Influence of Tea Consumption on the Development of Second Esophageal Neoplasm in Patients with Head and Neck Cancer.

Yao-Kuang Wang,I-Chen Wu,Shyng-Shiou Yuan,Chie-Tong Kuo,Yu-Peng Liu,Ming-Tsang Wu,Yi-Hsun Chen,Yen-Yun Wang,Ying-Ho Lai,Wei-Chung Chen

doi:10.3390/cancers11030387

Abstract

Alcohol is an important risk factor for the development of second esophageal squamous-cell carcinoma (ESCC) in head and neck squamous-cell carcinoma (HNSCC) patients. However, the influence of tea consumption is uncertain. We prospectively performed endoscopic screening in incident HNSCC patients to identify synchronous esophageal neoplasm. In total, 987 patients enrolled between October 2008 and December 2017 and were analyzed. In vitro studies were conducted to investigate the effect of epigallocatechin gallate (EGCG) on the betel alkaloid, arecoline-stimulated carcinogenesis in two ESCC cell lines. There were 151 patients (15.3%) diagnosed to have synchronous esophageal neoplasm, including 88 low-grade dysplasia, 30 high-grade dysplasia and 33 squamous-cell carcinoma (SCC). Tea consumption was associated with a significantly lower risk of having esophageal high-grade dysplasia or SCC in HNSCC patients, especially those who were betel nut chewers, alcohol drinkers or cigarette smokers (all adjusted odds ratio were 0.5; p-values: 0.045, 0.045 and 0.049 respectively). In vitro studies indicated that EGCG suppressed arecoline-induced ESCC cell proliferation and colony formation through the inhibition of the Akt and ERK1/2 pathway in a reactive oxygen species-independent manner. In conclusion, tea consumption may protect against the development of second esophageal neoplasms among HNSCC patients, especially those who regularly consume betel nuts, alcohol and cigarettes.

Highlights

Esophageal squamous-cell carcinoma (ESCC) is one of the most common second primary cancers occurring in patients with head and neck squamous-cell carcinoma (HNSCC) [1]
Factors Associated with the Development of Synchronous Esophageal Neoplasm in HNSCC Patients
990 HNSCC patients were enrolled in this study and only three (0.3%) were women; we excluded them in our analysis and focused on men

Summary

Introduction

Esophageal squamous-cell carcinoma (ESCC) is one of the most common second primary cancers occurring in patients with head and neck squamous-cell carcinoma (HNSCC) [1]. Betel nut, and cigarette use are established risk factors for ESCC [4], but the influence of these carcinogens on the development of second ESCC in HNSCC patients is less clear. Ours was the largest study and identified alcohol drinkers, but not cigarette smokers or betel nut chewers, were at a higher risk to have second ESCC when first diagnosed as HNSCC [3]. In addition to these carcinogen exposures, tea consumption is another substance commonly discussed in the development of ESCC, but its anti-cancer effect remains inconclusive [10,11,12]. Our previous case-control study showed an inverse association between tea consumption and ESCC risk in a dose-response manner [13]

Methods

Results

Conclusion