Craddock V M
MRC Toxicology Unit, Carshalton, Surrey, UK.
Eur J Cancer Prev. 1992 Feb;1(2):89-103. doi: 10.1097/00008469-199202000-00002.
Of the thousands of chemicals tested, the only compounds found to be potent carcinogens for the oesophagus are the N-nitrosamines. Many of these compounds are readily formed from common precursors in the environment (eg example in food during its storage or preparation) and also in vivo in the human stomach. Exposure is therefore likely to be ubiquitous. Although man may be exposed to other oesophageal carcinogens these have yet to be chemically identified, and at present nitrosamines are the sole contenders for the role of initiators of oesophageal cancer in man. Evidence suggests strongly that oesophageal cancer is initiated world-wide by nitrosamines, and promoted by secondary factors, the nature of which varies with the population concerned, notably alcohol in Europe and the USA, dietary deficiencies in China and Iran, mycotoxins in South Africa. When several risk factors coincide in one locality, the result can be a very high incidence of oesophageal cancer, with no one major cause.
在数千种经过测试的化学物质中，唯一被发现对食管有强致癌性的化合物是N-亚硝胺。这些化合物中的许多很容易由环境中的常见前体形成（例如食物在储存或制备过程中），也可在人体胃内体内形成。因此，接触可能无处不在。虽然人类可能接触到其他食管致癌物，但这些致癌物尚未在化学上得到鉴定，目前亚硝胺是人类食管癌起始剂角色的唯一竞争者。有强有力的证据表明，食管癌在全球范围内由亚硝胺引发，并由次要因素促成，这些因素的性质因相关人群而异，在欧洲和美国主要是酒精，在中国和伊朗是饮食缺乏，在南非是霉菌毒素。当几个风险因素在一个地区同时出现时，结果可能是食管癌的发病率非常高，而没有一个主要原因。
