Achkar J P, Post A B, Achkar E, Carey W D
Department of Gastroenterology, Cleveland Clinic Foundation, Ohio.
Am J Gastroenterol. 1995 Jan;90(1):39-43.
It has been suggested that the presence of Barrett's mucosa is a marker for potential malignancy in other organs. Our objective was to study subjects with adenocarcinoma of the esophagus arising in Barrett's epithelium.
We reviewed the medical records of patients with esophageal adenocarcinoma, with esophageal squamous cell carcinoma, and with no esophageal pathology and recorded the occurrence of extraesophageal malignancies and the heavy use of tobacco and alcohol.
The prevalence of extraesophageal malignancies was not higher in patients with esophageal adenocarcinoma (15%) than in patients in either control group (14% each). Patients with either type of cancer of the esophagus had higher rates of tobacco and alcohol use than normal controls (tobacco: p = 0.02 and p < 0.01 for adenocarcinoma and squamous cell carcinoma, respectively, vs. normal controls; alcohol: p < 0.01 for each esophageal malignancy vs. normal controls). The rate of tobacco and alcohol use was higher in patients with esophageal squamous cell carcinoma than in those with adenocarcinoma, but only the difference in alcohol consumption was statistically significant (p < 0.01).
Patients with adenocarcinoma of the esophagus are not at higher risk for development of extraesophageal malignancy. This observation applies to both those with and without underlying Barrett's epithelium. Alcohol and tobacco use appear to be related to the malignant transformation of esophageal epithelium.
有人提出，巴雷特黏膜的存在是其他器官潜在恶性肿瘤的一个标志物。我们的目的是研究起源于巴雷特上皮的食管腺癌患者。
我们回顾了食管腺癌患者、食管鳞状细胞癌患者以及无食管病变患者的病历，并记录了食管外恶性肿瘤的发生情况以及烟草和酒精的大量使用情况。
食管腺癌患者中食管外恶性肿瘤的患病率（15%）并不高于任何一个对照组患者（均为14%）。两种类型的食管癌患者的烟草和酒精使用率均高于正常对照组（烟草：腺癌和鳞状细胞癌与正常对照组相比，p分别为0.02和<0.01；酒精：每种食管恶性肿瘤与正常对照组相比，p均<0.01）。食管鳞状细胞癌患者的烟草和酒精使用率高于腺癌患者，但只有酒精消费差异具有统计学意义（p<0.01）。
食管腺癌患者发生食管外恶性肿瘤的风险并不更高。这一观察结果适用于有和没有潜在巴雷特上皮的患者。酒精和烟草使用似乎与食管上皮的恶性转化有关。
