Exploration Of Compound Risk Factors And Metabolic Markers For Esophageal Cancer

Objective:（1）Describe the mortality and changing trends of major diseases in the Linxian nutrition intervention trial’s general population,analyze factors influencing esophageal cancer mortality using 30-year follow-up data,and provide insights for primary prevention of esophageal cancer.（2）Identify metabolic tumor markers for esophageal cancer using blood specimens from the cohort population and assess their predictive potential in conjunction with esophageal cancer risk factors.Methods:The study utilized baseline and 30-year follow-up data from the NIT general population cohort to analyze factors influencing esophageal cancer mortality using logistic models.Esophageal metabolomics was conducted using blood specimens collected from the cohort during 1999-2000.A subset of patients with esophageal cancer and healthy controls were selected for further analysis using liquid chromatography mass spectrometry.Tumor marker combinations were identified and combined with risk factors for analysis using logistic models.Results:Esophageal cancer is the main malignant tumor in Linxian,exhibits a mortality trend in the cohort population that aligns with esophageal cancer mortality.Subgroup analysis reveals significantly higher mortality rates among men（531.24/100,000）compared to women（380.28/100,000）.Furthermore,the high age group exhibits a substantially greater mortality rate（730.82/100,000）than the young age group（347.43/100,000）.Risk factors for esophageal cancer include advancing age,male gender,overweight status,smoking,and a family history of upper gastrointestinal tract tumors.Conversely,increasing the consumption of fresh vegetables and fruits,meat and eggs,improving individual education,and residing in mountainous areas act as protective factors against esophageal cancer.The identified combination of metabolic markers for esophageal cancer in this study includes LPC 18₀,Choline,PC 38₅,and Decatrienoylcarnitine.The prediction model comprising these three markers demonstrates an AUC of 0.787,sensitivity of approximately 0.68,and specificity of around 0.78.Conclusion:In this study,smoking and being overweight were identified as the key modifiable risk factors affecting esophageal cancer mortality.Health education interventions targeting these factors can contribute to primary prevention efforts.Additionally,the investigation of tumor marker combinations for esophageal cancer holds promise for early detection and screening,offering potential avenues for cost-effective non-invasive methods.These findings have important implications for secondary prevention strategies and carry significant public health significance.