Tan Xinmiao, Nelson Heather H, Langevin Scott M, McClean Michael, Marsit Carmen J, Waterboer Tim, Pawlita Michael, Kelsey Karl T, Michaud Dominique S
Department of Epidemiology, Brown University School of Public Health, 121 S. Main St, 2nd Floor, Providence, RI, 02912, USA.
Cancer Causes Control. 2015 Jan;26(1):111-9. doi: 10.1007/s10552-014-0490-3. Epub 2014 Nov 15.
Previous studies examining the association of body mass index (BMI) with risk of and survival from head and neck squamous cell carcinoma (HNSCC) have been inconsistent, although an inverse association has been noted for obesity and risk of HNSCC in several studies. Previous studies have not examined whether these associations differ by human papillomavirus (HPV) status.
We utilized the resources of a population-based case-control study of HNSCC from the greater Boston area (959 cases and 1,208 controls were eligible for this analysis). Anthropometric history was collected through personal interviews, and HPV status was assessed using serology. We analyzed the association between BMI (assessed 5 years prior to disease incidence) and disease risk and survival using logistic regression and Cox proportional hazards regression, respectively.
After adjusting for known risk factors, the association between obesity and overall risk of HNSCC was not significant (OR 0.79, 95 % CI 0.60-1.04). However, obesity (BMI ≥30 kg/m(2)) was inversely associated with HNSCC risk among HPV-seronegative cases (OR 0.48, 95 % CI 0.32-0.70), but not among HPV-seropositive cases (OR 0.91, 95 % CI 0.68-1.21). BMI was not associated with survival overall or by HPV status. However, being overweight (BMI 25-29.9 kg/m(2)) was associated with longer survival among HPV-seropositive smokers (HR 0.48, 95 % CI 0.31-0.74).
Our findings are consistent with previous observations that obesity is inversely associated with the risk of HNSCC; however, this association appears to be confined to HPV-seronegative cases. Overall, obesity was not associated with HNSCC survival overall or by HPV status.
Obesity is associated with risk of non-HPV HNSCC, but not HPV HNSCC.
既往研究探讨体重指数（BMI）与头颈部鳞状细胞癌（HNSCC）风险及生存之间的关联，结果并不一致，尽管在多项研究中已注意到肥胖与HNSCC风险呈负相关。既往研究未探讨这些关联是否因人类乳头瘤病毒（HPV）状态而异。
我们利用了一项基于人群的大波士顿地区HNSCC病例对照研究的资源（959例病例和1208例对照符合该分析条件）。通过个人访谈收集人体测量史，并使用血清学评估HPV状态。我们分别使用逻辑回归和Cox比例风险回归分析BMI（在疾病发病前5年评估）与疾病风险及生存之间的关联。
在调整已知风险因素后，肥胖与HNSCC总体风险之间的关联不显著（比值比[OR]0.79，95%可信区间[CI]0.60 - 1.04）。然而，肥胖（BMI≥30 kg/m²）在HPV血清阴性病例中与HNSCC风险呈负相关（OR 0.48，95%CI 0.32 - 0.70），但在HPV血清阳性病例中并非如此（OR 0.91，95%CI 0.68 - 1.21）。BMI与总体生存或HPV状态无关。然而，超重（BMI 25 - 29.9 kg/m²）与HPV血清阳性吸烟者的较长生存期相关（风险比[HR]0.48，95%CI 0.31 - 0.74）。
我们的研究结果与既往观察一致，即肥胖与HNSCC风险呈负相关；然而，这种关联似乎仅限于HPV血清阴性病例。总体而言，肥胖与HNSCC总体生存或HPV状态无关。
肥胖与非HPV HNSCC风险相关，但与HPV HNSCC无关。
