胃と腸45巻2号

2010年02月発行

今月の主題 中・下咽頭表在癌の診断と治療

主題

中・下咽頭領域の表在癌の危険因子―アルコール依存症男性の内視鏡検診に基づく症例対照研究

著者： 横山顕¹ 大森泰² 横山徹爾³ 佐藤靖夫⁴ 川久保博文² 森朱夏¹ 松井敏史¹ 丸山勝也¹

所属機関： ¹国立病院機構久里浜アルコール症センター内科 ²川崎市立川崎病院外科 ³国立保健医療科学院人材育成部 ⁴川崎市立川崎病院耳鼻咽喉科

ページ範囲：P.180 - P.189

文献概要

要旨　アルコール依存症患者の口腔咽喉癌の症例対照研究を行った．内視鏡による口腔咽喉観察と食道ヨード染色を併用した5,210例の初回内視鏡検診から診断された55例の口腔咽喉癌〔43例は中・下咽頭癌（EP14例，SEP19例，より深い浸潤10例），13例は舌・口底・歯肉・声帯の癌（1例は中・下咽頭癌と重複）〕を対象症例とした．年齢と初回検診時期を1対5でマッチさせた275例を対照とした．中・下咽頭癌の危険因子は食道癌と類似し，ALDH2へテロ欠損型の非常に強い影響（odds比6.66）と，ADH1Bホモ低活性型（odds比3.15），フラッシャー（odds比2.71），赤血球MCVの増大（odds比3.60），高度の喫煙（odds比2.08）の影響がみられた．口腔咽喉癌全体でも類似のリスクを示したが，舌・口底・歯肉・声帯の癌でこれらの因子の影響は明らかでなかった．

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