Mizukami Takeshi, Yokoyama Akira, Yokoyama Tetsuji, Onuki Shuka, Maruyama Katsuya
National Hospital Organization Kurihama Medical and Addiction Center, 5-3-1 Nobi, Yokosuka, Kanagawa 239-0841, Japan.
Department of Health Promotion, National Institute of Public Health, 2-3-6 Minami, Saitama 351-0197, Japan.
Alcohol Alcohol. 2017 Mar 9;52(2):131-137. doi: 10.1093/alcalc/agw071.
Alcohol consumption increases the risk of colorectal adenoma and cancer. The fecal immunochemical test (FIT) is a widely used screening method for detecting colorectal neoplasia. We evaluated the results of screening and risk factors for colorectal neoplasia in individuals with alcohol dependence.
Total colonoscopic screening was performed for 1006 Japanese men with alcohol dependence (462 FIT-positive and 544 FIT-negative). Advanced neoplasia was defined as neoplasia ≥10 mm, villous or tubulovillous adenoma, high-grade adenoma, or carcinoma.
The detection rates for non-advanced adenoma, advanced neoplasia and intramucosal or invasive carcinoma were 38.7%, 39.4% and 9.7% for the FIT-positive group, and 33.3%, 10.8% and 2.2% for the FIT-negative group, respectively. Advanced neoplasia, especially carcinoma, was detected more frequently in the distal colon than in the proximal colon in the FIT-positive group. The respective multivariate odds ratios (ORs; 95% confidence interval) for non-advanced adenoma and advanced neoplasia were 2.83 (2.06–3.88) and 9.13 (6.19–13.5) for a positive FIT (vs. negative), 1.68 (1.39–2.02) and 1.83 (1.45–2.30) for age (per +10 years), 1.54 (1.06–2.23) and 1.88 (1.17–3.03) for current smoking (vs. non-smokers), and 1.35 (0.96–1.92) and 1.59 (1.02–2.48) for the presence of marked macrocytosis (mean corpuscular volume ≥106 fl vs. <106 fl). Genetic polymorphisms of alcohol dehydrogenase-1B and aldehyde dehydrogenase-2 did not affect the risk of colorectal neoplasia.
The detection rate for advanced colorectal neoplasia was extremely high in the FIT-positive group but remained high even in the FIT-negative group. An older age, smoking and macrocytosis were predictors of advanced colorectal neoplasia.
Total colonoscopic screening was performed for 1006 Japanese alcoholic men (462 fecal immunochemical test [FIT]-positive and 544 FIT-negative). The detection rate for advanced colorectal neoplasia was extremely high in the FIT-positive group (39.4%) and high in the FIT-negative group (10.8%). Ageing, smoking and macrocytosis were predictors of advanced colorectal neoplasia.
饮酒会增加患结直肠腺瘤和癌症的风险。粪便免疫化学检测（FIT）是一种广泛用于检测结直肠肿瘤的筛查方法。我们评估了酒精依赖个体的结直肠肿瘤筛查结果及风险因素。
对1006名日本酒精依赖男性进行了全结肠镜筛查（462名FIT阳性和544名FIT阴性）。高级别肿瘤定义为肿瘤≥10毫米、绒毛状或管状绒毛状腺瘤、高级别腺瘤或癌。
FIT阳性组非高级别腺瘤、高级别肿瘤及黏膜内或浸润性癌的检出率分别为38.7%、39.4%和9.7%，FIT阴性组分别为33.3%、10.8%和2.2%。在FIT阳性组中，高级别肿瘤，尤其是癌，在远端结肠的检出频率高于近端结肠。FIT阳性（vs阴性）时，非高级别腺瘤和高级别肿瘤的多因素优势比（OR；95%置信区间）分别为2.83（2.06 - 3.88）和9.13（6.19 - 13.5），年龄每增加10岁时分别为1.68（1.39 - 2.02）和1.83（1.45 - 2.30），当前吸烟者（vs非吸烟者）分别为1.54（1.06 - 2.23）和1.88（1.17 - 3.03），存在显著大细胞性（平均红细胞体积≥106飞升vs <106飞升）时分别为1.35（0.96 - 1.92）和1.59（1.02 - 2.48）。酒精脱氢酶-1B和乙醛脱氢酶-2的基因多态性不影响结直肠肿瘤的风险。
FIT阳性组中晚期结直肠肿瘤的检出率极高，但FIT阴性组中该检出率也很高。年龄较大、吸烟和大细胞性是晚期结直肠肿瘤的预测因素。
对1006名日本酒精依赖男性进行了全结肠镜筛查（462名粪便免疫化学检测[FIT]阳性和544名FIT阴性）。FIT阳性组中晚期结直肠肿瘤的检出率极高（39.4%），FIT阴性组中该检出率也较高（10.8%）。年龄增长、吸烟和大细胞性是晚期结直肠肿瘤的预测因素。
