1. GUT 2012;61:1533–1537. R3 Kim Dong Hyun / Prof. Chang Young-Woon Serum ghrelin is inversely associated with risk of subsequent oesophageal squamous cell arcinoma

2. INTRODUCTION Esophageal cancer  8th most common incident cancer and the 6th most common cause of cancer-related death worldwide.  Two histological subtypes  Adenocarcinoma and squamous cell carcinoma  Striking variation by both geographical and aetiologic factors.

3. INTRODUCTION Gastric atrophy as a risk factor  Low levels of serum pepsinogen I and/or a low serum pepsinogen I:II ratio  Serological markers of gastric fundic atrophy  Increased risk of oesophageal squamous cell carcinoma (OSCC)  Ghrelin  Hormone produced in the fundic glands of the stomach

4. INTRODUCTION Goal  To investigate the association between serum ghrelin concentration and the subsequent risk of OSCC in a case-control study nested within the Alpha-Tocopherol, Beta- Carotene Cancer Prevention (ATBC) study cohort

5. METHODS Settings and Participants  A randomised, double-blind, placebo-controlled primary prevention trial.  Case (n=82)  OSCC, diagnosed through 30 April 2006  Control (n=82)  Alive and cancer-free at the time of case diagnosis and were matched to cases (1:1) on age at randomisation and date of blood draw.

6. METHODS Data & Laboratory analysis  Participants completed questionnaires at baseline (1985-1988)  General risk factors, medical history, and dietary intake  Laboratory analysis  Total ghrelin  Serum pepsinogen I and II  Helicobacter pylori serostatus

7. RESULTS

8. Baseline characteristics of the cases and controls Pearson’s Correlation 1. Ghrelin vs pepsinogen I; r = 0.16 2. Ghrelin vs pepsinogen II; r = - 0.11 3. Ghrelin vs pepsinogen I:II; r = 0.39

9. ORs and 95% CIs for the association between serum ghrelin concentration and risk of OSCC in the ATBC cohort

10. Conclusion Lower baseline concentrations of serum ghrelin were associated with an increase in risk of OSCC.