Palladino-Davis A G, Mendez B M, Fisichella P M, Davis C S
Swallowing Center, Department of Surgery, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois, USA.
Dis Esophagus. 2015 Jan;28(1):59-67. doi: 10.1111/dote.12097. Epub 2013 Jun 24.
Cancer of the esophagus is an underestimated, poorly understood, and changing disease. Its overall 5-year survival is less than 20%, even in the United States, which is largely a function of a delay in diagnosis until its more advanced stages. Additionally, the epidemiologic complexities of esophageal cancer are vast, rendering screening and prevention limited at best. First, the prevalence of esophageal cancer is unevenly distributed throughout the world. Second, the two histological forms (squamous cell and adenocarcinoma) vary in terms of their geographic prevalence and associated risk factors. Third, some populations appear at particular risk for esophageal cancer. And fourth, the incidence of esophageal cancer is in continuous flux among groups. Despite the varied prevalence and risks among populations, some factors have emerged as consistent associations while others are only now becoming more fully recognized. The most prominent, scientifically supported, and long-regarded risk factors for esophageal cancer are tobacco, alcohol, and reflux esophagitis. Inasmuch as the above are regarded as important risk factors for esophageal cancer, they are not the sole contributors. Dietary habits, nutrition, local customs, and the environment may be contributory. Along these lines, vitamins, minerals, fruits, vegetables, meats, fats, salted foods, nitrogen compounds, carcinogens, mycotoxins, and even the temperature of what we consume are increasingly regarded as potential etiologies for this deadly although potentially preventable disease. The goal of this review is to shed light on the less known role of nutrition and dietary habits in esophageal cancer.
食管癌是一种未得到充分重视、了解不足且不断变化的疾病。其总体5年生存率低于20%,即使在美国也是如此,这在很大程度上是由于诊断延迟到疾病更晚期阶段所致。此外,食管癌的流行病学复杂性极大,使得筛查和预防效果极为有限。首先,食管癌的患病率在全球分布不均。其次,两种组织学类型(鳞状细胞癌和腺癌)在地理患病率和相关危险因素方面存在差异。第三,一些人群似乎特别容易患食管癌。第四,食管癌的发病率在不同群体中持续变化。尽管不同人群的患病率和风险各不相同,但一些因素已成为一致的关联因素,而其他一些因素直到现在才得到更充分的认识。食管癌最突出、有科学依据且长期被认可的危险因素是烟草、酒精和反流性食管炎。尽管上述因素被视为食管癌的重要危险因素,但它们并非唯一的致病因素。饮食习惯、营养、当地习俗和环境也可能起到一定作用。据此,维生素、矿物质、水果、蔬菜、肉类、脂肪、腌制食品、含氮化合物、致癌物、霉菌毒素,甚至我们所摄入食物的温度,都越来越被视为这种致命但可能可预防疾病的潜在病因。本综述的目的是阐明营养和饮食习惯在食管癌中鲜为人知的作用。