Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
Thorac Cancer. 2020 Oct;11(10):2804-2811. doi: 10.1111/1759-7714.13595. Epub 2020 Aug 18.
To investigate oral leukoplakia (OL) and risk of upper gastrointestinal (UGI) cancer deaths in the Linxian Dysplasia Nutrition Intervention Trial (NIT) cohort.
A total of 3318 subjects with esophageal squamous dysplasia enrolled on 1 May 1985, and were followed up until 30 September 2015. Participants with OL at baseline were treated as an exposed group, while the remainder was selected as a control group. All subjects were followed monthly and reviewed quarterly by the Linxian Cancer Registry. Cox proportional hazard model was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs).
During the 30-year follow-up, a total of 902 UGI cancer deaths occurred, including 541 esophageal squamous cell carcinoma (ESCC) related, 284 gastric cardia carcinoma (GCC) related, and 77 gastric noncardia carcinoma (GNCC) related deaths. Relative to subjects without OL, the long-term risk of ESCC mortality in participants with OL increased by 26.1% (HR = 1.26, 95% CI: 1.05-1.52). In the subgroup analyses, adverse effects of OL on ESCC mortality were observed especially in younger subjects (HR = 1.48, 95% CI: 1.11-1.97), females (HR = 1.44, 95% CI: 1.11-1.89), non-smokers (HR = 1.44, 95% CI: 1.15-1.81), nondrinkers (HR = 1.28, 95% CI: 1.04-1.57), and individuals with a family history of cancer (HR = 1.37, 95% CI: 1.05-1.79). No associations were observed between OL and risk of GCC and GNCC mortality.
OL may increase the long-term risk of ESCC mortality, especially in younger subjects, females, nondrinkers, non-smokers, and subjects with a family cancer history. Future studies are needed to explore the potentially etiological mechanism.
为了在林县发育不良营养干预试验（NIT）队列中调查口腔白斑（OL）和上消化道（UGI）癌症死亡的风险。
共有 3318 名食管鳞状上皮发育不良的受试者于 1985 年 5 月 1 日入组，并随访至 2015 年 9 月 30 日。基线时患有 OL 的参与者被视为暴露组，其余参与者被选为对照组。所有参与者每月随访一次，并由林县癌症登记处每季度复查一次。使用 Cox 比例风险模型估计风险比（HRs）和 95%置信区间（95%CI）。
在 30 年的随访期间，共发生 902 例 UGI 癌症死亡，包括 541 例食管鳞状细胞癌（ESCC）相关、284 例贲门癌（GCC）相关和 77 例胃非贲门癌（GNCC）相关死亡。与无 OL 的受试者相比，OL 患者的 ESCC 死亡率长期风险增加了 26.1%（HR=1.26，95%CI：1.05-1.52）。在亚组分析中，OL 对 ESCC 死亡率的不良影响尤其见于年轻患者（HR=1.48，95%CI：1.11-1.97）、女性（HR=1.44，95%CI：1.11-1.89）、不吸烟者（HR=1.44，95%CI：1.15-1.81）、不饮酒者（HR=1.28，95%CI：1.04-1.57）和有癌症家族史者（HR=1.37，95%CI：1.05-1.79）。OL 与 GCC 和 GNCC 死亡率之间无关联。
OL 可能会增加 ESCC 死亡率的长期风险，尤其是在年轻患者、女性、不饮酒者、不吸烟者和有癌症家族史的患者中。需要进一步的研究来探讨其潜在的病因机制。
