Department of Human and Environmental Sciences, Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Department of Gastroenterology and Hepatology, Izumi General Medical Center, Izumi city, Kagoshima, Japan.
PLoS One. 2021 May 19;16(5):e0251457. doi: 10.1371/journal.pone.0251457. eCollection 2021.
Patients with inactive acetaldehyde dehydrogenase 2 (ALDH2) are at high risk for esophageal squamous cell carcinoma (ESCC) and hypopharyngeal squamous cell carcinoma (HPSCC). The acetaldehyde breath test (ABT) may demonstrate ALDH2 gene polymorphisms. We evaluated the usefulness of the ABT in patients with ESCC and HPSCC. The squamous cell carcinoma (SCC) group consisted of 100 patients who were treated with endoscopic submucosal dissection (ESD) for ESCC or HPSCC, and the control group (HC) consisted of 275 healthy subjects. The SCC group comprised the "single subgroup" (n = 63), in which a single lesion was initially treated with ESD, and the "multiple subgroup" (n = 31), in which multiple lesions were initially treated with ESD. First, we compared the groups' risk factors for carcinogenesis and measured the acetaldehyde-to-ethanol (A/E) ratio. Then we tested the groups' differences in the abovementioned carcinogenic risk factors. We found that the proportion of individuals in the SCC group with inactive ALDH2 (A/E ratio ≥ 23.3) was significantly higher than that in the HC group (p = 0.035), as was the A/E ratio (p < 0.001). Also, the proportion of individuals with inactive ALDH2 in the multiple subgroup was significantly higher than that in single subgroup (p = 0.015), as was the A/E ratio (p = 0.008). In conclusion, ABT may be a potential screening tool for detecting people at risk of ESCC and HPSCC. In addition, it could be a useful tool in detecting patients at risk of multiple or double carcinomas among patients with ESCC and HPSCC. Trial registration: Trial Registration number: UMIN000040615 [https://rctportal.niph.go.jp/en/detail?trial_id=UMIN000040615], Data of Registration: 01 46 June 2020, retrospectively registered.
患有非活性乙醛脱氢酶 2（ALDH2）的患者患食管鳞状细胞癌（ESCC）和下咽鳞状细胞癌（HPSCC）的风险很高。乙醛呼气试验（ABT）可显示 ALDH2 基因多态性。我们评估了 ABT 在 ESCC 和 HPSCC 患者中的有用性。鳞状细胞癌（SCC）组由 100 名接受内镜黏膜下剥离术（ESD）治疗 ESCC 或 HPSCC 的患者组成，对照组（HC）由 275 名健康受试者组成。SCC 组包括“单发亚组”（n = 63），其中单发病变最初采用 ESD 治疗，以及“多发亚组”（n = 31），其中多发病变最初采用 ESD 治疗。首先，我们比较了两组致癌因素的风险，并测量了乙醛与乙醇（A/E）比值。然后，我们测试了上述致癌风险因素在两组之间的差异。我们发现，SCC 组中无活性 ALDH2 个体（A/E 比值≥23.3）的比例明显高于 HC 组（p = 0.035），A/E 比值也明显高于 HC 组（p<0.001）。此外，多发亚组中无活性 ALDH2 的个体比例明显高于单发亚组（p = 0.015），A/E 比值也明显高于单发亚组（p = 0.008）。总之，ABT 可能是一种潜在的筛查工具，可用于检测 ESCC 和 HPSCC 高危人群。此外，它还可以作为 ESCC 和 HPSCC 患者中检测多发性或双癌风险患者的有用工具。试验注册：试验注册号：UMIN000040615[https://rctportal.niph.go.jp/en/detail?trial_id=UMIN000040615]，数据注册日期：2020 年 6 月 1 日，回顾性注册。
