School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
PLoS One. 2012;7(10):e48109. doi: 10.1371/journal.pone.0048109. Epub 2012 Oct 25.
The association between viral hepatitis (B and C) and oral cavity cancer has been widely debated. This nationwide, population-based cohort study assessed the subsequent risk of oral cavity cancer among patients with chronic viral hepatitis infection.
Data were retrieved from insurance claims data of 1,000,000 randomly sampled individuals covered under the Taiwan National Health Insurance system. We identified a total of 21,199 adults with chronic viral hepatitis infection (12,369 with HBV alone, 5,311 with HCV alone, and 3,519 with HBV/HCV dual infections) from 2000-2005. Comparison group comprised 84,796 sex- and age-matched subjects without viral hepatitis during the same study period. Incidence and risk of subsequent oral cavity cancer were measured until 2008.
The incidence of oral cavity cancers was 2.28-fold higher among patients with HCV alone than non-viral hepatitis group (6.15 versus 2.69 per 10,000 person-years). After adjusting for sociodemographic covariates, HCV alone was significantly associated with an increased risk for oral cavity cancer (hazard ratio (HR) = 1.90, 95% confidence interval (CI) = 1.20-3.02). This positive association was highest among individuals in the 40-49-year age group (HR = 2.57, 95% CI = 1.21-5.46). However, there were no significant associations between HBV alone or HBV/HCV dual infections and risk for oral cavity cancer.
Our data suggest that HCV but not HBV infection is a risk factor for oral cavity cancer. In addition, subjects with HCV infection tend to be at early onset risk for oral cavity cancer. This finding needs to be replicated in further studies.
乙型肝炎和丙型肝炎与口腔癌之间的关联一直存在广泛争议。本项全国性、基于人群的队列研究评估了慢性病毒性肝炎感染患者发生口腔癌的后续风险。
从台湾全民健康保险系统覆盖的 100 万随机抽样个体的保险索赔数据中检索数据。我们从 2000 年至 2005 年确定了总共 21199 例慢性病毒性肝炎感染的成年人（单独乙型肝炎 12369 例，单独丙型肝炎 5311 例，乙型肝炎/丙型肝炎双重感染 3519 例）。比较组由同一研究期间 84796 名无病毒性肝炎的性别和年龄匹配的个体组成。直至 2008 年，测量了口腔癌的发病率和后续风险。
单独丙型肝炎患者的口腔癌发病率比非病毒性肝炎组高 2.28 倍（每 10000 人年为 6.15 比 2.69）。在调整了社会人口统计学协变量后，单独丙型肝炎与口腔癌风险增加显著相关（风险比（HR）=1.90，95%置信区间（CI）=1.20-3.02）。这种正相关在 40-49 岁年龄组中最高（HR=2.57，95%CI=1.21-5.46）。但是，单独乙型肝炎或乙型肝炎/丙型肝炎双重感染与口腔癌风险之间无显著关联。
我们的数据表明，丙型肝炎而不是乙型肝炎感染是口腔癌的危险因素。此外，丙型肝炎感染的患者有早发口腔癌的风险。这一发现需要在进一步的研究中得到复制。
