Maasland Denise H E, Schouten Leo J, Kremer Bernd, van den Brandt Piet A
Department of Epidemiology, GROW - School for Oncology & Developmental Biology, Maastricht University, Maastricht, The Netherlands.
Department of Otorhinolaryngology, Head & Neck Surgery, GROW - School for Oncology & Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
Eur J Cancer. 2016 Jun;60:83-92. doi: 10.1016/j.ejca.2016.03.003. Epub 2016 Apr 13.
There is limited prospective data on the relationship between selenium status and the risk of head-neck cancer (HNC) and HNC subtypes (i.e., oral cavity cancer [OCC], oro-/hypopharyngeal cancer [OHPC] and laryngeal cancer [LC]). Therefore, we investigated the association between toenail selenium, reflecting long-term selenium exposure, and HNC risk within the Netherlands Cohort Study.
At baseline, 120,852 participants completed a self-administered questionnaire about diet and other cancer risk factors and were asked to provide toenail clippings. After 20.3 years of follow-up, 294 cases of HNC (95 OCC, 62 OHPC, two oral cavity/pharynx unspecified or overlapping and 135 LC) and 2,164 subcohort members were available for case-cohort analysis using Cox proportional hazards models.
Toenail selenium status was statistically significantly associated with a decreased risk of HNC overall (multivariate RR for quartile four versus one: 0.55, 95% confidence interval [CI] 0.37-0.82, P trend = 0.001). The association between toenail selenium and risk of HNC overall was stronger among men than women, but no statistically significant interaction with sex was found. Toenail selenium level was also associated with a decreased risk of all HNC subtypes, with statistically significant associations in OHPC and LC. No statistically significant interaction was found between toenail selenium level and cigarette smoking or alcohol consumption for HNC overall.
In this large cohort study, we found an inverse association between toenail selenium level and HNC risk. Among HNC subtypes, this association was strongest for OHPC and LC. Furthermore, the association of toenail selenium status with HNC risk was stronger among men than women.
关于硒状态与头颈癌（HNC）及其亚型（即口腔癌[OCC]、口咽/下咽癌[OHPC]和喉癌[LC]）风险之间关系的前瞻性数据有限。因此，我们在荷兰队列研究中调查了反映长期硒暴露情况的趾甲硒与HNC风险之间的关联。
在基线时，120852名参与者完成了一份关于饮食和其他癌症风险因素的自填问卷，并被要求提供趾甲剪片。经过20.3年的随访，共有294例HNC病例（95例OCC、62例OHPC、2例未明确或重叠的口腔/咽部癌以及135例LC）和2164名队列成员可用于使用Cox比例风险模型进行病例队列分析。
趾甲硒状态与总体HNC风险降低在统计学上显著相关（四分位数4与四分位数1相比的多变量风险比：0.55，95%置信区间[CI]0.37 - 0.82，P趋势 = 0.001）。趾甲硒与总体HNC风险之间的关联在男性中比女性更强，但未发现与性别有统计学显著的相互作用。趾甲硒水平也与所有HNC亚型的风险降低相关，在OHPC和LC中存在统计学显著关联。对于总体HNC，未发现趾甲硒水平与吸烟或饮酒之间有统计学显著的相互作用。
在这项大型队列研究中，我们发现趾甲硒水平与HNC风险呈负相关。在HNC亚型中，这种关联在OHPC和LC中最为明显。此外，趾甲硒状态与HNC风险之间的关联在男性中比女性更强。
