Risk Factors for Esophageal Squamous Cell Carcinoma in Patients with Head and Neck Squamous Cell Carcinoma

Abstract

Background. Esophageal squamous cell carcinoma (ESCC) is a common second primary neoplasia in patients with a history of head and neck squamous cell carcinoma (HNSCC). The aim of this study was to provide further information and novel insights into the risk factors for ESCC in patients with HNSCC. Methods. We retrospectively analyzed 98 HNSCC patients diagnosed from 2007 to 2017, 30 HNSCC patients suffering from ESCC, who had undergone endoscopic examination because of positive imaging examinations or symptoms, and 68 HNSCC patients who had no ESCC occurrence for at least six years post-HNSCC diagnosis. Associated clinicopathological data and lifestyle information of the ESCC group and the without ESCC group were collected, and a case-control study of risk factors was analyzed between the two groups. Results. The majority (83.4%) of the cases with HNSCC esophageal cancers were male patients over 50 years. We established that 93.75% (30/32) of the ESCC occurred within six years after HNSCC diagnosis. HNSCC location, stage, and radiotherapy history had no significant association with the development of ESCC. High Ki67 labeling index (Ki67 LI) (>46) patients tended to be 3.1 times (95% CI = 1.3–7.6) more likely to develop ESCC compared to low Ki67 LI (≤45) patients ( P < 0.05 ). Drinkers with alcohol flushing response were at a 3.3 times higher risk to have ESCC (95% CI = 1.0–10.4) than drinkers without flush response ( P < 0.05 ). Conclusions. HNSCC patients, especially drinkers with an alcohol flushing response, as well as those with high Ki67 LI of HNSCC tissue, were more likely to develop ESCC.

Advances in traditional Chinese herbal medicine and their pharmacodynamic mechanisms in cancer immunoregulation: a narrative review

“…Some CHM including CHM monomers (e.g., polysaccharides, icariin, and Huaier extract), CHM compound prescriptions (e.g., Anfei decoction and compound yin-nourishing and yang-warming recipe), and CHM patent medicines (e.g., Xihuang pills) can induce the transformation of the immune balance and enhance antitumor immunity. In addition, the regulatory T cells (Tregs) can inhibit APCs through cytotoxic T lymphocyte antigen-4 (CTLA-4); by secreting inhibitory cytokines [e.g., IL-10, tumor growth factor-beta (TGF-β), and IL-35], expressing granzyme/perforin, and consuming IL-2, Tregs exert their immunosuppressive function, and are thus one of the major mechanisms of tumor escape from the immune system ( 59 ). Some CHM monomers and compound prescriptions can also inhibit the expression of Tregs ( Table 3 ).…”