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Abstract
Shantou, China, is one of the endemic regions of esophageal cancer (EC) in the coastal
areas, but the relationship between the multiple exposures of total N-nitroso compounds
(TNOCs) and the high risk of EC to date is unclear. This study is to estimate the
potential integrative role of multiple exposures of environmental and endogenous TNOC
on the EC risk. We collected randomly the samples of 72 h diet and 24 h urine from
256 healthy male (aged 30-65 years) in the high- and low-risk area for EC, and determined
the contents of TNOC and 4 N-nitrosamino acids (NAAs) by a method of chemical fission-Thermal
Energy Analyzer (TEA) and gas chromatography--TEA, respectively. We used TNOC and
NAAs index to evaluate the integrative effect of multiple TNOC exposures on the EC
risk by a logistic model. TNOC intake and urinary TNOC content were higher in the
high-risk subjects than that in the low-risk subjects by 1.60 micromol/day and 1.45
micromol/L, respectively. TNOC intake, urinary TNOC content and its interaction were
significant factors involved in the higher risk of EC (R(2)=0.685, p=0.000) with predicted
Correct Class of 85.6%. The risk of the occurrence of a larger SMR of EC may increase
by 4.841-fold for every 1 micromol/day increase in TNOC intake (95% CI 2.370-9.888,
p=0.000) and by 4.113-fold for every 1 micromol/L increase in urinary TNOC content
(95% CI 2.108-8.023, p=0.000), respectively. The integrally role of multiple exposures
of TNOC in environment and in vivo may increase the risk of EC in the coastal areas
in eastern Guangdong, China.