■上消化道鳞状异型增生和鳞状细胞癌(SCC)的多种发展已被野外癌变现象解释,并与饮酒和吸烟有关。治愈性治疗后的第二原发性SCC发展损害患者的生活质量和生存;然而,这些消费和停止如何影响田野癌变仍然是未知的。
■这是一项多中心队列研究,包括331例经内镜治疗的浅表食管SCC(ESCC)患者和1022名健康受试者的数据进行比较。背景食管粘膜的生理状况根据每个内窥镜视图的Lugol排泄病变(LVL)的数量分为3组:A级,0;B级,1-9;或C级,≥10LVLs。使用自我管理问卷进行生活方式调查。医生建议患者需要戒酒和戒烟,并每6个月进行一次内窥镜检查。
■LVL等级与饮酒强度呈正相关,冲洗反应,吸烟,和高温食物,与食用绿色和黄色蔬菜和水果呈负相关。在C级LVL中,第二主要ESCC和头颈部SCC更为普遍(累积5-y发生率为47.1%,95%置信区间[CI]=38.0-57.2和13.3%,95%CI分别=8.1-21.5)。酒精和戒烟显着减少了第二主要ESCC的发展(调整后的危险比分别为0.47,95%=CI0.26-0.85和0.49,95%CI=0.26-0.91)。
■饮酒,吸烟,冲洗反应,高温食物与田间癌变密切相关,停止饮酒和吸烟可显着降低第二原发癌发展的风险。UMIN临床试验注册ID:UMIN000001676。
UNASSIGNED: Multiple developments of squamous dysplasia and squamous cell carcinoma (SCC) in the upper aerodigestive tract have been explained by field cancerization phenomenon and were associated with alcohol and cigarette use. Second primary SCC development after curative treatment impairs patients\' quality of life and survival; however, how these consumption and cessation affect field cancerization is still unknown.
UNASSIGNED: This is a multicenter cohort study including 331 patients with superficial esophageal SCC (ESCC) treated endoscopically and pooled data from 1022 healthy subjects for comparison. Physiological condition in the background esophageal mucosa was classified into 3 groups based on the number of Lugol-voiding lesions (LVLs) per endoscopic view: grade A, 0; grade B, 1-9; or grade C, ≥10 LVLs. Lifestyle surveys were conducted using a self-administered questionnaire. Patients were counseled on the need for alcohol and smoking cessation by physicians and were endoscopically surveyed every 6 months.
UNASSIGNED: LVL grades were positively associated with alcohol drinking intensity, flushing reactions, smoking, and high-temperature food and were negatively associated with eating green and yellow vegetables and fruit. Second primary ESCC and head/neck SCC were significantly more prevalent in the grade C LVL (cumulative 5-y incidences 47.1%, 95% confidence interval [CI] = 38.0-57.2 and 13.3%, 95% CI = 8.1-21.5, respectively). Alcohol and smoking cessation significantly reduced the development of second primary ESCC (adjusted hazard ratios 0.47, 95% = CI 0.26-0.85 and 0.49, 95% CI = 0.26-0.91, respectively).
UNASSIGNED: Alcohol drinking, smoking, flushing reaction, and high-temperature food were closely associated with field cancerization, and cessation of alcohol and smoking significantly reduced the risk of development of second primary cancer. UMIN Clinical Trials Registry ID:UMIN000001676.