Salaspuro Mikko P
Research Unit of Substance Abuse Medicine, University Central Hospital of Helsinki, Biomedicum Helsinki, PL 700, 00029 HUS, Helsinki, Finland.
Best Pract Res Clin Gastroenterol. 2003 Aug;17(4):679-94. doi: 10.1016/s1521-6918(03)00035-0.
Excessive alcohol consumption and heavy smoking are the main risk factors for upper digestive tract cancers. Cancer risk is dose-dependent and alcohol and smoking have synergistic effects. Alcohol is not carcinogenic. However, its first metabolite-acetaldehyde-has recently been shown to be a local carcinogen in humans. Microbes representing normal human gut flora are able to produce acetaldehyde from ethanol. This results in high local acetaldehyde concentrations in the saliva and contents of the large intestine. Asian heavy drinkers with a genetic deficiency for detoxifying acetaldehyde form an exceptional human 'knockout' model for long-term acetaldehyde exposure. The risk of alcohol-related digestive tract cancers is particularly high among this population. All mechanisms that have an effect on salivary or intracolonic acetaldehyde concentration are of importance. The message for prevention is that one should take care to have good oral hygiene and to avoid smoking, heavy drinking and drinking to intoxication.
过量饮酒和大量吸烟是上消化道癌症的主要风险因素。癌症风险呈剂量依赖性，且酒精和吸烟具有协同作用。酒精本身不具有致癌性。然而，其首要代谢产物——乙醛——最近已被证明是人类的一种局部致癌物。代表正常人类肠道菌群的微生物能够将乙醇转化为乙醛。这导致唾液和大肠内容物中乙醛的局部浓度升高。因乙醛解毒存在基因缺陷的亚洲酗酒者形成了一个长期接触乙醛的特殊人类“基因敲除”模型。在这一人群中，与酒精相关的消化道癌症风险尤其高。所有影响唾液或结肠内乙醛浓度的机制都很重要。预防的要点是，人们应注意保持良好的口腔卫生，避免吸烟、酗酒和醉酒。
