Periodontal disease severity and cancer risk in postmenopausal women: the Buffalo OsteoPerio Study.
Periodontal disease severity and cancer risk in postmenopausal women: the Buffalo OsteoPerio Study.
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DOI：
10.1007/s10552-015-0699-9
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发表时间：
2016-02
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影响因子：
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通讯作者：
Wactawski-Wende J
中科院分区：
文献类型：
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作者：
Mai X;LaMonte MJ;Hovey KM;Freudenheim JL;Andrews CA;Genco RJ;Wactawski-Wende J
很少有前瞻性研究报道了客观牙周病（PD）测量与癌症风险之间的关系。1,337名绝经后妇女参加了Buffalo OsteoPerio研究，研究了这种关联。采用口腔x线片测量牙槽嵴骨高（ACH）。偶发性癌症是用医疗记录来判定的。使用Cox比例风险模型估计乙酰胆碱与癌症结局之间关联的风险比（HR）和95%置信区间（CI）。随访（12.2±4.2年）共确诊203例。在调整年龄和吸烟因素后，ach定义的PD类别与总癌症风险之间没有统计学意义的关联（轻度/中度vs无：HR=1.33, 95%CI: 0.91-1.94；重度vs无：HR=1.20, 95%CI: 0.77-1.86）。ach定义的PD类型与常见的部位特异性癌症无关。全口平均ACH和最差部位ACH（每1毫米损失）与肺癌风险增加显著相关（调整后的HR=1.81, 95% CI分别为1.30-2.54；调整后的HR=1.34, 95% CI分别为1.08-1.66），但与总癌或其他部位特异性癌症无关。吸烟状况改变了连续ACH变量与总癌症风险之间的关系；吸烟者的PD测量值与总癌症相关，而不吸烟者的PD测量值与总癌症相关（交互作用在全口平均ACH和最差部位分别为p=0.02和p<0.01）。在曾经吸烟但不吸烟的绝经后妇女中，ach定义的PD与总癌症风险相关。全口平均和最差部位乙酰胆酸与肺癌风险增加有关。然而，考虑到肺癌病例数量较少（n=18），这些结果需要谨慎解释。进一步的研究需要利用更大的样本来证实口腔骨质流失、部位特异性癌症和总癌症之间的关系。
Few prospective studies have reported on relationships between objective periodontal disease (PD) measures and cancer risk. This association was examined in 1,337 postmenopausal women participating in the Buffalo OsteoPerio Study. Oral alveolar crestal bone height (ACH) was measured using oral radiographs. Incident cancers were adjudicated with medical records. Hazard ratios (HR) and 95% confidence intervals (CI) for associations between ACH and incident cancer outcomes were estimated using Cox proportional hazards models. There were 203 confirmed total incident cancer cases during follow-up (12.2±4.2 years). After adjusting for age and smoking, there were no statistically significant associations between ACH-defined PD categories and total cancer risk (mild/moderate vs. none: HR=1.33, 95%CI: 0.91–1.94; severe vs. none: HR=1.20, 95%CI: 0.77–1.86). ACH-defined PD categories were not associated with common site-specific cancers. Whole mouth mean and worst site ACH (per 1mm loss) were significantly associated with increased risk of lung (adjusted HR=1.81, 95% CI: 1.30–2.54; adjusted HR=1.34, 95% CI: 1.08–1.66, respectively), but not total or other site-specific cancer. Smoking status modified the associations between continuous ACH variables and total cancer risk; measures of PD were associated with total cancer among smokers but not never-smokers (interaction p=0.02 and p<0.01 for whole mouth mean and worst site ACH, respectively). ACH-defined PD was associated with total cancer risk in ever but not never-smoking postmenopausal women. Whole mouth mean and worst site ACH were associated with increased lung cancer risk. However, these results need to be interpreted cautiously given the small number of lung cancer cases (n=18). Further research utilizing a larger sample is warranted to confirm the relationships among oral bone loss, site-specific cancers, and total cancer.