Objective: To investigate the association between the whole blood riboflavin level and the occurrence, development and prognosis of esophageal squamous cell carcinoma (ESCC) in China. Methods: From March 2014 to September 2018, ESCC patients from three hospitals (the Affiliated Hospital of Medical College of Shantou University, Shantou Central Hospital in Southern Chaoshan area and First Affiliated Hospital of Zhengzhou University in Northern Taihang Mountain) were selected as a case group; non-esophageal patients who had a physical examination were selected as a control group. The case and control group were paired by age (±5 years) and a 1:1 ration. A total of 1 528 subjects were enrolled including 764 patients in the case group and 764 patients in the control group. About 3-5 ml venous blood samples were collected, and the erythrocyte glutathione reductase activity coefficient (GRAC) was measured to assess the whole blood riboflavin level. A multivariate conditional logistic regression model was used to analyze the association between the GRAC and the risk of ESCC. The association between the GRAC and the prognosis of ESCC was analyzed by using Cox proportional risk regression model based on 288 patients with complete survival data. They were divided into two groups, the high GRAC group (GRAC≥7.87) group and the low GRAC group (GRAC<7.87) according to the strongest correlation between the total survival time, survival outcome and GRAC (GRAC=7.87). Results: Among the 1 528 patients, 958 patients were from Southern Chaoshan area, including 479 patients in the case group with an average age about (59.90±9.34) years and 479 patients in the control group with an average age about (59.55±8.77) years. Other 570 patients were from Northern Taihang Mountain area, including 285 patients in the case group with an average age (58.39±5.19) years and 285 patients in the control group with an average age about (58.74±4.57) years. The multivariate conditional logistic regression showed that the OR (95%CI) of the GRAC and the risk of ESCC was 1.009 (0.998-1.019). The Cox proportional hazard regression model analysis showed that the HR (95%CI) of the high GRAC group was 1.712 (1.034-2.824) compared with the low GRAC group in the 50-70 years group. Conclusion: The whole blood riboflavin level might not be associated with the occurrence of ESCC. The high whole blood riboflavin level would be more beneficial to the prognosis of ESCC patients aged 50-70 years.
目的： 探讨全血核黄素水平与食管鳞癌（ESCC）发生发展的关联。 方法： 采用病例对照的研究方法，于2014年3月至2018年9月，选取在南方潮汕地区的汕头大学医学院附属医院、汕头市中心医院和北方太行山地区的郑州大学第一附属医院就诊的ESCC患者为病例组；以在该医院体检的非ESCC患者为对照组，对照组按照年龄（±5岁）、性别进行1∶1匹配。最终共纳入1 528例研究对象，病例组和对照组各764例。采集研究对象的静脉血3~5 ml，检测红细胞谷胱甘肽还原酶活性系数（GRAC）代表血核黄素水平。采用多因素条件logistics回归模型分析GRAC与ESCC患病风险的关联；以生存资料完整的288例患者为研究对象，根据总生存期、生存结局与GRAC的关联最强点（GRAC=7.87）将研究对象分为两组：高谷胱甘肽还原酶组（GRAC≥7.87）和低GRAC组（GRAC<7.87），采用Cox比例风险回归模型分析GRAC与ESCC预后的关联。 结果： 1 528例研究对象中，南方潮汕地区958例，病例组和对照组分别有479例，年龄分别为（59.90±9.34）、（59.55±8.77）岁；北方太行山地区共570例，病例组和对照组分别有285例，年龄分别为（58.39±5.19）、（58.74±4.57）岁。多因素条件logistic回归模型分析结果显示，GRAC与ESCC患病风险OR（95%CI）值为1.009（0.998~1.019）；Cox比例风险回归模型分析结果显示，50~70岁年龄组中，与低GARC组相比，高GARC组的死亡风险HR（95%CI）值为1.712（1.034~2.824）。 结论： 全血核黄素水平与ESCC的发生可能没有关联；高全血核黄素水平利于50~70岁ESCC患者的预后。.
Keywords: Case-control studies; Esophageal neoplasms; Riboflavin.