Rogers M A, Thomas D B, Davis S, Weiss N S, Vaughan T L, Nevissi A E
Department of Preventive Medicine, State University of New York, Syracuse.
Int J Cancer. 1991 May 10;48(2):182-8. doi: 10.1002/ijc.2910480205.
A case-control study of oral cancer was conducted in western Washington state between 1983 and 1987. Cases (n = 379) were identified through a population-based registry, and controls (n = 514) were selected by telephone using random digit dialing. Subjects participated in a personal interview, completed a food-frequency questionnaire, and submitted clippings from the nails of each great toe for the determination of selenium and zinc concentrations. The odds ratio (OR) for low selenium levels in nail tissue (lowest 25% of the distribution compared to the upper 75%) was 1.4 (95% confidence interval (CI) 1.0-2.2). Likewise, the odds ratio for low zinc levels in nails was 1.6 (95% CI 1.0-2.3), but for low dietary zinc was 1.0 (95% CI 0.7-1.7). Men with oral cancer had lower nail selenium levels than did the controls (OR = 1.9), but women with oral cancer did not (OR = 0.6). Individuals 20 to 39 years of age with oral cancer, in particular, were more likely to have lower selenium levels in nail tissue than controls (OR = 16.4). There was a significant interaction between selenium and ascorbic acid levels which could not be explained by cigarette use. Subjects at greatest risk had low levels of both nutrients (OR = 3.8 for smokers and OR = 5.7 for non-smokers). However, since the elements were deposited in the nail matrix close to the date of diagnosis, the differences in the element concentrations between cases and controls may have been a result of the disease. Further etiologic studies of selenium, vitamin intake and oral carcinoma are warranted.
1983年至1987年间，在华盛顿州西部开展了一项口腔癌病例对照研究。通过基于人群的登记系统确定病例（n = 379），并使用随机数字拨号通过电话选择对照（n = 514）。受试者参与个人访谈，完成食物频率问卷，并提交每个大脚趾指甲的剪片以测定硒和锌的浓度。指甲组织中低硒水平（分布最低的25%与最高的75%相比）的比值比（OR）为1.4（95%置信区间（CI）1.0 - 2.2）。同样，指甲中低锌水平的比值比为1.6（95% CI 1.0 - 2.3），但饮食中低锌的比值比为1.0（95% CI 0.7 - 1.7）。患口腔癌的男性指甲硒水平低于对照组（OR = 1.9），但患口腔癌的女性则不然（OR = 0.6）。尤其是20至39岁患口腔癌的个体，其指甲组织中的硒水平比对照组更有可能较低（OR = 16.4）。硒和抗坏血酸水平之间存在显著的交互作用，这无法用吸烟来解释。风险最高的受试者两种营养素水平都较低（吸烟者的OR = 3.8，非吸烟者的OR = 5.7）。然而，由于这些元素在接近诊断日期时沉积在指甲基质中，病例组和对照组之间元素浓度的差异可能是疾病导致的。有必要对硒、维生素摄入与口腔癌进行进一步的病因学研究。
