Tobacco smoking, alcohol drinking, and the risk of different histological types of nasopharyngeal cancer in a low-risk population
Tobacco smoking, alcohol drinking, and the risk of different histological types of nasopharyngeal cancer in a low-risk population
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DOI：
10.1016/j.oraloncology.2011.03.017
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发表时间：
2011-06-01
期刊：
影响因子：
4.8
通讯作者：
Serraino, Diego
中科院分区：
文献类型：
--
作者：
Polesel, Jerry;Franceschi, Silvia;Serraino, Diego
鼻咽癌（NPC）在西方国家很少见。吸烟是公认的危险因素，而饮酒的作用仍存在争议。我们在意大利开展了一项以医院为基础的病例对照研究，对象为 150 例经组织学证实的白种人鼻咽癌病例，年龄为 18-76 岁，其中包括 118 例未分化鼻咽癌和 22 例分化鳞状细胞鼻咽癌。对照是 450 名因急性病症入住综合医院的无癌症白人患者。病例和对照根据性别、年龄和居住地进行匹配。使用逻辑回归来估计比值比 (OR) 和相应的 95% 置信区间 (CI)，同时调整已知的混杂因素。吸烟与所有 NPC 之间没有出现显着关联（当前吸烟者与从不吸烟者的 OR = 1.52；95% CI：0.89-2.60）。相反，仅对于分化型鼻咽癌，统计显着升高的 OR 与吸烟强度增加（≥ 15 支烟/天的 OR = 5.40；95% CI：1.34-21.76）和习惯持续时间（≥ 32 年的 OR = 4.48；95% CI：1.11-18.04）相关。尽管饮酒本身与鼻咽癌风险没有显着相关，但吸烟和饮酒的组合占分化型鼻咽癌的 57%，而仅占未分化型鼻咽癌的 14%。我们的研究结果表明，在西方人群中，鼻咽癌包括两个独立的实体：分化型鼻咽癌，与其他头颈癌一样与吸烟相关；以及未分化型鼻咽癌，吸烟对其影响很小或没有影响。 (C) 2011 Elsevier Ltd. 保留所有权利。
Nasopharyngeal carcinoma (NPC) is rare in western Countries. Tobacco smoking is a well-recognised risk factor, whereas the role of alcohol drinking is still in debate.We conducted a hospital-based case-control study in Italy on 150, histologically-confirmed, NPC cases of Caucasian ethnicity, aged 18-76 years, including 118 undifferentiated NPCs and 22 differentiated squamous-cell NPC. Controls were 450 Caucasian cancer-free patients admitted to general hospitals for acute conditions. Cases and controls were matched according to sex, age, and place of residence. Logistic regression was used to estimate odds ratios (OR) and the corresponding 95% confidence intervals (CI) while adjusting for known confounders.No significant association emerged between tobacco smoking and all NPCs (OR for current vs. never smokers = 1.52; 95% CI: 0.89-2.60). Conversely, for differentiated NPC only, statistically significant elevated OR were associated with increasing smoking intensity (OR for >= 15 cigarettes/day = 5.40; 95% CI: 1.34-21.76) and duration of the habit (OR for >= 32 years = 4.48; 95% CI: 1.11-18.04). Although alcohol drinking was not, per se, significantly associated to NPC risk, the combination of tobacco smoking and alcohol drinking accounted for 57% of differentiated NPCs, whereas it accounted for only 14% of undifferentiated carcinomas.Our findings suggest that, in western populations, NPC includes two separate entities: the differentiated NPC, associated with tobacco smoking like other cancers of head and neck, and the undifferentiated NPC, upon which tobacco smoking has little or no influence. (C) 2011 Elsevier Ltd. All rights reserved.