抄録
The genetic polymorphisms of aldehyde dehydrogenase-2 (ALDH2) affect the metabolism of alcohol. The inactive ALDH2*1/2*2 heterozygote genotype increases the risk of esophageal squamous cell carcinoma because of accumulation of acetaldehyde. The aim of this prospective study was to investigate whether daily alcohol consumption and the genetic polymorphisms of ALDH2 were risk factors for esophageal squamous intraepithelial neoplasia, as low-grade intraepithelial neoplasia (LGIN) is considered to be an initial lesion of esophageal squamous cell carcinoma. Lugol chromoendoscopy was performed in 400 subjects at Showa University Hospital from January 2004 to August 2008. The effects of smoking, alcohol consumption, and ALDH2 genotype were evaluated in subjects with high-grade intraepithelial neoplasia (HGIN) , LGIN, and controls without neoplasia. Of the 400 subjects, 32 (8%) had HGIN, 21 (5%) had LGIN, and 347 (87%) were controls. There were no significant differences in the proportion of male subjects, or the prevalence of smoking, drinking, or the ALDH2*1/2*2 genotype between LGIN subjects and controls. In contrast, the prevalence of ALDH2*1/2*2 was significantly higher in HGIN (24/32, 75%) than in LGIN subjects (8/21, 38%; P = 0.007). Furthermore, the prevalence of alcohol consumption plus ALDH2*1/2*2 differed significantly between HGIN (20/25, 80%) and LGIN (3/12, 25%; P = 0.001) , while there was no significant difference between LGIN and controls. Daily alcohol consumption and the ALDH2*1/2*2 genotype were not risk factors for LGIN, however, alcohol consumption was a high-risk factor for HGIN in subjects with ALDH2*1/2*2.
