Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
Department of Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Cancer. 2018 Jun 15;124(12):2515-2522. doi: 10.1002/cncr.31359. Epub 2018 Apr 12.
Oral tongue cancer incidence has increased among whites in the United States; however, the cause remains unknown. If an infectious agent is implicated, then elevated risk would be expected among immunosuppressed individuals.
By using population-based registry linkage information from the US Transplant Cancer Match and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) Cancer Match studies, the authors examined the risk of oral tongue squamous cell carcinoma (SCC) among immunocompromised transplantation recipients and HIV-infected individuals. In addition, the risks of oropharyngeal SCC (strongly related to human papillomavirus infection; modestly affected by immunosuppression), other tobacco/alcohol-related oral cavity SCCs (not thought to be infection/immunosuppression-related), and non-Hodgkin lymphoma of oral cavity/pharynx (strongly related to Epstein-Barr virus; profoundly affected by immunosuppression) were evaluated.
Compared with the general population, the risk of non-Hodgkin lymphoma was strongly increased (standardized incidence ratio [SIR] > 8.0). The risk of all SCCs was modestly and similarly elevated among transplantation recipients (SIR range, 2.2-2.7; P = .2); whereas, among HIV-infected individuals, the risk of oral tongue SCC was higher compared with the risk of other SCCs (SIR, 3.0 vs 1.7 [for oropharyngeal SCCs] and 2.3 [for other oral cavity SCCs]; P < .001). The risk of SCCs was significantly higher among men, older individuals, and whites; and risk increased with the time since transplantation/AIDS onset. The risk of oral tongue SCC was significantly higher among HIV-infected men who have sex with men compared with the average risk in HIV-infected individuals (adjusted incidence rate ratio = 2.0).
Similar modest increases in the risk of oral tongue and other oral cavity SCCs do not suggest that an infectious agent or exposure profoundly affected by immunosuppression underlies the increase in oral tongue cancer. Cancer 2018;124:2515-22. © 2018 American Cancer Society.
美国白人的口腔舌癌发病率有所上升，但病因仍不清楚。如果涉及传染性病原体，那么免疫抑制个体的风险预计会增加。
作者利用来自美国移植癌症匹配和人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）癌症匹配研究的基于人群的登记链接信息，检查了免疫功能低下的移植受者和 HIV 感染者中口腔舌鳞状细胞癌（SCC）的风险。此外，评估了口咽 SCC 的风险（与人类乳头瘤病毒感染密切相关；适度受免疫抑制影响），其他与烟草/酒精相关的口腔 SCC（不认为与感染/免疫抑制相关），以及口腔/咽非霍奇金淋巴瘤（与 Epstein-Barr 病毒密切相关；受免疫抑制影响很大）。
与普通人群相比，非霍奇金淋巴瘤的风险明显增加（标准化发病率比 [SIR]＞8.0）。移植受者的所有 SCC 风险适度且相似升高（SIR 范围为 2.2-2.7；P＜.001）；然而，与其他 SCC 相比，HIV 感染者的口腔舌 SCC 风险更高（SIR，3.0 与 1.7 [口咽 SCC]和 2.3 [其他口腔 SCC]；P＜.001）。男性、年龄较大和白人的 SCC 风险更高；并且风险随着移植/艾滋病发病时间的增加而增加。与 HIV 感染者的平均风险相比，HIV 感染的男男性行为者的口腔舌 SCC 风险明显更高（调整后的发病率比=2.0）。
口腔舌和其他口腔 SCC 风险的适度增加并不能表明免疫抑制作用下的传染性病原体或暴露是导致口腔舌癌增加的原因。癌症 2018;124:2515-22. © 2018 美国癌症协会。
