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Chen SB, Liu DT, Chen YP. Prognostic Value of Body Mass Index Stratified by Alcohol Drinking Status in Patients With Esophageal Squamous Cell Carcinoma. Front Oncol 2022; 12:769824. [PMID: 35251960 PMCID: PMC8891140 DOI: 10.3389/fonc.2022.769824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/31/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The goal of this study was to investigate the prognostic value of body mass index (BMI) in patients with esophageal squamous cell carcinoma (ESCC) when stratified by alcohol drinking status. METHODS A total of 620 patients with ESCC who underwent esophagectomy were analyzed. A receiver operating characteristic curve was constructed to set the appropriate cutoff point for BMI. Alcohol drinking was divided into ever and never. Kaplan-Meier and multivariate Cox regression analyses were conducted to investigate the association between clinicopathological factors and survival. RESULTS The cutoff point was 18.75 kg/m2 for BMI. Two hundred and twenty-nine patients were ever drinkers, while the other 391 patients were never drinkers. The ever drinker group was found to have more males, longer tumor lengths, advanced pT category disease, advanced pN category disease, and lower tumor locations. However, no significant difference in BMI was found between ever drinkers and never drinkers. For ever drinkers, low BMI was significantly correlated with worse overall survival (hazard ratio = 1.690; P=0.035) and cancer-specific survival (hazard ratio = 1.763; P=0.024) than high BMI after adjusting for other factors. However, BMI was not a prognostic factor in univariate and multivariate analyses for never drinkers. CONCLUSIONS BMI is a prognostic factor only in ever drinkers with ESCC but not in never drinkers. Further studies are needed to elucidate the mechanism underlying the effect of the interaction between BMI and alcohol consumption on the prognosis of patients with ESCC.
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Affiliation(s)
- Shao-bin Chen
- Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Di-tian Liu
- Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Yu-ping Chen
- Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College, Shantou, China
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Cho JH, Shin CM, Han KD, Yoon H, Park YS, Kim N, Lee DH. Abdominal obesity increases risk for esophageal cancer: a nationwide population-based cohort study of South Korea. J Gastroenterol 2020; 55:307-316. [PMID: 31792601 DOI: 10.1007/s00535-019-01648-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 11/18/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND The relationship between overall obesity, as measured by body mass index (BMI) and risk of esophageal squamous cell carcinoma (ESCC) has been reported to show a negative correlation. However, the relationship of ESCC, which accounts for around 90% of esophageal cancers in South Korea, with abdominal obesity, as measured by waist circumference (WC), may be different. Thus, we investigated the association between abdominal obesity and esophageal cancer in a nationwide population-based cohort. METHODS A retrospective cohort study of 22,809,722 individuals who had undergone regular health check-ups provided by the National Health Insurance Corporation between 2009 and 2012 (median follow-up period, 6.4 years) in South Korea was conducted. Abdominal obesity was defined as a WC > 90 cm for men and > 85 cm for women. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using χ2 test and Cox proportional hazards model adjusted for confounding factors. The primary outcome was newly developed esophageal cancer. RESULTS After adjusting for BMI, abdominal obesity increased the risk of esophageal cancer (HR 1.29, 95% CI 1.23-1.36). WC increased the risk for esophageal cancer in a dose-dependent manner (p values for trend < 0.0001). Among overweight (BMI 23-24.9 kg/m2) and obese I (BMI 25-29.9 kg/m2) individuals, abdominal obesity was a risk factor for esophageal cancer (HR 1.22, 95% CI 1.11-1.34; HR 1.28, 95% CI 1.18-1.39, respectively). CONCLUSION Increasing abdominal obesity may be associated with an increased risk for esophageal cancer. Further studies are warranted to confirm the relationship.
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Affiliation(s)
- Jae Ho Cho
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, 13620, Republic of Korea
| | - Cheol Min Shin
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, 13620, Republic of Korea
| | - Kyung-Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Hyuk Yoon
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, 13620, Republic of Korea
| | - Young Soo Park
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, 13620, Republic of Korea
| | - Nayoung Kim
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, 13620, Republic of Korea
| | - Dong Ho Lee
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, 13620, Republic of Korea.
