Poor oral health is associated with an increased risk of esophageal squamous cell carcinoma - a population-based case-control study in China
Poor oral health is associated with an increased risk of esophageal squamous cell carcinoma - a population-based case-control study in China
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口腔健康状况不佳与食管鳞状细胞癌风险增加相关：中国的一项基于人群的病例对照研究
DOI：
10.1002/ijc.30484
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发表时间：
2017-02-01
影响因子：
6.4
通讯作者：
Ye, Weimin
中科院分区：
文献类型：
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作者：
Chen, Xingdong;Yuan, Ziyu;Ye, Weimin
为了进一步研究口腔卫生与食管鳞状细胞癌（ESCC）风险之间的关系以及其他暴露的影响，我们在2010年至2012年期间在中国泰兴（ESCC的高危地区）进行了一项基于人群的病例对照研究。病例主要从当地医院的内窥镜检查部门招募，并与当地癌症登记处联系。对照组受试者按性别和年龄（5岁组）与病例频率匹配，并从泰兴人口登记处随机选择。对于当前的分析，分析了616例组织病理学确诊病例和770例对照组的数据，这些病例和对照组具有完整的口腔卫生信息。非条件logistic回归模型，包括口腔卫生指标和潜在的行为混杂因素，用于推导比值比（OR）和95%置信区间（CI）。牙齿缺失与ESCC风险仅轻微显著相关（是与否，OR=1.29，95%CI 0.94-1.74）。然而，随着牙齿脱落数量的增加，过度风险增加（牙齿脱落超过6颗与无牙齿，OR=1.48，95%CI 1.04-2.11）。每天刷牙一次或更少，与每天刷牙两次或更多次相比，与ESCC风险增加1.81倍相关。在分层分析中，与这些口腔健康指标相关的风险增加在老年受试者（年龄70岁）、女性、非吸烟者和非饮酒者中更为明显。需要进一步的研究来验证这些发现并探索潜在的机制，例如，改变了口腔微生物群，与口腔卫生不良有关。有什么新情况？食管鳞状细胞癌（ESCC）的发病率高的地区的病因知之甚少。酒精和吸烟似乎不能完全解释这一现象。在这项研究中，作者发现，在中国泰兴地区，口腔健康状况不佳与食管癌的高发病率有关。更好的口腔卫生和更频繁的刷牙与风险降低有关。这些结果可能对预防高风险地区（如中国，印度和非洲部分地区）的ESCC具有重要的公共卫生意义。
To further examine the association between oral hygiene and esophageal squamous cell carcinoma (ESCC) risk and the effect modification of other exposures, we conducted a population-based case-control study between 2010 and 2012 in Taixing, China, a high-risk area for ESCC. Cases were primarily recruited from endoscopy units at local hospitals, supplemented by linkage to the local Cancer Registry. Control subjects were frequency matched to cases by sex and age (5-year groups) and were randomly selected from the Taixing Population Registry. For the current analysis, data from 616 histopathologically confirmed cases and 770 controls with complete information on oral hygiene were analyzed. Unconditional logistic regression models, including oral hygiene indicators and potential behavioral confounders, were used to derive odds ratios (ORs) and 95% confidence intervals (CIs). Tooth loss was only marginally significantly associated with ESCC risk (yes vs. no, OR=1.29, 95% CI 0.94-1.74). However, the excess risk increased with increasing numbers of lost teeth (more than 6 teeth lost vs. none, OR=1.48, 95% CI 1.04-2.11). Tooth brushing once or less per day, compared with tooth brushing twice or more per day, was associated with a 1.81-fold increased risk of ESCC. In the stratification analyses, the increased risks associated with these indicators of oral health were more pronounced in older subjects (age70 years), women, non-smokers, and non-drinkers. Further studies are warranted to verify these findings and to explore the underlying mechanisms, e.g., changed oral microbiota, associated with poor oral hygiene.What's new? Little is known about the etiology of esophageal squamous-cell carcinoma (ESCC) in regions with a high incidence of this cancer. Alcohol and smoking don't seem to fully explain it. In this study, the authors found that poor oral health was associated with a higher incidence of ESCC in the Taixing region of China. Better oral hygiene and more frequent tooth brushing were associated with decreased risk. These results may have important public-health implications for preventing ESCC in high-risk regions such as China, India, and some parts of Africa.