食道癌的病因及其基因相關的研究

Study of etiology and its associated genes in esophageal cancer

陳玉桂(Yu-Kuei Chen)

指導教授 ： 黃俊雄 ； 吳明蒼&nbsp

高雄醫學大學/醫學院/醫學研究所/博士(2010年)

摘要

本研究目的是為了探討食物與發生在三個不同部位的食道癌之間的相關性。本研究對象是收集自西元1996年至西元2005年間的344位食道麟狀上皮細胞癌的病患及755位健康對照者。研究發現蔬菜、生洋蔥/大蒜及水果對於食道麟狀上皮細胞癌有顯著的保護作用，吃燙口的食物，使得到食道癌的危險性增加。而且，茶葉的攝取頻率與食道麟狀上皮細胞癌呈現負相關 (p for trend = 0.005)。喝不發酵茶或混合性茶葉 (不發酵茶及發酵茶都喝) 者與不喝茶葉者比較，對食道癌的發生具有保護作用(OR=0.5; 95%CI=0.2-0.5)，達統計上顯著差異。根據食物對發生在不同部位的食道癌的保護作用及危險性分析發現，咖啡對於發生在中1/3的食道麟狀上皮細胞癌相對於發生在下1/3的食道癌有明顯的保護作用 (AOR= 0.4; 95%CI=0.2-0.9)。我們研究結果推測燙口的食物可能直接刺激食道黏膜而致癌，而導致癌症發生在食道上1/3的危險性高於發生在食道下1/3。相對的，蔬菜、水果和茶葉的抑癌成分可能被吸收後對發生在三個部位的食道癌都具保護作用。我們的研究結果特定食物中的成分可能會有局部的影響，有一些也會造成系統性的影響。

關鍵字

食道癌 ； 熱食 ； 蔬菜 ； 水果 ； 茶葉 ； 咖啡 ； 位置

並列摘要

The main objective of this study was to further elucidate the effect of consuming various foods on the development of squamous-cell carcinoma (SCC) in three different sections of the esophagus. A total of 343 cases with SCC of esophagus and 755 cancer-free controls were recruited for this study between 1996 and 2005. We found that intake of vegetables, raw onions/ garlic and fruits are significantly protect against esophageal SSC risk, whereas intake of hot foods can significantly increase its risk. There was a significant inverse relationship between the frequency of tea consumption and esophageal SCC risk (p for trend = 0.005), with a 0.5-fold lower risk associated with the intake of unfermented tea (green tea, oolong tea or jasmine tea). The effects of dietary factors on esophageal SCC were similar in all subsites, with the exception of consumption of coffee. Coffee consumption was more pronounced to have the protective effect in the middle-third section, compared to the lower-third section of the esophagus (AOR = 0.4; 95% CI = 0.2-0.9), though this protective effect was marginally significant (AOR = 0.6; 95% CI = 0.4-1.0) against esophageal SCC in all subsites. Our data also suggests that discomfort when eating hot foods may exert a carcinogenic effect by direct contact with the esophageal mucosa and tend to have more harmful effects in the upper than in the lower esophagus. In contrast, vegetables, fruits, and tea with components that are thought to inhibit carcinogenesis by absorbed components affected all subsites similarly. In conclusion, our results add additional information that certain dietary components may affect carcinogenesis locally and others by systemic exposure.

並列關鍵字

Esophageal cancer ； hot foods ； vegetables ； fruits ； tea ； coffee ； subsite

參考文獻

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