School of Dentistry, Biohealth Research Institute (IBS), University of Granada, Granada, Spain.
Endocrinology and Nutrition Department, Cadiz Biomedical Research and Innovation Institute (INiBICA), Puerta del Mar University Hospital, Cádiz, Spain.
Oral Dis. 2021 Apr;27(3):404-421. doi: 10.1111/odi.13289. Epub 2020 Feb 18.
The objective was to evaluate current evidence on the prevalence and risk of oral cancer and potentially malignant oral disorders among patients with diabetes mellitus. We searched PubMed, Embase, Web of Science, and Scopus for observational studies published before November 2019. We evaluated the study quality using GRADE, QUIPS, and a specific method for systematic reviews addressing prevalence questions. Meta-analyses were conducted, and heterogeneity and publication bias were examined. A total of 1,489 studies were found, 116 analyzed in full text, 52 included in qualitative synthesis and 49 meta-analyzed. Pooled prevalence (PP) of oral cancer in patients with diabetic was 0.25% (95% CI = 0.15-0.39)-250 per 100,000 patients with diabetes mellitus -with a greater chance of oral cancer among patients with diabetes mellitus (OR = 1.41 [95% CI = 1.10-1.81], p = .007). Patients with oral cancer and diabetes mellitus had a higher mortality than controls (HR = 2.09 [95%CI = 1.36-3.22], p = .001). Leukoplakia had a PP = 2.49% (95% CI = 1.14-4.29)-2,490 per 100,000 patients with diabetes mellitus -(OR = 4.34 [95% CI = 1.14-16.55], p = .03). A PP of 2.72 (95% CI = 1.64-4.02) was obtained for oral lichen planus among patients with diabetic -2,720 per 100,000 patients with diabetes mellitus (OR = 1.87 [95% CI = 1.37-2.57], p < .001). A low PP was estimated for erythroplakia (0.02%[95%CI = 0.00-0.12]-20 per 100,000 patients with diabetes mellitus. In conclusion, patients with diabetes mellitus have a higher prevalence and greater chance of oral cancer and OPMD development in comparison with non-diabetic patients. In addition, patients with oral cancer suffering from diabetes mellitus have a higher mortality compared to non-diabetic patients with oral cancer.
目的在于评估糖尿病患者口腔癌和潜在恶性口腔疾病的患病率和风险的现有证据。我们在 PubMed、Embase、Web of Science 和 Scopus 中检索了 2019 年 11 月之前发表的观察性研究。我们使用 GRADE、QUIPS 和专门针对系统评价患病率问题的方法评估了研究质量。进行了荟萃分析，并检查了异质性和发表偏倚。共发现 1489 项研究，对 116 项进行了全文分析，52 项纳入定性综合分析，49 项进行了荟萃分析。糖尿病患者口腔癌的总患病率（PP）为 0.25%（95%CI=0.15-0.39）-每 100000 名糖尿病患者中有 250 名患有口腔癌-糖尿病患者患口腔癌的可能性更大（OR=1.41[95%CI=1.10-1.81]，p=0.007）。患有口腔癌和糖尿病的患者比对照组的死亡率更高（HR=2.09[95%CI=1.36-3.22]，p=0.001）。口腔白斑病的 PP 为 2.49%（95%CI=1.14-4.29）-每 100000 名糖尿病患者中有 2490 名患有口腔白斑病（OR=4.34[95%CI=1.14-16.55]，p=0.03）。糖尿病患者口腔扁平苔藓的 PP 为 2.72%（95%CI=1.64-4.02）-每 100000 名糖尿病患者中有 2720 名患有口腔扁平苔藓（OR=1.87[95%CI=1.37-2.57]，p<0.001）。红斑的 PP 估计值较低（0.02%[95%CI=0.00-0.12]-每 100000 名糖尿病患者中有 20 名患有红斑）。结论：与非糖尿病患者相比，糖尿病患者的口腔癌和 OPMD 发病率更高，发生几率更大。此外，患有口腔癌并患有糖尿病的患者比患有口腔癌但无糖尿病的患者死亡率更高。
