Nair S, Datta S, Thiagarajan S, Chakrabarti S, Nair D, Chaturvedi P
Department of Head and Neck Surgery, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Department of Head and Neck Surgery, Narayana Hrudayalaya, Kolkata, West Bengal, India.
Indian J Cancer. 2016 Oct-Dec;53(4):538-541. doi: 10.4103/0019-509X.204759.
Tobacco consumption is the major risk factor for developing head and neck squamous cell cancer (SCC). The site of development of HNSCC may depend on the way the tobacco is consumed. While laryngeal cancers are more common among smokers, oral cancers are more common among tobacco chewers. Since the use of smokeless tobacco is increasing, it is important to know whether this difference is restricted only to site wise distribution or it has other clinical and pathological implications.
We analyzed a prospectively collected dataset of HNSCC patients other than nasopharyngeal cancers attending our outpatient department at a single unit of the head and neck services at Tata Memorial Hospital, Mumbai, India, between January 2010 and September 2011. There were 747 eligible patients and were divided into three groups: Those with chewing as the only habit (chewers), those with smoking as the only habit (smokers), and those with no habits. Patients with regular use of alcohol were excluded from the study. The clinical and pathological parameters were analyzed.
Of the 747 patients, the tobacco chewers formed 69.3% followed by smokers (19.5%) and patients with no habits (11.1%). Majority of smokers were men (98%). Site distribution revealed patients with chewing as the only habit had oral cancers (most commonly gingivobuccal complex cancers) as the most common site and those with smoking as the only habit had larynx as the most common site. In patients with no habits, oral tongue was found to be the most common site. No statistically significant pathological differences were observed in between these groups in patients who underwent surgery (n = 366) at the initial modality of treatment.
There is a direct relationship between the form of tobacco use and site of appearance of HNSCC. However, there are no differences in clinical or pathological parameters between HNSCC caused by tobacco chewing or tobacco smoking.
烟草消费是导致头颈部鳞状细胞癌（SCC）的主要风险因素。头颈部鳞状细胞癌的发病部位可能取决于烟草的消费方式。喉癌在吸烟者中更为常见，而口腔癌在嚼烟者中更为常见。由于无烟烟草的使用正在增加，了解这种差异是否仅局限于部位分布，还是具有其他临床和病理意义非常重要。
我们分析了2010年1月至2011年9月期间在印度孟买塔塔纪念医院头颈服务单一科室门诊就诊的非鼻咽癌头颈部鳞状细胞癌患者的前瞻性收集数据集。共有747名符合条件的患者，分为三组：仅以咀嚼为习惯的患者（嚼烟者）、仅以吸烟为习惯的患者（吸烟者）和无相关习惯的患者。经常饮酒的患者被排除在研究之外。对临床和病理参数进行了分析。
在747名患者中，嚼烟者占69.3%，其次是吸烟者（19.5%）和无相关习惯的患者（11.1%）。大多数吸烟者为男性（98%）。部位分布显示，仅以咀嚼为习惯的患者中，口腔癌（最常见的是牙龈颊侧复合体癌）是最常见的部位，而仅以吸烟为习惯的患者中，喉是最常见的部位。在无相关习惯的患者中，口腔舌是最常见的部位。在初始治疗方式为手术的患者（n = 366）中，这些组之间未观察到统计学上显著的病理差异。
烟草使用形式与头颈部鳞状细胞癌的出现部位之间存在直接关系。然而，嚼烟或吸烟导致的头颈部鳞状细胞癌在临床或病理参数上没有差异。
