Risk stratification of synchronous gastric cancers including alcohol‐related genetic polymorphisms

Author:

Asonuma Sho1,Hatta Waku2ORCID,Koike Tomoyuki2,Okata Hideki1,Uno Kaname1,Iwai Wataru3,Saito Masashi3,Yonechi Makoto4,Fukushi Daisuke4,Kayaba Shoichi5,Kikuchi Ryosuke6,Ito Hirotaka7,Fushiya Jun8,Maejima Ryuhei9,Abe Yasuhiko10,Kawamura Masashi11ORCID,Honda Junya12,Kondo Yutaka13,Dairaku Naohiro14,Toda Shusuke15,Watanabe Kenta16ORCID,Takahashi Kiichi17,Echigo Hiroharu18,Abe Yasuaki19,Endo Hiroyuki20,Okata Tomoki21,Hoshi Tatsuya22,Kinoshita Kenji23,Kisoi Madoka23,Nakamura Tomohiro24,Nakaya Naoki25,Iijima Katsunori16ORCID,Masamune Atsushi2

Affiliation:

1. Department of Gastroenterology South Miyagi Medical Center Ogawara‐machi Japan

2. Division of Gastroenterology Tohoku University Graduate School of Medicine Sendai Japan

3. Department of Gastroenterology Miyagi Cancer Center Natori Japan

4. Division of Gastroenterology Tohoku Medical and Pharmaceutical University School of Medicine Sendai Japan

5. Department of Gastroenterology Iwate Prefectural Isawa Hospital Ohshu Japan

6. Department of Gastroenterology JR Sendai Hospital Sendai Japan

7. Department of Gastroenterology Osaki Citizen Hospital Osaki Japan

8. Department of Gastroenterology Iwate Prefectural Central Hospital Morioka Japan

9. Department of Gastroenterology Red Cross Ishinomaki Hospital Ishinomaki Japan

10. Department of Gastroenterology, Faculty of Medicine Yamagata University Yamagata Japan

11. Department of Gastroenterology Sendai City Hospital Sendai Japan

12. Department of Gastroenterology Iwate Prefectural Iwai Hospital Ichinoseki Japan

13. Department of Gastroenterology Tohoku Rosai Hospital Sendai Japan

14. Department of Gastroenterology Japanese Red Cross Sendai Hospital Sendai Japan

15. Department of Gastroenterology Obihiro Daiichi Hospital Obihiro Japan

16. Department of Gastroenterology Akita University Graduate School of Medicine Akita Japan

17. Department of Gastroenterology Hachinohe City Hospital Hachinohe Japan

18. Department of Gastroenterology Iwaki City Medical Center Iwaki Japan

19. Department of Gastroenterology Yamagata City Hospital Saiseikan Yamagata Japan

20. Department of Gastroenterology Japan Community Health Care Organization Sendai Hospital Sendai Japan

21. Department of Gastroenterology Iwate Prefectural Chubu Hospital Kitakami Japan

22. Department of Gastroenterology Kesennuma City Hospital Kesennuma Japan

23. Bio Education Laboratory Osaka Japan

24. Faculty of Data Science Kyoto Women's University Kyoto Japan

25. Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization Tohoku University Sendai Japan

Abstract

AbstractBackground and AimWe previously identified that ever‐smoking and severe gastric atrophy in pepsinogen are risk factors for synchronous gastric cancers (SGCs). This study aimed to determine the association of alcohol drinking status or alcohol‐related genetic polymorphism with SGCs and also stratify their risk.MethodsThis multi‐center prospective cohort study included patients who underwent endoscopic submucosal dissection for the initial early gastric cancers at 22 institutions in Japan. We evaluated the association of alcohol drinking status or alcohol dehydrogenase 1B (ADH1B) and acetaldehyde dehydrogenase 2 (ALDH2) genotypes with SGCs. We then stratified the risk of SGCs by combining prespecified two factors and risk factors identified in this study.ResultsAmong 802 patients, 130 had SGCs. Both the ADH1B Arg and ALDH2 Lys alleles demonstrated a significant association with SGCs on multivariate analysis (odds ratio, 1.77), although alcohol drinking status showed no association. The rates of SGCs in 0–3 risk factors in the combined evaluation of three risk factors (ever‐smoking, severe gastric atrophy in pepsinogen, and both the ADH1B Arg and ALDH2 Lys alleles) were 7.6%, 15.0%, 22.0%, and 32.1%, respectively. The risk significantly increased from 0 to 3 risk factors on multivariate analysis (P for trend <0.001).ConclusionsBoth the ADH1B Arg and ALDH2 Lys alleles were at high risk for SGCs. The risk stratification by these three factors may be a less invasive and promising tool for predicting their risk.

Publisher

Wiley

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