Khanna Anshu, Sturgis Eric M, Dahlstrom Kristina R, Xu Li, Wei Qingyi, Li Guojun, Gross Neil D
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center Houston, TX, USA.
Duke Cancer Institute, Duke University Medical Center Durham, NC, USA.
Am J Cancer Res. 2021 May 15;11(5):2343-2350. eCollection 2021.
Smoking and alcohol exposure continue to be the dominant risk factors for the development of head and neck squamous cell carcinoma (SCCHN) worldwide. Moreover, human papillomavirus (HPV) is associated with SCCHN, particularly SCC of the oropharynx (SCCOP). Body mass index (BMI) has been reported as a possible risk factor for SCCHN, yet the data available so far about the relationship between BMI and SCCHN risk have been mixed. We sought to clarify this relationship. BMI and demographic, clinical, and epidemiological information at diagnosis were collected from 2310 SCCHN cases and 1915 controls (who were cancer-free) from October 2001 through May 2013. The odds ratios (ORs) and 95 percent confidence intervals (95% CI) were determined using the logistic regression process. Multivariable models were used to evaluate the strength of the relation between BMI and SCCHN risk. At diagnosis, 64 (2.8%) of the cases were underweight (BMI <18.5 kg/m), 661 (28.6%) were normal weight (BMI 18.5<25 kg/m), 833 (36.1%) were overweight (BMI 25<30 kg/m), and 752 (32.6%) were obese (BMI ≥30 kg/m). Comparatively, the ORs (95% CIs) for SCCHN associated with being underweight, overweight, and obese were 2.6 (1.54.7), 0.7 (0.6-0.8), and 0.8 (0.7-0.9), respectively, after adjusting for age, gender, race/ethnicity, smoking, and alcohol consumption. On analysis stratified by tumor sites, the risk of SCCOP among patients seropositive for HPVE6 and/or HPVE7 was higher among the overweight (OR, 5.4, 95% CI, 1.3-23.1) and obese patients (OR, 2.4, 95% CI, 1.1-7.6) compared to the normal weight patients. These findings suggest that pretreatment BMI could be a major risk factor for SCCHN, and the association between BMI and HPV may increase the risk of SCCOP.
在全球范围内，吸烟和接触酒精仍然是头颈部鳞状细胞癌（SCCHN）发生的主要危险因素。此外，人乳头瘤病毒（HPV）与SCCHN相关，尤其是口咽鳞状细胞癌（SCCOP）。据报道，体重指数（BMI）可能是SCCHN的一个危险因素，但目前关于BMI与SCCHN风险之间关系的数据并不一致。我们试图阐明这种关系。收集了2001年10月至2013年5月期间2310例SCCHN病例和1915名对照者（无癌症）诊断时的BMI以及人口统计学、临床和流行病学信息。使用逻辑回归分析确定比值比（OR）和95%置信区间（95%CI）。采用多变量模型评估BMI与SCCHN风险之间关系的强度。诊断时，64例（2.8%）病例体重过轻（BMI<18.5kg/m²），661例（28.6%）体重正常（BMI 18.5-25kg/m²），833例（36.1%）超重（BMI 25-30kg/m²），752例（32.6%）肥胖（BMI≥30kg/m²）。相比之下，在调整年龄、性别、种族/民族、吸烟和饮酒因素后，体重过轻、超重和肥胖与SCCHN相关的OR（95%CI）分别为2.6（1.5-4.7）、0.7（0.6-0.8）和0.8（0.7-0.9）。在按肿瘤部位分层分析时，与体重正常的患者相比，HPV E6和/或E7血清阳性患者中，超重（OR，5.4，95%CI，1.3-23.1）和肥胖患者（OR，2.4，95%CI，1.1-7.6）发生SCCOP的风险更高。这些研究结果表明，治疗前BMI可能是SCCHN的一个主要危险因素，且BMI与HPV之间的关联可能会增加SCCOP的风险。
