Matsuda Yuhei, Okui Tatsuo, Tatsumi Hiroto, Okuma Satoe, Kato Akira, Morioka Reon, Takeda Mayu, Kanno Takahiro
Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
Dysphagia. 2023 Aug;38(4):1096-1105. doi: 10.1007/s00455-022-10531-4. Epub 2022 Oct 15.
Patients with oral cancer have poor nutritional status before treatment. However, there have been no reports of the detailed evaluation of preoperative oral function in patients with oral squamous cell carcinoma (OSCC). Therefore, this study aimed to evaluate the preoperative oral function of patients with OSCC and examine the relationship with nutritional status. Oral function measurements (microorganisms, oral dryness, occlusal force, tongue pressure, masticatory function, Eating Assessment Tool, and Postoperative Oral Dysfunction Scale) and Mini Nutritional Assessment-Short Form (MNA-SF) data were collected from 51 patients with OSCC (men: 37, women: 14, mean age: 72.1 years) who visited the Shimane University Hospital, Department of Oral and Maxillofacial Surgery, from September 2019 to September 2021. The tongue was the most prevalent primary gingiva site [22 patients (43.1%)], and 36 patients (70.6%) had advanced cancer. Comparisons between nutritional status and each related factor revealed significant differences in the number of individuals in the household, cancer stage, presence of pulmonary disease, number of teeth, microorganisms (grade), and masticatory function (mg/dL) (p < 0.05). Multiple regression analysis using the total MNA-SF score as the dependent variable with adjustment for confounding factors showed significant association between oral dryness and tongue pressure (p < 0.05). No significant association was found for the Eating Assessment Tool or Postoperative Oral Dysfunction scale. Patients with OSCC may have decreased oral function because of the tumor at the time of diagnosis, which causes a decline in nutritional status. Preoperative interventions are necessary to improve nutrition based on the state of oral function.
口腔癌患者在治疗前营养状况较差。然而，尚无关于口腔鳞状细胞癌（OSCC）患者术前口腔功能详细评估的报道。因此，本研究旨在评估OSCC患者的术前口腔功能，并探讨其与营养状况的关系。收集了2019年9月至2021年9月期间就诊于岛根大学医院口腔颌面外科的51例OSCC患者（男性：37例，女性：14例，平均年龄：72.1岁）的口腔功能测量数据（微生物、口腔干燥、咬合力、舌压力、咀嚼功能、饮食评估工具和术后口腔功能障碍量表）以及微型营养评定简表（MNA-SF）数据。舌是最常见的原发牙龈部位[22例患者（43.1%）]，36例患者（70.6%）患有晚期癌症。营养状况与各相关因素之间的比较显示，家庭中个体数量、癌症分期、肺部疾病的存在、牙齿数量、微生物（分级）和咀嚼功能（mg/dL）存在显著差异（p<0.05）。以MNA-SF总分作为因变量并对混杂因素进行调整的多元回归分析显示，口腔干燥与舌压力之间存在显著关联（p<0.05）。饮食评估工具或术后口腔功能障碍量表未发现显著关联。OSCC患者在诊断时可能由于肿瘤导致口腔功能下降，进而引起营养状况下降。基于口腔功能状态进行术前干预以改善营养状况是必要的。
