SEROLOGICAL MARKERS OF PERIODONTAL DISEASE AND PANCREATIC CANCER RISK

描述(申请人提供)：胰腺癌是癌症相关死亡的第四大原因，具有很高的致命性；95%的这种癌症患者在首次诊断后5年内死亡。了解胰腺癌的病因是实施预防措施的关键，同时也可能为如何治疗和检测这种恶性肿瘤提供见解。人们对胰腺癌的病因知之甚少；吸烟、慢性胰腺炎、家族综合症和其他可疑的危险因素只能解释25-30%的胰腺癌病例。几项研究支持牙周炎和胰腺癌风险之间的联系；在最近的一篇文章中，在一大群健康专业人员的前瞻性队列中观察到了这种联系。如果得到证实，这对这种联系的影响是巨大的，并将包括需要做出更多努力来了解基本机制。由于牙周病很难在流行病学环境中测量，我们提出的使用牙周有机体抗体的建议应该会以有效和快速的方式阐明这种联系的合理性。此外，我们的方法将避免在病例对照环境中使用牙周病自我报告或使用牙周病回顾评估相关的测量误差。我们的研究将能够直接解决在癌症发生之前是否存在牙周感染的问题，因为所有的血液都是在诊断前收集的。在这项研究中，我们建议测量四种常见牙周细菌病原体和厌氧细菌的抗体，这些细菌与胰腺炎有关，也是口腔微生物群的一部分。来自欧洲癌症前瞻性调查(EPIC)队列研究的468例胰腺癌病例和相匹配的对照，将检验所检测的抗体与胰腺癌之间的联系。关于胰腺癌危险因素的详细数据可在本研究中获得，并将被纳入分析以控制潜在的混杂。这项研究将为进一步评估牙周病在胰腺癌病因中的潜在作用提供有价值的数据，并可能为预防这种高度致命的癌症提供一个新的研究领域。 公共卫生相关性：这项研究将提供有关牙周病和胰腺癌风险的有价值的数据，并可能为这种高度致命的癌症开辟一个新的研究领域。此外，这项研究的发现可能有助于深入了解胰腺癌的发病机制，从而可能转化为预防建议或治疗方案，从而降低这种高度致命的恶性肿瘤的发病率和死亡率。

DESCRIPTION (provided by applicant): Pancreas cancer is the fourth leading cause of cancer-related death and is highly lethal; 95% of patients with this cancer die within 5 years of initial diagnosis. Understanding the etiology of pancreatic cancer is critical to implement steps towards prevention and may concurrently provide insights on how to treat and detect this malignancy. Little is known about the causes of pancreatic cancer; tobacco smoke, chronic pancreatitis, familial syndromes, and other suspected risk factors can only explain 25-30% of all pancreatic cancer cases. Several studies support an association between periodontitis and pancreatic cancer risk; in a recent publication, this association was observed among never smokers in a large prospective cohort of health professionals. The implications for this association, if confirmed, are substantial and will include the need for more efforts towards understanding the underlying mechanisms. As periodontal disease is difficult to measure in epidemiologic settings, our proposal to use antibodies to periodontal organisms should shed light on the plausibility of this association in an efficient and rapid fashion. Furthermore, our approach will avoid concerns of measurement error related to use of self-report of periodontal disease or use of retrospective assessment of periodontal disease in a case-control setting. Our study will be able to directly address the question of whether periodontal infection was present before the cancer onset as all bloods were collected pre-diagnostically. For this study, we propose to measurement antibodies to four common periodontal bacterial pathogens and to anaerobic bacteria that have been linked to pancreatitis and are also part of the oral microbiome. The association between the antibodies tested and pancreatic cancer will be examined using 468 pancreatic cancer cases and matched controls from the European Prospective Investigation into Cancer (EPIC) cohort study. Detailed data on risk factors of pancreatic cancer are available in this study and will be included in the analysis to control for potential confounding. This study should provide valuable data to further evaluate the potential role of periodontal disease in the etiology of pancreatic cancer and may provide a new area of research for the prevention of this highly fatal cancer. PUBLIC HEALTH RELEVANCE: This study will provide valuable data on periodontal disease and pancreatic cancer risk and may open a new area of research for this highly fatal cancer. In addition, findings from this study could lead to insights into the mechanism of pancreatic cancer which may translate into prevention recommendations or treatments that could reduce the incidence and mortality from this highly lethal malignancy.