Periodontal disease, Porphyromonas gingivalis serum antibody levels and orodigestive cancer mortality
Periodontal disease, Porphyromonas gingivalis serum antibody levels and orodigestive cancer mortality
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DOI：
10.1093/carcin/bgs112
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发表时间：
2012-05-01
期刊：
影响因子：
4.7
通讯作者：
Hayes, Richard B.
中科院分区：
文献类型：
--
作者：
Ahn, Jiyoung;Segers, Stephanie;Hayes, Richard B.
牙周炎是牙齿周围牙槽骨的逐渐丧失，是成年人牙齿丧失的主要原因，是由于口腔微生物，包括牙龈卟啉单胞菌。牙周炎与局部过度攻击性免疫反应和一系列全身效应有关，但这种情况在口腔消化道癌症中的作用尚不清楚。我们前瞻性研究了临床确诊的牙周炎（N = 12 605）和血清IgG免疫反应牙龈卟啉单胞菌（N = 7852）与口腔消化道癌症死亡率的关系，在全国健康和营养检查调查III中的男性和女性。1988年至1994年在调查阶段I和II进行了详细的口腔健康检查，而1991年至1994年仅在阶段II测量了牙龈卟啉单胞菌的血清IgG。截至2006年12月31日，已查明有105例口腔消化道癌症死亡。牙周炎（中度或重度）与口腔消化道癌死亡率增加相关[相对危险度（RR）= 2.28，95%置信区间（CI）= 1.17-4.45];死亡风险也随着牙周病严重程度的增加而增加（P趋势= 0.01）。牙周炎相关的死亡率在结直肠癌（RR = 3.58; 95%CI = 1.15-11.16）和胰腺癌（RR = 4.56; 95%CI = 0.93-22.29）中较高。血清牙龈卟啉单胞菌IgG水平升高总体上与口腔消化道癌死亡率升高相关（P趋势= 0.06）;牙龈卟啉单胞菌相关的过度口腔消化道死亡率也见于未表现出明显牙周疾病的健康受试者（RR = 2.25; 95%CI = 1.23-4.14）。口腔消化道癌死亡率与牙周炎和牙周病原体牙龈卟啉单胞菌有关，与牙周病无关。牙龈卟啉单胞菌是口腔消化道癌症死亡风险的生物标志物。
Periodontitis, the progressive loss of the alveolar bone around the teeth and the major cause of tooth loss in adults, is due to oral microorganisms, including Porphyromonas gingivalis. Periodontitis is associated with a local overly aggressive immune response and a spectrum of systemic effects, but the role of this condition in orodigestive cancers is unclear. We prospectively examined clinically ascertained periodontitis (N = 12 605) and serum IgG immune response to P.gingivalis (N = 7852) in relation to orodigestive cancer mortality among men and women in the National Health and Nutrition Examination Survey III. A detailed oral health exam was conducted from 1988 to 1994 in survey Phases I and II, whereas serum IgG for P.gingivalis was measured from 1991 to 1994 in Phase II only. One hundred and five orodigestive cancer deaths were ascertained through 31 December 2006. Periodontitis (moderate or severe) was associated with increased orodigestive cancer mortality [relative risks (RR) = 2.28, 95% confidence interval (CI) = 1.17-4.45]; mortality risks also increased with increasing severity of periodontal disease (P trend = 0.01). Periodontitis-associated mortality was in excess for colorectal (RR = 3.58; 95% CI = 1.15-11.16) and possibly for pancreatic cancer (RR = 4.56; 95% CI = 0.93-22.29). Greater serum P.gingivalis IgG tended to be associated overall with increased orodigestive cancer mortality (P trend = 0.06); P.gingivalis-associated excess orodigestive mortality was also found for healthy subjects not exhibiting overt periodontal disease (RR = 2.25; 95% CI = 1.23-4.14). Orodigestive cancer mortality is related to periodontitis and to the periodontal pathogen, P.gingivalis, independent of periodontal disease. Porphyromonas gingivalis is a biomarker for microbe-associated risk of death due to orodigestive cancer.