Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Alcohol Clin Exp Res. 2019 Jun;43(6):1225-1233. doi: 10.1111/acer.14049. Epub 2019 Apr 29.
Carriers of the ALDH22 allele have impaired alcohol metabolism and are more susceptible to the development of alcohol-related cancers, including head and neck cancer (HNC). Screening for ALDH22 allele may identify high-risk individuals for alcohol health education. Although genotyping of ALDH2 is the most accurate way to identify ALDH2 deficiency, it may not be practical due to the cost and requirement for genotyping service.
This study evaluated the accuracy of the alcohol flushing questionnaire to identify ALDH2 deficiency in a case-control study of HNC conducted in Taiwan using data collected from 904 patients with HNC and 1,078 controls.
Overall, alcohol flushing questionnaire had a high sensitivity (89%) of identifying ALDH22 carriers among the control subjects and a good sensitivity (79%) among the patients with HNC. The sensitivity of the alcohol flushing questionnaire in identifying ALDH22 carriers was affected by alcohol use, with a lower sensitivity among individuals who consumed alcohol, particularly among current regular (drinking alcohol once per week or more) alcohol drinkers.
The current validation study showed that the alcohol flushing questionnaire may be a reasonable method to identify ALDH2-deficient individuals. However, current regular users of alcohol who reported no alcohol flushing may need to undergo genotyping of ALDH2 for a more accurate assessment of the ALDH2 status.
ALDH22 等位基因携带者的酒精代谢受损，更容易发生与酒精相关的癌症，包括头颈部癌症（HNC）。筛查 ALDH22 等位基因可能可以识别出有酒精健康风险的个体，对其进行健康教育。虽然 ALDH2 的基因分型是确定 ALDH2 缺乏最准确的方法，但由于基因分型服务的成本和需求，它可能并不实用。
本研究通过对来自台湾的 904 名 HNC 患者和 1078 名对照的研究数据进行病例对照研究，评估了酒精潮红问卷在识别 HNC 中 ALDH2 缺乏的准确性。
总的来说，酒精潮红问卷在识别对照组中 ALDH22 携带者时具有较高的敏感性（89%），在 HNC 患者中也具有较好的敏感性（79%）。酒精潮红问卷在识别 ALDH22 携带者时的敏感性受酒精使用的影响，在饮酒者中，特别是在目前经常（每周饮酒一次或以上）饮酒者中，敏感性较低。
目前的验证研究表明，酒精潮红问卷可能是一种识别 ALDH2 缺乏个体的合理方法。然而，报告没有酒精潮红的目前经常饮酒者可能需要进行 ALDH2 基因分型，以更准确地评估 ALDH2 状态。
