Ilhan Mahmut, Erbaydar Tugrul, Akdeniz Necmettin, Arslan Sevket
Internal Medicine Department, School of Medicine, Yuzuncu Yil University, Van, Turkey.
BMC Cancer. 2005 Jul 28;5:90. doi: 10.1186/1471-2407-5-90.
Esophagus squamous cell cancer (ESCC) is the most common cancer in women with 20.2% and second in men with 10.7% relative frequency among all cancer cases diagnosed in Van Region in the east of Turkey. Ninety percent of all esophageal cancer cases are ESCC and 20-30% of them have family history of esophageal cancer. The most clear defined hereditary predisposition associated with ESCC is palmoplantar keratoderma (PPK). To examine the relationship between ESCC and PPK, we have carried out this case control study.
The case group consisted of 48 subjects who had new diagnosis of ESCC and did not receive any chemo or radiotherapy. The control group consisted of 96 healthy individuals who were visitors of their relatives in the hospital. Two control persons who matched for age, gender, living place (urban/rural) and region were selected for each case. All subjects were evaluated for PPK by dermatologist. Evaluation was graded as none, mild, evident and severe. None and mild subjects were classified as negative for PPK; and others as positive. Relationship between ESCC and PPK was evaluated with odds ratios and confidence intervals for cases with or without family history of ESCC.
The PPK frequencies were 92.3% in ESCC cases with family history, 62.5% in ESCC cases without family history, 70.8% in all ESCC cases, and 28.1% in the control group. Odds ratios for cases with or without family history of esophageal cancer, and for the whole case group were found as 30.7 (95%CI = 3.8-247.4), 4.3 (95%CI = 1.9-9.8) and 6.2 (95%CI = 2.9-13.3) respectively.
Presence of PPK lesions represents genetic susceptibility for ESCC. This susceptibility for ESCC is the highest among those who have PPK lesions and a positive family history of esophageal cancer. Furthermore, a PPK sufferer has an increased risk of developing ESCC even if there is no family history of esophageal cancer.
食管鳞状细胞癌（ESCC）是土耳其东部凡城地区诊断出的所有癌症病例中，女性中最常见的癌症，相对发病率为20.2%，男性中排第二，相对发病率为10.7%。所有食管癌病例中有90%为ESCC，其中20 - 30%有食管癌家族史。与ESCC相关的最明确的遗传易感性是掌跖角化病（PPK）。为了研究ESCC与PPK之间的关系，我们开展了这项病例对照研究。
病例组由48名新诊断为ESCC且未接受任何化疗或放疗的受试者组成。对照组由96名在医院探望亲属的健康个体组成。为每个病例选择两名年龄、性别、居住地点（城市/农村）和地区相匹配的对照者。所有受试者均由皮肤科医生评估PPK情况。评估分为无、轻度、明显和重度。无和轻度受试者被分类为PPK阴性；其他则为阳性。通过比值比和置信区间评估有或无ESCC家族史的病例中ESCC与PPK之间的关系。
有家族史的ESCC病例中PPK发生率为92.3%，无家族史的ESCC病例中为62.5%，所有ESCC病例中为70.8%，对照组中为28.1%。有或无食管癌家族史的病例以及整个病例组的比值比分别为30.7（95%CI = 3.8 - 247.4）、4.3（95%CI = 1.9 - 9.8）和6.2（95%CI = 2.9 - 13.3）。
PPK病变的存在代表了ESCC的遗传易感性。在有PPK病变且有食管癌家族史的人群中，这种ESCC易感性最高。此外，即使没有食管癌家族史，PPK患者患ESCC的风险也会增加。
