奥山智緒専門研究員の執筆した論文が、英文誌に掲載されました（Online ahead of print)。

掲載日
2021年3月9日（Online ahead of print）
雑誌名
Alcohol. 2021 Mar 9；S0741-8329(21)00033-1. doi: 10.1016/j.alcohol.2021.03.003. Online ahead of print.
著者
Okuyama C, Higashi T, Ishizu K, Takahashi M, Kusano K, Kagawa S, Saga T, Yamauchi H.
題名
Physiologically decreased F-18 fluorodeoxyglucose uptake in the lower vertebrae associated with daily drinking habit in Japanese men with alcohol flushing reaction
要旨
Alcohol flushing reaction (AFR) is known as one of risks for esophageal squamous cell cancer and scientists have been elucidating this issue. However, little attention has been given to relevant imaging features.
This study aims to investigate whether physiological 18F-fluorodeoxyglucose (FDG) uptake patterns in vertebrae are associated with drinking-habit or AFR.
Japanese male patients who underwent FDG positron emission tomography/computed tomography for evaluation of their known or suspected malignancy or inflammatory disease were asked about their drinking-habit and AFR.
Altogether, 192 patients, 139 everyday-drinkers and 53 non-drinkers were evaluated. Comparing the FDG uptake between in the thoracic region and that in the lumbar region, vertebral uptake was visually classified into 4 patterns:
Ld, dominant in lumbar region； TL, almost equal in both regions； BL, slightly higher in thoracic region (borderline pattern)； Td, dominant in thoracic region.
The uptake patterns were evaluated according to drinking-habit (everyday- or non-drinker), AFR (flusher or non-flusher) and the combination of these two factors (habit/reaction: everyday-drinker/flusher, everyday-drinker/non-flusher, non-drinker/flusher, or non-drinker/non-flusher).
There were 95 flushers (51 everyday-drinkers and 44 non-drinkers) and 97 non-flushers (88 everyday-drinkers and 9 non-drinkers). Ld, TL, BL, and Td patterns were observed in 0, 109 (56.8%), 31 (16.1%), and 52 (27.1%) patients, respectively.
Td and BL patterns were more frequently observed in everyday-drinkers compared with non-drinkers (p = 0.0467).
Though the uptake patterns did not differ between in flushers and non-flushers (p = 0.116), Td pattern was more frequently observed in everyday-drinkers/flusher (51%) compared with everyday-drinkers/non-flusher (20.5%), non-drinker/flusher (13.6%), and non-drinker/non-flusher (22.2%) (p = 0.0014).
Td pattern was observed in patients with various diseases, with higher frequency in esophageal cancer, head and neck cancer and lung cancer compared with other diseases.
In conclusion, drinking-habit and AFR were related to the vertebral uptake pattern with decreased uptake in the lumbar region in Japanese male patients.
これまでに当該研究員らは、日本人の食道癌の男性患者において、限局性の機能性骨髄がFDG-PETにて骨転移と誤診される（Bone pseudometastasis)症例がたびたび報告されることに注目し、食道癌症例と骨髄集積の関係について検討を続けてきました。
この論文では、東アジア人の食道癌には扁平上皮癌が多く、飲酒やアルデヒドデヒドロゲナーゼの低活性が食道癌や扁平上皮癌のリスクであることに注目し、飲酒歴と飲酒後のFlushing反応（アルデヒドデヒドロゲナーゼ低活性者に見られる飲酒後の顔面紅潮、動悸などの症状）の有無と、骨髄のFDG集積パターンを解析し、Flushing反応陽性の常習飲酒者において、不均一な腰椎集積の低下所見がみられやすいことを明らかにしました。
直接の原因については未解明ですが、bone pseudometastasisの要因ともかかわる重要な新知見です。