Epidemiological study on influence of micronutrients for occurring oral cancer -comparative study among different ethnic groups-

所选对象的吸烟、咀嚼液体饮料和饮酒等个人习惯特征的流行病学数据来自于与筛查项目相同的调查表中记录的问卷。采集受试者静脉血样本。获得了所有受试者的知情同意（所有被选中的受试者通过唱歌或在准备好的同意书上指印来同意本程序）。血样立即离心分离血清和细胞成分。血清样品保存在马来亚大学-70℃冷冻库中，用于血清微量营养素分析。采用高效液相色谱法测定血清中视黄醇、α-生育酚、番茄红素、玉米黄质/叶黄素、豆黄质、α-胡萝卜素和β-胡萝卜素的浓度。口腔癌前病变（白斑、红斑和口腔黏膜下纤维化）的诊断标准是根据1998年世界卫生组织的建议制定的。More c病变的诊断标准也以1998年世界卫生组织和Axcell描述的标准为基础，这些标准与世界卫生组织对牙科和口腔科国际疾病分类的应用相一致。印度人口腔黏膜病变的患病率为40.5% （N=255）。口腔癌患病率为0.2%（1例），白斑10.9%（95例），扁平苔藓0.7%（21例），口腔黏膜下纤维化0.3%（13例），红斑0.5%（3例），咀嚼黏膜20.7%（133例），其他非opc病变0.4%（13例）。以OPC为因变量进行logistic回归的多变量分析显示，咀嚼液和血清α-胡萝卜素水平两个自变量的比值比分别为30.2和0.5。在砂拉越原住民中，口腔黏膜病变的患病率为30.1% （N=203）。OPC 23例（0.7%），咀嚼黏膜88例（14.3%），其他非OPC病变129例（20.0%）。OPC病变包括2例（0.3%）口腔癌，20例（0.3%）口腔白斑，1例（0.2%）口腔黏膜下纤维化。在马来人（N=276）中，口腔黏膜病变的患病率为20.3%。OPC 4例（0.4%），咀嚼黏膜30例（10.3%），其他非OPC病变21例（20.0%）。OPC病变包括2例（0.3%）口腔白斑，2例（0.2%）口腔扁平苔藓。逻辑回归分析显示，印第安人患OPC的可能性是土著居民的8倍。当以口腔白斑作为因变量时，马来人种族和液体咀嚼这两个自变量的显著性也很明显。与OPC类似，支持口腔白斑与咀嚼液体之间正相关的双变量分析，有咀嚼液体习惯的受试者患口腔白斑的可能性显著增加（系数=0.81），即患口腔白斑的可能性约为123倍（优势比=120.6）。该多变量分析还显示，马来人患口腔白斑的可能性明显低于原住民（系数=-0.245），即马来人患口腔白斑的可能性是原住民的十分之一（优势比=0.106）。本文使用的自变量只能占到口腔白斑作为因变量的60%左右（拟R2=0.603）。少

For the selected subjects, epidemiological data of individual habit characteristics such as smoking, quid chewing and alcohol drinking were obtained from the same questionnaires recorded in the survey forms as for screening program. Venous blood samples were taken from subjects. Informed consent was obtained from all subjects (All selected subjects consented to this procedure by singing or thumb-printing the prepared consent form). The blood samples were centrifuged immediately to separate the serum from the cellular components. The serum samples were stored in -70℃ in freezer in University of Malaya prior to analysis of the serum micronutrients. The serum concentrations of retinol, α-tocopherol, lycopene, zeaxianthin/lutein , criptoxanthin, α-carotene, and β-carotene were determined using high performance liquid chromatography.The diagnostic criteria for oral precancer (leukoplakia, erythroplakia and oral submucos fibrosis were based on the recommendation by WHO in 1998. The diagnosti … More c criteria for lesions were also based on WHO in 1998 and criteria described by Axcell which were in accordance with the WHO's application of the International Classification of Diseases to Dentistry and Stomatology.The prevalence of oral mucosal lesions in Indians was 40.5% (N=255) . Oral cancer prevalence was 0.2% (1) , leukoplakia 10.9% (95) , lichen planus 0.7% (21) , oral submucous fibrosis 0.3% (13) , erythroplakia 0.5% (3) , chewer's mucosa 20.7% (133) and other non-OPC lesions 0.4% (13) . A multivariate analysis using logistic regression with OPC as the dependent variable showed significance for 2 independent variable namely, quid chewing and serum levels of α-carotene with 30.2 and 0.5 of odds ratio, respectively.In indigenous people in Sarawaku, the prevalence of oral mucosal lesions was 30.1% (N=203) . There were 23 (0.7%) subjects with OPC, 88 (14.3%) with chewer's mucosa and 129 (20.0%) with other non-OPC lesions. The OPC lesions consisted of 2 (0.3%) cases of oral cancer, 20 (0.3%) cases of oral leukoplakia, 1 (0.2%) case of oral submucous fibrosis.In Malays (N=276) , the prevalence of oral mucosal lesions was 20.3%. There were 4 (0.4%) subjects with OPC, 30 (10.3%) with chewer's mucosa and 21 (20.0%) with other non-OPC lesions. The OPC lesions consist of 2 (0.3%) cases of oral leukoplakia, 2 (0.2%) cases of oral lichen planus.The logistic regression analyses showed that the Indians are 8 times more likely to have OPC as compared to the Indigenous people. When oral leukoplakia was used as the dependent variable, significance for 2 independent variables were also evident namely, the Malays ethnicity and quid chewing. Similar to OPC, support for the bivariate analyses of positive correlation between oral leukoplakia and quid chewing was observed where subjects with quid chewing habit are significantly more likely to suffer from oral leukoplakia (coefficient=0.81), i. e., about 123 times more likely to have oral leukoplakia (odds ratio=120.6). This mulitvariate analysis also showed that Malays are significantly less likely to suffer from oral leukoplakia as compared to Indigenous people (coefficient=-0.245), i. e., the Malays are one-tenth times less to suffer from oral leukoplakia as compared to Indigenous people (odds ratio=0.106). The independent variable used here can only account for about 60% of oral leukoplakia as the dependent variable (Pseudo R2=0.603). Less