Abnet Christian C, Kamangar Farin, Islami Farhad, Nasrollahzadeh Dariush, Brennan Paul, Aghcheli Karim, Merat Shahin, Pourshams Akram, Marjani Haj Amin, Ebadati Abdolhakim, Sotoudeh Masoud, Boffetta Paolo, Malekzadeh Reza, Dawsey Sanford M
Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Executive Plaza South, Room 320, 6120 Executive Boulevard, MSC 7232, Rockville, MD 20852, USA.
Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):3062-8. doi: 10.1158/1055-9965.EPI-08-0558.
We tested the association between tooth loss and oral hygiene and the risk of esophageal squamous cell carcinoma (ESCC) in people living in a high-risk area of Iran. We used a case-control study of pathologically confirmed ESCC cases (n = 283) and controls (n = 560) matched on sex, age, and neighborhood. Subjects with ESCC had significantly more decayed, missing, or filled teeth (DMFT) with a median (interquartile range) of 31 (23-32) compared with controls 28 (16-32; P = 0.0045). Subjects with ESCC were significantly more likely than controls to fail to practice regular oral hygiene (78% versus 58%). In multivariate-adjusted conditional logistic regression models, having 32 DMFT compared with < or = 15 conferred an odds ratio (95% confidence interval) of 2.10 (1.19-3.70). Compared with daily tooth brushing, practicing no regular oral hygiene conferred an odds ratio (95% confidence interval) of 2.37 (1.42-3.97). Restricting the analysis to subjects that had never smoked tobacco did not materially alter these results. We found significant associations between two markers of poor oral hygiene, a larger number of DMFT and lack of daily tooth brushing, and risk of ESCC in a population at high risk for ESCC where many cases occur in never smokers. Our results are consistent with several previous analyses in other high-risk populations.
我们在伊朗的一个高风险地区，对牙齿缺失与口腔卫生状况和食管鳞状细胞癌（ESCC）风险之间的关联进行了测试。我们采用病例对照研究，选取了经病理确诊的ESCC病例（n = 283）和对照（n = 560），并按照性别、年龄和邻里关系进行匹配。与对照组相比，ESCC患者的龋、失、补牙数（DMFT）显著更多，中位数（四分位间距）为31（23 - 32），而对照组为28（16 - 32；P = 0.0045）。ESCC患者不经常进行口腔卫生护理的可能性显著高于对照组（78% 对58%）。在多变量调整的条件逻辑回归模型中，DMFT为32颗与≤15颗相比，优势比（95%置信区间）为2.10（1.19 - 3.70）。与每天刷牙相比，不经常进行口腔卫生护理的优势比（95%置信区间）为2.37（1.42 - 3.97）。将分析限制在从不吸烟的受试者中，这些结果没有实质性改变。我们发现，在ESCC高风险人群中，口腔卫生不良的两个指标——DMFT数量较多和缺乏每日刷牙习惯，与ESCC风险之间存在显著关联，该人群中许多病例发生在从不吸烟者中。我们的结果与之前在其他高风险人群中的多项分析一致。
