食管癌的病因与预防
Etiology and Prevention of Esophageal Cancer.
作者信息
Yang Chung S, Chen Xiaoxin, Tu Shuiping
机构信息
Department of Chemical Biology, Susan Lehman Cullman Laboratory for Cancer Research, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, N.J, USA.
Julius L. Chambers Biomedical/Biotechnology Research Institute, North Carolina Central University, Durham, N.C, USA; Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA.
出版信息
Gastrointest Tumors. 2016 Sep;3(1):3-16. doi: 10.1159/000443155. Epub 2016 Feb 3.
BACKGROUND
Esophageal cancer (EC) occurs commonly, especially in Asia, and is the sixth leading cause of cancer deaths worldwide. Recently, great progress has been made in research on the etiology and prevention of EC.
SUMMARY
The major risk factors for esophageal squamous cell carcinoma (ESCC) are tobacco smoking and alcohol drinking, which act synergistically. Dietary parameters, including dietary carcinogens and insufficiency of micronutrients, could also be important risk factors in certain areas. A common etiological factor for both EC and some other cancers are low levels of intake of fruits and vegetables. With improvements in diet and drinking water in developing countries, the incidence of ESCC decreased. However, in economically well-developed countries, the incidence of esophageal adenocarcinoma (EAC) has markedly increased in the past 40 years. The major etiological factor for EAC is gastroesophageal reflux, which is also an etiological factor for gastric cardia adenocarcinoma (GCA). In certain areas of China, the occurrence of GCA is closely related to ESCC. Susceptibility genes for EC are starting to be discovered, and this may help to identify high-risk groups that have more need for preventive measures. Mitigation of the risk factors, early detection and treatment of precancerous lesions are effective approaches for prevention. Smoking cessation, avoidance of excessive alcohol, meat and caloric consumption, increasing physical activity and frequent consumption of vegetables and fruits are prudent lifestyle modifications for the prevention of EC as well as other diseases.
KEY MESSAGE
The etiology of EC includes tobacco smoking, alcohol drinking, low levels of intake of fruits and vegetables as well as gastroesophageal reflux and susceptibility genes.
PRACTICAL IMPLICATIONS
A healthy lifestyle including smoking cessation, increasing physical activity, consumption of vegetables as well as reduction of alcohol intake and caloric consumption are major approaches to the prevention of EC.
背景
食管癌（EC）常见，尤其是在亚洲，是全球癌症死亡的第六大主要原因。最近，食管癌的病因学和预防研究取得了很大进展。
总结
食管鳞状细胞癌（ESCC）的主要危险因素是吸烟和饮酒，二者起协同作用。饮食参数，包括饮食致癌物和微量营养素不足，在某些地区也可能是重要的危险因素。食管癌和其他一些癌症的一个共同病因是水果和蔬菜摄入量低。随着发展中国家饮食和饮用水的改善，ESCC的发病率有所下降。然而，在经济发达的国家，食管腺癌（EAC）的发病率在过去40年中显著增加。EAC的主要病因是胃食管反流，这也是贲门腺癌（GCA）的一个病因。在中国的某些地区，GCA的发生与ESCC密切相关。食管癌的易感基因开始被发现，这可能有助于识别更需要预防措施的高危人群。减轻危险因素、早期发现和治疗癌前病变是预防的有效方法。戒烟、避免过量饮酒、肉类和热量摄入、增加体育活动以及经常食用蔬菜和水果是预防食管癌以及其他疾病的明智生活方式改变。
关键信息
食管癌的病因包括吸烟、饮酒、水果和蔬菜摄入量低以及胃食管反流和易感基因。
实际意义
健康的生活方式，包括戒烟、增加体育活动、食用蔬菜以及减少酒精摄入和热量消耗，是预防食管癌的主要方法。
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