Wang Yao-Kuang, Chen Wei-Chung, Lai Ying-Ho, Chen Yi-Hsun, Wu Ming-Tsang, Kuo Chie-Tong, Wang Yen-Yun, Yuan Shyng-Shiou F, Liu Yu-Peng, Wu I-Chen
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan.
Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
Cancers (Basel). 2019 Mar 19;11(3):387. doi: 10.3390/cancers11030387.
Alcohol is an important risk factor for the development of second esophageal squamous-cell carcinoma (ESCC) in head and neck squamous-cell carcinoma (HNSCC) patients. However, the influence of tea consumption is uncertain. We prospectively performed endoscopic screening in incident HNSCC patients to identify synchronous esophageal neoplasm. In total, 987 patients enrolled between October 2008 and December 2017 and were analyzed. In vitro studies were conducted to investigate the effect of epigallocatechin gallate (EGCG) on the betel alkaloid, arecoline-stimulated carcinogenesis in two ESCC cell lines. There were 151 patients (15.3%) diagnosed to have synchronous esophageal neoplasm, including 88 low-grade dysplasia, 30 high-grade dysplasia and 33 squamous-cell carcinoma (SCC). Tea consumption was associated with a significantly lower risk of having esophageal high-grade dysplasia or SCC in HNSCC patients, especially those who were betel nut chewers, alcohol drinkers or cigarette smokers (all adjusted odds ratio were 0.5; -values: 0.045, 0.045 and 0.049 respectively). In vitro studies indicated that EGCG suppressed arecoline-induced ESCC cell proliferation and colony formation through the inhibition of the Akt and ERK1/2 pathway in a reactive oxygen species-independent manner. In conclusion, tea consumption may protect against the development of second esophageal neoplasms among HNSCC patients, especially those who regularly consume betel nuts, alcohol and cigarettes.
酒精是头颈部鳞状细胞癌（HNSCC）患者发生第二原发性食管鳞状细胞癌（ESCC）的重要危险因素。然而，饮茶的影响尚不确定。我们对新诊断的HNSCC患者进行了前瞻性内镜筛查，以确定同步性食管肿瘤。2008年10月至2017年12月期间共纳入987例患者并进行分析。开展体外研究，以调查表没食子儿茶素没食子酸酯（EGCG）对两种ESCC细胞系中槟榔生物碱、槟榔碱刺激的致癌作用的影响。有151例患者（15.3%）被诊断为患有同步性食管肿瘤，包括88例低级别发育异常、30例高级别发育异常和33例鳞状细胞癌（SCC）。饮茶与HNSCC患者发生食管高级别发育异常或SCC的风险显著降低相关，尤其是那些咀嚼槟榔、饮酒或吸烟的患者（所有校正比值比均为0.5；P值分别为0.045、0.045和0.049）。体外研究表明，EGCG通过以不依赖活性氧的方式抑制Akt和ERK1/2途径，抑制槟榔碱诱导的ESCC细胞增殖和集落形成。总之，饮茶可能预防HNSCC患者发生第二原发性食管肿瘤，尤其是那些经常食用槟榔、饮酒和吸烟的患者。
