Gastrocentrum, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Curr Opin Clin Nutr Metab Care. 2012 Sep;15(5):457-67. doi: 10.1097/MCO.0b013e3283566699.
The data indicating that alcohol is an important factor increasing the risk to develop gastrointestinal cancer are consolidating. The purpose of this review is to summarize current evidence.
Acetaldehyde is the first metabolite of ethanol metabolism and has direct carcinogenic and mutagenic effects by modifying DNA via generation of DNA adducts. Oxidative stress has a prominent role in triggering chronic inflammation and carcinogenesis through formation of reactive oxygen species. Recently published large prospective cohort studies with sufficient statistical power and meta-analyses could refine the knowledge regarding the impact of alcohol on gastrointestinal cancer. Functional genetic variants of alcohol-metabolizing enzymes proved to be associated with increased risk for esophageal and gastric cancer.The highest risk increase for malignancy was observed in the upper aerodigestive tract (oral cavity, pharynx, larynx) and esophagus (squamous cell carcinoma), weaker correlations were established regarding gastric, pancreatic, and colorectal neoplasias.
Alcohol overconsumption is a serious avoidable risk factor for the development of gastrointestinal tract cancer, both alone but even more in combination with other risk factors such as tobacco and obesity.
越来越多的数据表明,酒精是增加胃肠道癌症风险的重要因素。本文旨在总结目前的证据。
乙醛是乙醇代谢的第一代谢物,通过生成 DNA 加合物来修饰 DNA,具有直接的致癌和致突变作用。氧化应激通过形成活性氧,在引发慢性炎症和癌变方面起着重要作用。最近发表的具有足够统计效力的大型前瞻性队列研究和荟萃分析可以细化关于酒精对胃肠道癌症影响的知识。酒精代谢酶的功能遗传变异已被证明与食管癌和胃癌的风险增加相关。恶性肿瘤的最高风险增加发生在上呼吸道(口腔、咽、喉)和食管(鳞状细胞癌),而胃癌、胰腺癌和结直肠癌的相关性较弱。
酒精过度摄入是胃肠道癌症发展的一个严重的可避免的危险因素,无论是单独的因素,还是与其他危险因素(如烟草和肥胖)结合时更是如此。