Multiple primary esophageal and concurrent upper aerodigestive tract cancer and the aldehyde dehydrogenase-2 genotype of Japanese alcoholics

Akira Yokoyama, Taro Muramatsu, Tai Ohmori, Hiroyasu Makuuchi, Susumu Higuchi, Sachio Matsushita, Keiichi Yoshino, Katsuya Maruyama, Masayuki Nakano, Hiromasa Ishii

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

BACKGROUND. Multiple intraesophageal primary cancer and upper aerodigestive tract (UADT) cancer associated with esophageal cancer are common diseases, especially in heavy drinkers. They are often explained by the concept of field cancerization, which suggests a similar etiology. However, little is known about the nature of the hypothesized etiology. METHODS. Among 901 Japanese male alcoholics systematically screened by upper gastrointestinal endoscopy (with esophageal iodine staining), 33 had squamous cell carcinoma of the esophagus. The multiplicity of their esophageal carcinoma and their concurrent UADT cancer was compared with their genotype for aldehyde dehydrogenase-2 (ALDH2), the major determinant of blood acetaldehyde concentration after drinking. RESULTS. Of 17 patients with inactive ALDH2, 13 (76.5%) had multiple primary carcinoma of the esophagus, whereas 5 of 16 (31.3%) with active ALDH2 had multiple carcinomas (P < 0.01). The prevalence of concurrent UADT cancer was 29.4% in those patients with inactive ALDH2, compared with 6.3% in those patients with active ALDHZ. CONCLUSIONS. Inactive ALDH2 is a risk factor for multiple carcinoma of the esophagus in alcoholics. Acetaldehyde, a recognized animal carcinogen, appears to play a critical role in field cancerization.

Original languageEnglish
Pages (from-to)1986-1990
Number of pages5
JournalCancer
Volume77
Issue number10
DOIs
Publication statusPublished - 1996 May 15
Externally publishedYes

Fingerprint

Aldehyde Dehydrogenase
Alcoholics
Genotype
Esophagus
Carcinoma
Acetaldehyde
Neoplasms
Gastrointestinal Endoscopy
Esophageal Neoplasms
Iodine
Carcinogens
Drinking
Squamous Cell Carcinoma
Staining and Labeling

Keywords

  • acetaldehyde
  • alcohol
  • aldehyde dehydrogenase
  • esophagus
  • field cancerization
  • multiple carcinoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Multiple primary esophageal and concurrent upper aerodigestive tract cancer and the aldehyde dehydrogenase-2 genotype of Japanese alcoholics. / Yokoyama, Akira; Muramatsu, Taro; Ohmori, Tai; Makuuchi, Hiroyasu; Higuchi, Susumu; Matsushita, Sachio; Yoshino, Keiichi; Maruyama, Katsuya; Nakano, Masayuki; Ishii, Hiromasa.

In: Cancer, Vol. 77, No. 10, 15.05.1996, p. 1986-1990.

Research output: Contribution to journalArticle

Yokoyama, Akira ; Muramatsu, Taro ; Ohmori, Tai ; Makuuchi, Hiroyasu ; Higuchi, Susumu ; Matsushita, Sachio ; Yoshino, Keiichi ; Maruyama, Katsuya ; Nakano, Masayuki ; Ishii, Hiromasa. / Multiple primary esophageal and concurrent upper aerodigestive tract cancer and the aldehyde dehydrogenase-2 genotype of Japanese alcoholics. In: Cancer. 1996 ; Vol. 77, No. 10. pp. 1986-1990.
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AU - Higuchi, Susumu

AU - Matsushita, Sachio

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AB - BACKGROUND. Multiple intraesophageal primary cancer and upper aerodigestive tract (UADT) cancer associated with esophageal cancer are common diseases, especially in heavy drinkers. They are often explained by the concept of field cancerization, which suggests a similar etiology. However, little is known about the nature of the hypothesized etiology. METHODS. Among 901 Japanese male alcoholics systematically screened by upper gastrointestinal endoscopy (with esophageal iodine staining), 33 had squamous cell carcinoma of the esophagus. The multiplicity of their esophageal carcinoma and their concurrent UADT cancer was compared with their genotype for aldehyde dehydrogenase-2 (ALDH2), the major determinant of blood acetaldehyde concentration after drinking. RESULTS. Of 17 patients with inactive ALDH2, 13 (76.5%) had multiple primary carcinoma of the esophagus, whereas 5 of 16 (31.3%) with active ALDH2 had multiple carcinomas (P < 0.01). The prevalence of concurrent UADT cancer was 29.4% in those patients with inactive ALDH2, compared with 6.3% in those patients with active ALDHZ. CONCLUSIONS. Inactive ALDH2 is a risk factor for multiple carcinoma of the esophagus in alcoholics. Acetaldehyde, a recognized animal carcinogen, appears to play a critical role in field cancerization.

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