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慢性牙周炎的严重程度与胃肠道癌症风险:一项基于台湾人群的随访研究。

Severity of chronic periodontitis and risk of gastrointestinal cancers: A population-based follow-up study from Taiwan.

作者信息

Chou Shing-Hsien, Tung Ying-Chang, Wu Lung-Sheng, Chang Chee-Jen, Kung Suefang, Chu Pao-Hsien

机构信息

Department of Cardiology Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University Section of Periodontics, Department of Dentistry, Chang Gung Memorial Hospital, Taoyuan Cheers Dental Clinic, New Taipei, Taiwan.

出版信息

Medicine (Baltimore). 2018 Jul;97(27):e11386. doi: 10.1097/MD.0000000000011386.

Abstract

The present study aimed to assess the association between the severity of chronic periodontitis and the risk of gastrointestinal (GI) cancers by investigating whether severe chronic periodontitis (CP), rather than mild CP, correlates with an increased risk of total or individual GI cancers.Adults (≥18 years) with mild and severe CP were identified from a random sample of 2 million insured patients in the National Health Insurance Research Database (2001-2010). After propensity score matching, 25,485 individuals, each with mild or severe CP, were included for comparison. The primary endpoint was the incidence of total or individual GI cancers, including cancers of the esophagus, stomach, small intestine, colon/rectum, and pancreas. Cox proportional hazard models with the robust aggregated sandwich estimator were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) after adjusting for known risk factors.GI cancers occurred in 275 individuals with mild CP and 324 individuals with severe CP. After adjusting for known risk factors, severe CP was not associated with an increased risk of total GI cancer relative to mild CP (HR: 0.99, 95% CI: 0.84-1.16) or individual GI cancers, including esophageal (HR: 1.15, 95% CI: 0.62-2.15), gastric (HR: 1.01, 95% CI: 0.68-1.49), small intestinal (HR: 0.70, 95% CI: 0.22-2.22), colorectal (HR: 0.95, 95% CI: 0.78-1.16), and pancreatic cancers (HR: 0.90, 95% CI: 0.47-1.75).Severe CP was not associated with an increased risk of total or individual GI cancers when compared with mild CP.

摘要

本研究旨在通过调查重度慢性牙周炎而非轻度慢性牙周炎是否与总体或特定胃肠道癌症风险增加相关,来评估慢性牙周炎的严重程度与胃肠道(GI)癌症风险之间的关联。从“国民健康保险研究数据库”(2001 - 2010年)中200万参保患者的随机样本中确定患有轻度和重度慢性牙周炎的成年人(≥18岁)。经过倾向得分匹配后,纳入25485名分别患有轻度或重度慢性牙周炎的个体进行比较。主要终点是总体或特定胃肠道癌症的发病率,包括食管癌、胃癌、小肠癌、结肠/直肠癌和胰腺癌。在调整已知风险因素后,使用具有稳健聚合三明治估计量的Cox比例风险模型来计算风险比(HR)和95%置信区间(95%CI)。

275名患有轻度慢性牙周炎的个体和324名患有重度慢性牙周炎的个体发生了胃肠道癌症。在调整已知风险因素后,与轻度慢性牙周炎相比,重度慢性牙周炎与总体胃肠道癌症风险增加无关(HR:0.99,95%CI:0.84 - 1.16),也与特定胃肠道癌症无关,包括食管癌(HR:1.15,95%CI:0.62 - 2.15)、胃癌(HR:1.01,95%CI:0.68 - 1.49)、小肠癌(HR:0.70,95%CI:0.22 - 2.22)、结肠直肠癌(HR:0.95,95%CI:0.78 - 1.16)和胰腺癌(HR:0.90,95%CI:0.47 - 1.75)。

与轻度慢性牙周炎相比,重度慢性牙周炎与总体或特定胃肠道癌症风险增加无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3e/6076176/04dca4c7cb1b/medi-97-e11386-g001.jpg

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