牙周病和牙齿脱落作为癌症风险：文献系统综述
Periodontal Disease and Tooth Loss as Risks for Cancer: A Systematic Review of the Literature.
作者信息
Sadighi Shamami M, Sadighi Shamami M, Amini S
机构信息
Department of Periodontology, Faculty of Dentistry, Islamic Azad University Khorasgan Brunch, Isfahan, Iran.
Department of Periodontology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
出版信息
Iran J Cancer Prev. 2011 Fall;4(4):189-98.
BACKGROUND
Periodontal disease is a chronic destructive disease which occurs in adults, young people, and children. Periodontal disease and periodontal pathogens have been associated with several systemic diseases and more recently, several studies have suggested the relationship between periodontal disease and cancer. Studies with adjustment for the effect of smoking exposure, have found significant positive associations with different cancer sites. This review has outlined recent epidemiologic researches pointing to a possible role for tooth loss and periodontal disease in carcinogenesis.
METHODS
In this review, articles were selected from PubMed between1995 and June 2010 including human. Amongst 5,984 articles identified from the electronic search, 17 articles were selected for a full-text reading based on the inclusion and the exclusion criteria.
RESULTS
Nine out of 10 case-control studies reported a significant increase in the risk of oral cancer in patients with periodontitis and one with no significant association. Among 6 studies examining esophageal cancer and periodontal disease, 5 studies found a significant association between them and one study failed to find a significant increased risk of cancer. Also amongst 5 studies which focused on upper gastrointestinal, gastric cancer, and periodontal disease, 4 studies found an increased risk of cancer while one study did not report any relationship. In lung cancer evaluations, 3 out of 4 studies showed some levels of association between lung cancer and periodontal disease but after adjustment for smoking, no relationship were found. Three cohort studies have evaluated overall cancer rates in periodontal patients; two of them found small but significant association between cancers and periodontal disease.
CONCLUSION
The results indicate that there is a possible link between cancer and severe periodontal disease after adjustment for smoking and drinking habits.
背景
牙周病是一种发生于成人、年轻人和儿童的慢性破坏性疾病。牙周病和牙周病原体与多种全身性疾病有关，最近，多项研究表明牙周病与癌症之间存在关联。在对吸烟暴露的影响进行调整的研究中，发现与不同癌症部位存在显著的正相关。本综述概述了近期的流行病学研究，这些研究指出牙齿脱落和牙周病在致癌过程中可能发挥的作用。
方法
在本综述中，从1995年至2010年6月期间的PubMed中选取了包括人类的文章。在通过电子检索确定的5984篇文章中，根据纳入和排除标准选择了17篇文章进行全文阅读。
结果
10项病例对照研究中有9项报告称，牙周炎患者患口腔癌的风险显著增加，1项未发现显著关联。在6项研究食管癌与牙周病的研究中，5项研究发现两者之间存在显著关联，1项研究未发现癌症风险显著增加。在5项关注上消化道、胃癌和牙周病的研究中，4项研究发现癌症风险增加，1项研究未报告任何关系。在肺癌评估中，4项研究中有3项显示肺癌与牙周病之间存在一定程度的关联，但在对吸烟进行调整后，未发现两者之间的关系。3项队列研究评估了牙周病患者的总体癌症发病率；其中2项发现癌症与牙周病之间存在小但显著的关联。
结论
结果表明，在对吸烟和饮酒习惯进行调整后，癌症与严重牙周病之间可能存在联系。
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