD, Soria, Spain. Dr Saigi is with the Department of Oncology, Hospital General de Granollers, Granollers, Spain. Dr Verge is with the Department of Surgery, Hospital de Terrassa, Terrassa, Spain. Dr Boleda is with the Department of Oncology, Hospital S. Camil, Sant Pere de Riba, Sapin. Dr Ortego is with the Department of Pathology, Hospital Clínico, Zaragoza, Spain. Address correspondence to Dr Agudo, Unit of Epidemiology, Hospital de Mataró, c. Hospital 31, 08301 Mataró, Spain. This study received financial support from the Health Research Fund (FIS) of the Spanish Ministry of Health (Financial Aid for Research exp. 87/1703, exp. 89/0018 and exp. 89/0743) and from the International Agency for Research on Cancer (Collaborative Research Agreement AEP/88/02).     

Intakes of folate,methionine, vitamin B6, and vitamin B12 with risk of esophageal and gastric cancer in a large cohort study

Background:

Nutrients in the one-carbon metabolism pathway may be involved in carcinogenesis. Few cohort studies have investigated the intakes of folate and related nutrients in relation to gastric and esophageal cancer.

Methods:

We prospectively examined the association between self-reported intakes of folate, methionine, vitamin B6, and vitamin B12 and gastric and esophageal cancer in 492 293 men and women.

Results:

We observed an elevated risk of esophageal squamous cell carcinoma with low intake of folate (relative risk (95% confidence interval): Q1 vs Q3, 1.91 (1.17, 3.10)), but no association with high intake. Folate intake was not associated with esophageal adenocarcinoma, gastric cardia adenocarcinoma, or non-cardia gastric adenocarcinoma. The intakes of methionine, vitamin B6, and vitamin B12 were not associated with esophageal and gastric cancer.

Conclusion:

Low intake of folate was associated with increased risk of esophageal squamous cell carcinoma.     

The role of alcohol, tobacco, and dietary factors in upper aerogastric tract cancers: a prospective study of 10,900 Norwegian men

Previous knowledge on risk factors for oral, pharyngeal, laryngeal, and esophageal cancer has been based mainly on case-control studies. In the present study, the impact of alcohol consumption, tobacco smoking, and dietary factors on upper aerogastric tract cancer risk was studied in a cohort of 10,960 Norwegian men followed from 1968 through 1992, in which period a total of 71 upper aerogastric tract cancers occurred. The relative risk (RR) of cancer was 3.9 (95 percent confidence interval [CI] = 2.1-7.1) for the highest consumption group of alcohol and 4.7 (CI = 1.7-13.2) for the highest smoking level, compared with the respective reference groups. Among the dietary items, high consumption of oranges was associated with reduced cancer risk (RR = 0.5, CI = 0.3-1.0), as was high consumption of bread (RR = 0.2, CI = 0.1-0.5). Frequent consumption of beef and bacon increased relative cancer risk bordering on significance. The present results are largely in accordance with previous studies. The decreased risk associated with a high intake of bread deserves further investigation.     

NDRG2基因在贲门腺癌中的甲基化状态及表达

目的： 探讨贲门腺癌(GCA)中NDRG2(N-myc downstream-regulated gene 2)基因启动子区的甲基化状态,并分析其甲基化与表达之间的相关性。方法：应用甲基化特异性PCR(MSP)方法检测97例贲门腺癌组织及相应癌旁组织中NDRG2基因的甲基化状态,应用RT-PCR和免疫组织化学方法检测97例贲门腺癌组织及相应癌旁组织中NDRG2的mRNA和蛋白表达情况。结果：NDRG2基因启动子区在贲门腺癌组织中的甲基化率(49.5%)显著高于癌旁正常组织(5.1%)(P<0.05),且Ⅲ期和Ⅳ期贲门腺癌患者中NDRG2基因甲基化的比率显著高于Ⅰ期和Ⅱ期患者,低分化组中NDRG2基因发生甲基化的比率显著高于高中分化组。贲门腺癌组织中NDRG2 mRNA表达水平显著低于癌旁正常组织(P<0.05)。贲门腺癌组织中NDRG2蛋白表达阳性率为44.3%(43/97),显著低于相应癌旁正常组织的蛋白表达94.8%(92/97)(P<0.01),且贲门腺癌组织中NDRG2蛋白表达缺失与其启动子区的甲基化有明显的相关性(r=-0.510,P<0.01)。结论：NDRG2基因启动子区的高甲基化导致的基因沉默可能是贲门腺癌中此基因表达降低的机制之一。