the changing face of esophageal cancer食道癌的改变的脸.pdfVIP

Cancers 2010, 2, 1379-1404; doi:10.3390/cancers2031379 OPEN ACCESS cancers ISSN 2072-6694 /journal/cancers Review The Changing Face of Esophageal Cancer Rachel E. Melhado *, Derek Alderson and Olga Tucker Academic Department of Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, UK; E-Mails: Derek.Alderson@uhb.nhs.uk (D.A.); Olga.Tucker@uhb.nhs.uk (O.T.) * Author to whom correspondence should be addressed; E-Mail: raye732001@yahoo.co.uk or Rachel.Melhado@uhb.nhs.uk; Tel.: +44-0121-627-1627. Received: 17 June 2010; in revised form: 24 June 2010 / Accepted: 24 June 2010 / Published: 28 June 2010 Abstract: The two main histological esophageal cancer types, adenocarcinoma and squamous cell carcinoma, differ in incidence, geographic distribution, ethnic pattern and etiology. This article focuses on epidemiology with particular reference to geographic and temporal variations in incidence, along with a review of the evidence supporting environmental and genetic factors involved in esophageal carcinogenesis. Squamous cell carcinoma of the esophagus remains predominantly a disease of the developing world. In contrast, esophageal adenocarcinoma is mainly a disease of western developed societies, associated with obesity and gastro-esophageal reflux disease. There has been a dramatic increase in the incidence of adenocarcinoma in developed countries in parallel with migration of both esophageal and gastric adenocarcinomas towards the gastro-es