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Yang X, Zhang T, Yin X, Yuan Z, Chen H, Plymoth A, Jin L, Chen X, Lu M, Ye W. Adult height, body mass index change, and body shape change in relation to esophageal squamous cell carcinoma risk: A population-based case-control study in China. Cancer Med 2019; 8:5769-5778. [PMID: 31369212 PMCID: PMC6746109 DOI: 10.1002/cam4.2444] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 07/13/2019] [Accepted: 07/15/2019] [Indexed: 12/24/2022] Open
Abstract
The relationship between risk of esophageal squamous cell carcinoma (ESCC) and adult height, changes in individual body mass index (BMI) and body shape is not established. We performed a large population‐based case‐control study, which enrolled a total of 1414 ESCC cases and 1989 controls in a high‐incidence area in China. Using face‐to‐face interview with a structured questionnaire, information on participants' heights, weights, and perceived body shapes at 20 years of age was collected. Additionally, data on weight and perceived body shape among the same participants 10 years prior to ascertainment were collected using the same method. Odd ratios (ORs) of ESCC risk in relation to BMI and body shape were estimated using unconditional logistic regression models. The adjusted results indicated that ESCC risk in adults rapidly rose as height increased, plateauing at 170 cm among men and 157 cm among women. Among participants who were underweight, normal weight, or thinner than body shape 4, body weight loss was associated with increased risk of ESCC, and body weight gain was associated with decreased incidence of ESCC (ORs ranging from 0.40 to 0.76). Notably, however, changes in body weight did not significantly affect ESCC risk among participants who were overweight, obese, or larger than body shape 3. Maintaining a fit body shape and a reasonable BMI is advisable and of vital importance to reduce the risk of ESCC, especially in high‐risk areas.
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Affiliation(s)
- Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
| | - Tongchao Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China
| | - Xiaolin Yin
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China
| | - Ziyu Yuan
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Hui Chen
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
| | - Amelie Plymoth
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Li Jin
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China
| | - Xingdong Chen
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China
| | - Ming Lu
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Weimin Ye
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Yang D, Li R, Wang H, Wang J, Li Y, Wang H, Wang W, Liu Z. Clinical significance of tumor necrosis factor receptor 2 in middle and lower thoracic esophageal squamous cell carcinoma. Oncol Lett 2018; 16:2971-2978. [PMID: 30127886 PMCID: PMC6096069 DOI: 10.3892/ol.2018.8998] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Accepted: 05/31/2018] [Indexed: 12/27/2022] Open
Abstract
High expression and role of tumor necrosis factor receptor 2 (TNFR2) in cancer progression and prognosis has been reported in several types of tumors. However, its role in esophageal carcinoma (EC) remains unknown. In the present study, TNFR2 expression in middle and lower thoracic esophageal squamous cell carcinoma (ESCC) was detected using immunohistochemistry (IHC). Chi-square test revealed that TNFR2 was positively correlated with invasion depth, advanced clinical stage and low differentiation degree. Furthermore, survival analysis revealed that TNFR2 was positively correlated with poor overall survival (OS). Moreover, univariate COX regression analysis revealed that clinical stage, lymph node involvement, and invasion depth can affect the OS of ESCC patients, while multivariate COX regression analysis revealed that lymph node involvement and invasion depth can affect the OS of ESCC patients. In middle thoracic ESCC patients, TNFR2 was positively correlated with invasion depth, advanced clinical stage and poor OS. Furthermore, univariate and multivariate COX regression analysis both revealed that clinical stage, lymph node involvement, and invasion depth can affect OS. In lower thoracic ESCC patients, TNFR2 was positively correlated with low differentiation degree. Furthermore, the positive correlation of TNFR2 with poor OS did not reach statistical significance. In addition, univariate COX regression analysis revealed that only lymph node involvement could affect OS. All the results suggest that TNFR2 can play an important role in the progression and poor prognosis of ESCC patients. Moreover, the role of TNFR2 in the prognosis of middle thoracic ESCC patients was earlier and stronger than in lower thoracic ESCC patients.
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Affiliation(s)
- Dong Yang
- Oncology Department, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Ruidong Li
- Oncology Department, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Huili Wang
- Oncology Department, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Junye Wang
- Oncology Department, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Ye Li
- Pathology Department, Feixian People's Hospital, Linyi, Shandong 273400, P.R. China
| | - Hongbo Wang
- Pathology Department, Juye County Hospital of Traditional Chinese Medicine, Heze, Shandong 274900, P.R. China
| | - Wei Wang
- Pathology Department, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Zifeng Liu
- Digestive Department, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
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