title: Soft palatal melanosis, a simple predictor for neoplasia in the upper aerodigestive tract in Japanese alcoholic men.
abstract: Soft palatal melanosis can be detected by visual inspection during routine physical examination or even personally in a mirror. The aim of this study was to evaluate the association between squamous cell neoplasia in the upper aerodigestive tract (UAT) and soft palatal melanosis. We reviewed digitized records of high-quality endoscopic images of the soft palate of 1786 Japanese alcoholic men who underwent endoscopic screening. Soft palatal melanosis was observed in 381 (21.3%) of the subjects (distinct, 6.3%). Older age, an inactive heterozygous aldehyde dehydrogenase-2 genotype, smoking, and a high mean corpuscular volume were positively associated with the presence of soft palatal melanosis. The age-adjusted odds ratio (95% confidence interval) for UAT neoplasia was 1.92 (1.40-2.64) in the group with melanosis and 2.51 (1.55-4.06) in the group with distinct melanosis, compared with the melanosis-free group. A multivariate analysis showed that the presence of soft palatal melanosis was independently associated with a high risk of UAT neoplasia. We calculated the individual number of risk factors out of four easily identifiable and significant factors: age ≥55 years, current/former alcohol flushing, mean corpuscular volume ≥106 fL, and distinct soft palatal melanosis. Compared with the risk-factor-free condition, the odds ratio (95% confidence interval) values of UAT neoplasia for one, two, three, and four risk factors were 1.49 (0.97-2.30), 3.14 (2.02-4.88), 4.80 (2.71-8.51), and 7.80 (2.17-28.1), respectively. The presence of soft palatal melanosis provides a simple new strategy for identifying heavy drinkers with a high risk for UAT neoplasia.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Kenro
authors.identifier: http://orcid.org/0000-0003-4536-7781
authors.initials: K
authors.lastname: Hirata
authors.affiliation: National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yokoyama
authors.affiliation: Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Rieko
authors.initials: R
authors.lastname: Nakamura
authors.affiliation: Endoscopy Center, Kawasaki Municipal Ida Hospital, Kawasaki, Japan.
authors.forename: Tai
authors.initials: T
authors.lastname: Omori
authors.affiliation: Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kawakubo
authors.affiliation: National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mizukami
authors.affiliation: National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Maruyama
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Kanai
authors.affiliation: Department of Health Promotion, National Institute of Public Health, Wako, Japan.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Yokoyama
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D000444:Aldehyde Dehydrogenase / Q000378:metabolism; D044466:Asian People; D006258:Head and Neck Neoplasms / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D008297:Male; D008548:Melanosis / Q000150:complications* / Q000209:etiology / Q000473:pathology*; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000209:etiology / Q000473:pathology; D016017:Odds Ratio; D010160:Palate, Soft / Q000473:pathology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
chemical_list: D000444:Aldehyde Dehydrogenase
keywords: Neoplasia; predictive factor; soft palatal melanosis; squamous cell carcinoma; upper aerodigestive tract