Yokoyama Akira, Kato Hoichi, Yokoyama Tetsuji, Igaki Hiroyasu, Tsujinaka Toshimasa, Muto Manabu, Omori Tai, Kumagai Yoshiya, Yokoyama Masako, Watanabe Hiroshi
National Hospital Organization Kurihama Alcoholism Center, Kanagawa, Japan.
Alcohol Clin Exp Res. 2006 Mar;30(3):491-500. doi: 10.1111/j.1530-0277.2006.00053.x.
Aldehyde dehydrogenase-2 (ALDH2) is the key enzyme for elimination of acetaldehyde, an established animal carcinogen produced after drinking. In persons with inactive ALDH2, the body fails to metabolize acetaldehyde rapidly, leading to excessive accumulation of acetaldehyde. Inactive heterozygous ALDH2 enhances the risk of esophageal squamous cell carcinoma (SCC) in Japanese male drinkers.
We studied whether this is the case for women. The risk factors of esophageal SCC were examined in 52 Japanese women with esophageal SCC and 412 cancer-free Japanese women.
The increasing trend in cancer risk according to the quantity of alcohol consumption was significantly steeper in women with inactive heterozygous ALDH2 than in those with active ALDH2 [adjusted odds ratios (ORs) (95% confidence intervals (CIs)) per +7 U/wk increment of alcohol drinking were 3.91 (2.09-7.31) and 1.39 (0.92-2.09), respectively; p = 0.006 for difference in OR; 1 Ut = 22 g of ethanol]. The results obtained using an alcohol-flushing questionnaire were essentially comparable with those obtained by ALDH2 genotyping [adjusted ORs (95% CIs) per +7 U/wk increment of alcohol drinking were 3.94 (1.87-8.31) and 1.46 (0.96-2.23) in those with and without flushing, respectively; p = 0.021 for difference in OR]. The risk of esophageal cancer was markedly higher in heavy drinkers with ALDH2*1/2 than in never/rare drinkers with ALDH21/*1 [adjusted OR (95% CI) = 59.1 (4.65-750)]. Other independent significant risk factors of esophageal SCC were smoking, a preference for hot food or drinks, and lower intake of green and yellow vegetables.
Japanese men and women shared several common risk factors of esophageal SCC, including drinking with inactive heterozygous ALDH2.
乙醛脱氢酶2（ALDH2）是消除乙醛的关键酶，乙醛是饮酒后产生的一种已确定的动物致癌物。对于ALDH2无活性的人，身体无法快速代谢乙醛，导致乙醛过度积累。无活性杂合子ALDH2会增加日本男性饮酒者患食管鳞状细胞癌（SCC）的风险。
我们研究了女性是否也是这种情况。对52名患有食管SCC的日本女性和412名无癌日本女性进行了食管SCC危险因素的检查。
与具有活性ALDH2的女性相比，无活性杂合子ALDH2的女性中，根据饮酒量增加的癌症风险上升趋势明显更陡[每周饮酒量每增加7单位（U），调整后的优势比（OR）（95%置信区间（CI））分别为3.91（2.09 - 7.31）和1.39（0.92 - 2.09）；OR差异p = 0.006；1 U相当于22克乙醇]。使用酒精潮红问卷获得的结果与通过ALDH2基因分型获得的结果基本相当[每周饮酒量每增加7 U，有和无潮红者的调整后OR（95% CI）分别为3.94（1.87 - 8.31）和1.46（0.96 - 2.23）；OR差异p = 0.021]。与ALDH2*1/1的从不/很少饮酒者相比，ALDH21/*2的大量饮酒者患食管癌的风险明显更高[调整后的OR（95% CI）= 59.1（4.65 - 750）]。食管SCC的其他独立显著危险因素包括吸烟、偏好热食或热饮以及绿色和黄色蔬菜摄入量较低。
日本男性和女性共有几种食管SCC的常见危险因素，包括携带无活性杂合子ALDH2饮酒。
