Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung County, Taiwan, Republic of China.
Head Neck. 2011 Jan;33(1):77-81. doi: 10.1002/hed.21397.
This study investigated the risk factors for synchronous esophageal neoplasia in patients with head and neck squamous cell carcinoma (HNSCC).
All 315 consecutive patients with newly diagnosed HNSCC received endoscopic esophageal screening with image-enhanced endoscopy.
Sixty-nine patients (21.9%) had synchronous esophageal neoplasia, 37 (53.6%) with superficial neoplasia and 21 (30.4%) with multiple esophageal lesions. Univariate analysis revealed age <50 years, drinking alcohol, and location of index HNSCC were significant risk factors for developing synchronous esophageal neoplasia. In multivariate analysis, drinking alcohol (odds ratio [OR], 3.792; p = .0035), index oropharynxgeal cancers (OR, 3.618; p = .0045) and hypopharyngeal cancers (OR, 2.627; p = .0029) were independent risk factors. Drinking alcohol was clearly dose-response related (p = .001).
Alcohol consumption and index tumor location are associated with the development of synchronous esophageal neoplasia in patients with HNSCC. Because of the high prevalence, routine endoscopic examination of the esophagus should be recommended, especially in patients with the risk factors identified.
本研究旨在探讨头颈部鳞状细胞癌（HNSCC）患者合并食管肿瘤的相关危险因素。
对 315 例新诊断的 HNSCC 患者进行内镜下食管筛查，采用增强内镜。
69 例（21.9%）患者存在食管肿瘤，其中 37 例（53.6%）为食管表浅肿瘤，21 例（30.4%）为多发性食管病变。单因素分析显示，年龄<50 岁、饮酒以及 HNSCC 原发部位是发生食管肿瘤的显著危险因素。多因素分析显示，饮酒（比值比[OR]，3.792；p =.0035）、口咽癌（OR，3.618；p =.0045）和下咽癌（OR，2.627；p =.0029）是独立的危险因素。饮酒与食管肿瘤的发生呈明显的剂量反应关系（p =.001）。
HNSCC 患者的饮酒和肿瘤原发部位与食管肿瘤的发生相关。鉴于其高患病率，应推荐对 HNSCC 患者进行常规食管内镜检查，尤其是对具有这些危险因素的患者。
