Introduction

Increases in the rates of esophageal adenocarcinoma (EAC) have paralleled rises in the prevalence of overweight and obesity. Despite not being fully understood, obesity-related EAC seems to have different carcinogenic pathways.

Areas covered

This comprehensive review will thoroughly evaluate the current literature, describing the underlying mechanisms that help understanding the strong association between obesity and esophageal cancer.

Expert commentary

The risk of esophageal cancer among obese individuals could be partially explained by several factors: high prevalence of GERD; linear association between central adiposity and Barrett´s esophagus development; low levels of adiponectin and high levels of leptin that alter cell proliferation processes; insulin-resistant state that creates a tumorigenesis environment; and changes in the esophageal microbiota due to unhealthy dietary habits that promote carcinogenesis. In addition, a large proportion of obese patients are undergoing sleeve gastrectomy which can worsen GERD or cause de novo reflux, esophagitis, and Barrett´s metaplasia.

中文翻译：

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肥胖和食管癌：胃食管反流病、巴雷特食管和分子致癌途径。

介绍

食管腺癌 (EAC) 发病率的增加与超重和肥胖症患病率的增加同步。尽管尚未完全了解，与肥胖相关的 EAC 似乎具有不同的致癌途径。

涵盖的领域

这篇全面的综述将彻底评估当前的文献，描述有助于理解肥胖与食道癌之间密切关联的潜在机制。

专家评论

肥胖个体患食道癌的风险可以部分解释为以下几个因素：GERD 的高患病率；中心性肥胖与 Barrett 食管发育之间的线性关系；改变细胞增殖过程的低水平脂联素和高水平瘦素；产生肿瘤发生环境的胰岛素抵抗状态；由于促进致癌的不健康饮食习惯引起的食道微生物群变化。此外，很大一部分肥胖患者正在接受袖状胃切除术，这可能会使 GERD 恶化或导致重新出现反流、食管炎和 Barrett 化生。