Riedel Frank, Goessler Ulrich R, Hormann Karl
Department of Otolaryngology, Head and Neck, University Hospital Mannheim, Mannheim, Germany.
Dig Dis. 2005;23(3-4):195-203. doi: 10.1159/000090166.
Chronic consumption of alcoholic beverages is an accepted social custom worldwide. In the upper aerodigestive tract, local morphologic, metabolic and functional alterations are present due to alcohol consumption. A clinical link between the chronic consumption of alcohol and head and neck cancer has been observed for decades. While alcohol was described initially as a risk enhancer only in smokers, a number of epidemiological studies have now provided sufficient evidence that chronic alcohol consumption increases the risk of head and neck cancer independent of exposure to tobacco smoke. The systemic effects of alcohol interact with local changes in the morphology and function of the salivary glands. In addition, alcohol leads to accumulation of pathologic microbes within the mucosa, leading to chronic infection. Susceptibility to carcinogens and cell proliferation in the mucosa are increased, resulting in genetic changes with the development of dysplasia, leukoplacia and carcinoma. Chronic alcohol consumption is correlated with an increased risk of cancer and an increased mortality in a dose-effect relationship. A number of biologically plausible mechanisms exist by which alcohol may cause cancer. These mechanisms are discussed in this article.
长期饮用酒精饮料是一种在全球范围内被认可的社会习俗。在上消化道，饮酒会导致局部形态、代谢和功能改变。长期饮酒与头颈癌之间的临床关联已被观察到数十年。虽然酒精最初仅被描述为吸烟者的风险增强因素，但现在一些流行病学研究已提供了充分证据，表明长期饮酒会增加头颈癌风险，且与接触烟草烟雾无关。酒精的全身效应与唾液腺形态和功能的局部变化相互作用。此外，酒精会导致黏膜内病原微生物积聚，引发慢性感染。黏膜对致癌物的易感性和细胞增殖增加，导致发育异常、白斑和癌症发展过程中的基因变化。长期饮酒与癌症风险增加以及剂量效应关系中的死亡率增加相关。酒精可能致癌存在多种生物学上合理的机制。本文将对这些机制进行讨论。
