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慢性黏膜皮肤念珠菌病与食管癌

Chronic mucocutaneous candidiasis and oesophageal cancer.

作者信息

Rosa Daniela D, Pasqualotto Alessandro C, Denning David W

机构信息

Paterson Institute for Cancer Research, Cancer Research UK, Manchester.

出版信息

Med Mycol. 2008 Feb;46(1):85-91. doi: 10.1080/13693780701616023.

Abstract

Chronic mucocutaneous candidiasis (CMC) is often accompanied by endocrine or inflammatory disorders. The association of CMC with squamous cell carcinoma of the oral cavity or oesophagus have been described in patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED). We describe three cases of CMC and oesophageal cancer without the APECED syndrome. The first case refers to a 41-year-old man with Candida paronychia and oral infection and selective IgA deficiency since childhood, who later developed an oesophageal cancer. The second case is a 30-year-old man who presented CMC features at the age of 2 together with selective IgA deficiency. Later on he was diagnosed with an oesophageal squamous cell carcinoma. His mother, the third case reported, had oral thrush since childhood and at the age of 29 she presented with an oesophageal squamous cell carcinoma. The three patients reported died due to oesophageal cancer. This is the first case report describing the development of oesophageal cancer in patients with CMC without the APECED syndrome. Patients with CMC need close follow-up with good oral hygiene and aggressive treatment of oral and oesophageal candidiasis. Routine endoscopic screening for patients with CMC that develop symptoms of oesophageal candidiasis and for patients with CMC with a family history of oesophageal cancer is suggested. Avoidance of additional risk factors for oral and oesophageal cancer like cigarette smoking and excessive alcohol consumption are also warranted.

摘要

慢性黏膜皮肤念珠菌病(CMC)常伴有内分泌或炎症性疾病。自身免疫性多内分泌病-念珠菌病-外胚层营养不良(APECED)患者中,已描述了CMC与口腔或食管癌的关联。我们报告了3例无APECED综合征的CMC和食管癌病例。第一例是一名41岁男性,自幼患有念珠菌性甲沟炎和口腔感染以及选择性IgA缺乏症,后来发展为食管癌。第二例是一名30岁男性,2岁时出现CMC特征并伴有选择性IgA缺乏症。后来他被诊断为食管鳞状细胞癌。报告的第三例是他的母亲,自幼患有口腔鹅口疮,29岁时患食管鳞状细胞癌。报告的这3例患者均死于食管癌。这是第一例描述无APECED综合征的CMC患者发生食管癌的病例报告。CMC患者需要密切随访,保持良好的口腔卫生,并积极治疗口腔和食管念珠菌病。建议对出现食管念珠菌病症状的CMC患者以及有食管癌家族史的CMC患者进行常规内镜筛查。还应避免吸烟和过量饮酒等口腔和食管癌的其他危险因素。

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