1 Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.
2 Oral Cancer Center and Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea.
J Dent Res. 2019 May;98(5):526-533. doi: 10.1177/0022034519827565. Epub 2019 Feb 19.
The association between oral squamous cell carcinoma (OSCC) and periodontitis in large hospital cases with cohort controls has yet to be evaluated. The aim of this study was to investigate the association of periodontitis with OSCC across tumor location and tumor-node-metastasis (TNM) stage among Koreans ( N = 424). OSCC cases ( n = 146) were recruited from Seoul National University Dental Hospital and matched by age, sex, and smoking to controls ( n = 278) from the Yangpyeong health and periodontal cohort in Korea. OSCC was diagnosed through biopsy and radiographs, including computed tomography and magnetic resonance imaging. Tumor location and TNM stage were classified after the surgery. Periodontitis was defined by alveolar bone loss with panoramic radiographs following the guidelines of the Fifth European Workshop in Periodontology. Alcohol intake, education, physical activity, obesity by body mass index, hypertension by blood pressure, diabetes by plasma glucose, and hypercholesterolemia by plasma cholesterol were considered as confounders. Information about age, sex, smoking, alcohol intake, education, and physical activity was obtained through interview; body mass index and blood pressure, through physical examination; and preoperative glucose and cholesterol, through laboratory tests. Bivariate analysis was applied with Fisher's exact chi-square test. Multivariable conditional logistic regression models were applied to evaluate the adjusted association of periodontitis with OSCC after controlling for confounders. Subgroup analyses were explored by OSCC and periodontitis. Participants with periodontitis were 3.7 times more likely to have OSCC (adjusted odds ratio [aOR] = 3.66, 95% CI = 1.46 to 9.23) than participants without periodontitis. The differences in periodontitis were not statistically significant across TNM stages of OSCC ( P > 0.05) and its location ( P > 0.05). The link was highlighted among males (aOR = 6.55), elders aged >60 y (aOR = 4.98), and those with more tooth loss (aOR = 9.99). Our data showed that periodontitis was independently associated with OSCC. Thus, the risk of OSCC could be modulated by reducing periodontitis.
口腔鳞状细胞癌 (OSCC) 与牙周炎之间的关联在大型医院病例的队列对照研究中尚未得到评估。本研究的目的是调查牙周炎与韩国人群中肿瘤位置和肿瘤-淋巴结-转移 (TNM) 分期之间的 OSCC 之间的关联 (N = 424)。OSCC 病例 (n = 146) 来自首尔国立大学牙科医院，并按年龄、性别和吸烟情况与韩国 Yangpyeong 健康和牙周队列中的对照组 (n = 278) 匹配。OSCC 通过活检和影像学检查（包括计算机断层扫描和磁共振成像）进行诊断。手术后对肿瘤位置和 TNM 分期进行分类。牙周炎通过牙周炎第五次欧洲研讨会指南下的全景放射影像中牙槽骨丧失来定义。饮酒、教育、体力活动、身体质量指数的肥胖、血压的高血压、血浆葡萄糖的糖尿病和血浆胆固醇的高胆固醇血症被认为是混杂因素。年龄、性别、吸烟、饮酒、教育和体力活动的信息通过访谈获得；体重指数和血压通过体检获得；术前血糖和胆固醇通过实验室检查获得。采用 Fisher 确切卡方检验进行双变量分析。采用多变量条件逻辑回归模型，在校正混杂因素后，评估牙周炎与 OSCC 的调整关联。通过 OSCC 和牙周炎进行亚组分析。患有牙周炎的参与者患 OSCC 的可能性是没有牙周炎的参与者的 3.7 倍（调整后的优势比 [aOR] = 3.66，95%置信区间 [CI] = 1.46 至 9.23）。在 OSCC 的 TNM 分期（P > 0.05）及其位置（P > 0.05）方面，牙周炎的差异无统计学意义。该关联在男性（aOR = 6.55）、年龄 > 60 岁的老年人（aOR = 4.98）和牙齿缺失较多的人群中更为显著（aOR = 9.99）。我们的数据表明，牙周炎与 OSCC 独立相关。因此，通过减少牙周炎，OSCC 的风险可能会得到调节。
