Carcinogenesis Advance Access published online on August 29, 2003
Carcinogenesis, doi:10.1093/carcin/bgg142
© 2003 by Oxford University Press
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MOLECULAR EPIDEMIOLOGY AND CANCER PREVENTION
1 National Institute on Alcoholism, Kurihama National Hospital, Yokosuka, Kanagawa 239-0841, Japan
* Corresponding author. E-mail: shiguchi{at}wa2.so-net.ne.jp.
Received 12 March 2003
; revised 20 June 2003
; accepted 4 August 2003
Early esophageal squamous cell carcinoma detected by esophageal iodine staining can be easily treated by endoscopic mucosectomy, and identifying its predictors is important in better selecting candidates to screen for this high-mortality cancer. The common etiologies of elevated mean corpuscular volume (MCV) and esophageal cancer, including folate deficiency, smoking, drinking, and high acetaldehyde exposure, suggest testing MCV as such a predictor. Japanese alcoholic men with (n = 65) and without (n = 206) esophageal squamous cell carcinomas, excluding those with liver cirrhosis, were assessed for MCV within 7 days of their last drink, alone or in combination with findings from either the alcohol flushing questionnaire or genotyping to identify inactive aldehyde dehydrogenase-2 (ALDH2*1/2*2) and the less-active form of alcohol dehydrogenase-2 (ADH2*1/2*1), which pose risks for esophageal squamous cell carcinoma. MCV was higher in cancer patients than in the control group. MCV was higher in both groups in those who were heavier smokers, had lower body mass index (BMI), experienced alcohol flushing, and had ALDH2*1/2*2. After adjusting for age, drinking and smoking habits, BMI, and ALDH2/ADH2 genotypes, macrocytosis of MCV
Macrocytosis, a new predictor for esophageal squamous cell carcinoma in Japanese alcoholic men
2 Department of Technology Assessment and Biostatistics, National Institute of Public Health, Wako, Saitama 351-0197, Japan
3 Department of Neuropsychiatry, School of Medicine, Keio University, Shinjuku-ku, Tokyo 160-8582, Japan
4 Departments of Gastroenterology and Surgery, Kawasaki Municipal Hospital, Kawasaki, Kanagawa 210-0013, Japan
5 Department of Internal Medicine, School of Medicine, Keio University, Shinjuku-ku, Tokyo 160-8582, Japan
106 fl was associated with increased risk for esophageal cancer (OR = 2.75). Men with both MCV 106 fl and alcohol flushing had an even higher cancer risk (OR = 5.51). The combinations of MCV 106 fl with ALDH2*1/2*2 or ADH2*1/2*1 alone, and both ALDH2*1/2*2 and ADH2*1/2*1 (ORs = 11.44, 21.22, and 319.7, respectively) showed consistently higher risk than the corresponding group with MCV <106 fl (ORs = 7.24, 4.71, and 27.01, respectively). In conclusion, MCV measurement, alone or in combination with the markers of alcohol sensitivity, provides a new means of predicting risk for esophageal squamous cell carcinoma in Japanese alcoholic men.
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