Risk of superficial squamous cell carcinoma developing in the head and neck region in patients with esophageal squamous cell carcinoma.
OBJECTIVE
Multicentric squamous dysplasia in the esophagus can be visualized by Lugol chromoendoscopy as multiple Lugol-voiding lesions (LVLs). Narrow-band imaging combined with magnifying endoscopy (NBI-ME) facilitates the detection of superficial squamous cell carcinoma within the head and neck region (HNSCC). We investigated risk factors for superficial HNSCC in patients with esophageal squamous cell carcinoma (ESCC).


METHODS
Case-control study.


METHODS
We studied 71 patients with synchronous or former ESCC. All patients underwent screening of the head and neck by NBI-ME and Lugol chromoendoscopy of the esophageal mucosa. The history of tobacco and alcohol use was documented. Genetic polymorphisms of aldehyde dehydrogenase type 2 (ALDH2) were identified by the sequence-specific primer polymerase chain reaction. Clinical factors related to superficial HNSCC were analyzed.


RESULTS
All patients with superficial HNSCC were drinkers. On univariate analysis, multiple LVLs (odds ratio [OR], 56.92; 95% confidence interval [CI] 6.93-467.38; P < .001), ALDH2-2 allele (OR, 14.48; 95% CI, 1.8-116.56; P = .01), current smoker (OR, 4.25; 95% CI, 1.44-12.57; P = .009), and smoking index ≥ 1,000 (OR, 3.45; 95% CI, 1.19-9.99; P = .02) were associated with superficial HNSCC. On multivariate analysis, multiple LVLs (OR, 61.12; 95% CI, 5.4-691.64; P = .001), ALDH2-2 allele (OR, 16.19; 95% CI, 1.15-228.06; P = .04), and current smoker (OR, 8.02; 95% CI, 1.09-59.22; P = .04) were associated with superficial HNSCC.


CONCLUSIONS
Patients with ESCC, particularly drinkers, current smokers, and those with the ALDH2-2 allele and multiple LVLs, have an increased risk of superficial HNSCC.
Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan. ckatada@med.kitasato-u.ac.jp
Chikatoshi
C
Katada
Manabu
M
Muto
Meijin
M
Nakayama
Satoshi
S
Tanabe
Katsuhiko
K
Higuchi
Tohru
T
Sasaki
Mizutomo
M
Azuma
Kenji
K
Ishido
Natsuya
N
Katada
Keishi
K
Yamashita
Masayuki
M
Nemoto
Tomotaka
T
Shibata
Takashi
T
Masaki
Makito
M
Okamoto
Wasaburo
W
Koizumi
D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000556:secondary* / Q000628:therapy; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000556:secondary* / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis