Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
Department of Chemistry & Biochemistry, Florida Atlantic University, Jupiter, FL, USA.
Ann Oncol. 2017 May 1;28(5):985-995. doi: 10.1093/annonc/mdx019.
Periodontal disease (PD), now our commonest infectious disorder leads to tooth loss, and has been linked to various systemic diseases, including various types of cancer. The aim of this study is to provide a systematic review and a meta-analysis of the relationship between PD, edentulism, and pancreatic cancer (PC).
From an initial review of 327 references we selected eight studies concerning periodontitis or edentulism with sufficient quantitative information to allow us to examine the risk of PC. We used relative risks (RRs), hazard ratios, or odds ratios to measure the association between periodontitis, edentulism, and PC. We employed random effects models to obtain summary risks, and we also provide measures of study differences and possible biases.
The summary RR for periodontitis and PC was 1.74 [95% confidence interval (CI) 1.41-2.15] and 1.54 for edentulism (95% CI 1.16-2.05). There was no evidence of heterogeneity for either variable, and no evidence of publication bias. The studies included reports from three continents, suggesting that the association is generalizable. Most of the studies were adjusted for variables thought to be associated with PC, such as gender, smoking, BMI, diabetes, and alcohol.
Using meta-analysis, both periodontitis and edentulism appear to be associated with PC, even after adjusting for common risk factors. As yet, the mechanisms linking oral disease and PC are uncertain, but could be related to changes in the oral microbiome-an area of current research.
牙周病（PD）是目前最常见的传染病，可导致牙齿脱落，并与各种系统性疾病有关，包括各种类型的癌症。本研究旨在对牙周病、无牙症与胰腺癌（PC）之间的关系进行系统回顾和荟萃分析。
从最初的 327 篇参考文献中，我们选择了 8 项关于牙周炎或无牙症的研究，这些研究有足够的定量信息，使我们能够检查 PC 的风险。我们使用相对风险（RR）、风险比或比值比来衡量牙周炎、无牙症与 PC 之间的关联。我们使用随机效应模型获得汇总风险，并提供研究差异和潜在偏倚的度量。
牙周炎和 PC 的汇总 RR 分别为 1.74（95%置信区间 [CI] 1.41-2.15）和 1.54（95% CI 1.16-2.05）。两个变量均无异质性证据，也无发表偏倚证据。纳入的研究报告来自三大洲，表明该关联具有普遍性。大多数研究都调整了与 PC 相关的变量，如性别、吸烟、BMI、糖尿病和酒精。
使用荟萃分析，牙周炎和无牙症似乎都与 PC 有关，即使在调整了常见的危险因素后也是如此。目前，将口腔疾病与 PC 联系起来的机制尚不清楚，但可能与口腔微生物组的变化有关，这是当前研究的一个领域。
