Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Japan.
Department of General Internal Medicine 2, Kawasaki Medical School, Japan.
Intern Med. 2024 Nov 15;63(22):3019-3024. doi: 10.2169/internalmedicine.2950-23. Epub 2024 Apr 2.
Objective Esophageal cancer is a gastrointestinal cancer with a poor prognosis. However, it is curable and can be treated endoscopically if it is detected at an early stage. The objective of this study was to identify the factors that contribute to early detection. Methods From April 2011 to December 2019, we retrospectively investigated consecutive patients diagnosed with esophageal squamous cell carcinoma (ESCC) through upper gastrointestinal endoscopy at two hospitals of Kawasaki Medical University based on medical records. The factors contributing to the early detection of ESCC were investigated by comparing patients with ESCC with those undergoing health checkups in whom no organic lesions were found in the upper gastrointestinal tract on endoscopy (controls). Patients Factors contributing to early detection were examined in 402 ESCC cases and 391 sex- and age-matched controls, and early and advanced cancers were compared along with the risk factors for ESCC. Results A multivariate analysis showed that alcohol consumption and smoking, concomitant cancer of other organs, and a low body mass index (BMI) were factors associated with ESCC (odds ratio [OR], 4.65; 95% confidence interval [CI], 2.880-7.520, OR, 3.63; 95% CI, 2.380-5.540, OR, 2.09; 95% CI, 1.330-3.270, OR, 6.38; 95% CI, 3.780-10.800), whereas dyslipidemia was significantly less common in patients with ESCC (OR, 0.545; 95% CI, 0.348-0.853). Comparing early and advanced cancers, a history of endoscopic screening was the only factor involved in early detection (OR, 7.93; 95% CI, 4.480-14.000). Conclusion The factors associated with ESCC include alcohol consumption, smoking, concomitant cancer of other organs, and a low BMI. Endoscopy in subjects with these factors may therefore be recommended for the early detection of ESCC.
食管癌是一种预后不良的胃肠道癌症。然而，如果在早期发现，它是可以治愈的，可以通过内镜进行治疗。本研究的目的是确定有助于早期发现的因素。
从 2011 年 4 月至 2019 年 12 月，我们根据病历，对在川崎医科大学的两家医院通过上消化道内镜诊断为食管鳞状细胞癌（ESCC）的连续患者进行了回顾性调查。通过比较内镜检查时在上消化道未发现器质性病变的 ESCC 患者（对照组）和健康检查患者，研究了 ESCC 早期发现的相关因素。
我们对 402 例 ESCC 病例和 391 例性别和年龄匹配的对照组进行了患者因素检查，并比较了早期和晚期癌症以及 ESCC 的危险因素。
多因素分析显示，饮酒和吸烟、其他器官的合并癌以及低体重指数（BMI）是与 ESCC 相关的因素（比值比[OR]，4.65；95%置信区间[CI]，2.880-7.520，OR，3.63；95%CI，2.380-5.540，OR，2.09；95%CI，1.330-3.270，OR，6.38；95%CI，3.780-10.800），而 ESCC 患者的血脂异常明显较少（OR，0.545；95%CI，0.348-0.853）。比较早期和晚期癌症，内镜筛查史是唯一涉及早期发现的因素（OR，7.93；95%CI，4.480-14.000）。
与 ESCC 相关的因素包括饮酒、吸烟、其他器官的合并癌和低 BMI。因此，对于具有这些因素的患者，可能建议进行内镜检查以早期发现 ESCC。
