Government Medical College, Omandurar, Government Estate, Chennai, Tamilnadu, 600 002, India.
Department of Pathology, Government Medical College, Omandurar, Government Estate, Chennai, Tamilnadu, 600 002, India.
BMC Cancer. 2024 Aug 1;24(1):930. doi: 10.1186/s12885-024-12685-w.
Betel quid chewing, prevalent in Southeast Asia and South Asia, involves components such as betel leaf, areca nut, slaked lime, and sometimes tobacco. This study aims to assess buccal mucosa changes in betel quid chewers, develop a clinical tool for assessing exposure, and investigate its usability in predicting dysplasia.
After obtaining ethical approval and informed consent, patients were recruited from the Out-Patient Department of Government Medical College, Omandurar, Government Estate, India. A target sample size of 200 was calculated. The data included the history of betel quid chewing, buccal mucosa cells obtained by oral cytology, and the severity of dysplasia of the slides assessed by pathologists. We utilized principal component analysis (PCA) and confirmatory factor analysis (CFA) to validate a new outcome variable reflecting nuclear morphometric parameters (NMPs). Multiplicative regression models were developed for betel years based on betel exposure and additives. Spearman correlation and Kruskal-Wallis test was used to check the association between betel years and dysplasia.
Significant differences in NMPs were observed among different betel chewing groups. We derived multiplicative regression models for betel years. In the logarithmic transformation approach, betel year = 0.05×betel-exposure×0.09×slaked-lime use×0.11×tobacco-use. In the original variable approach, betel year = 5.05×betel-exposure^0.00048×slaked-lime-use^0.18133×tobacco-use^1.47513. Spearman correlation and Kruskal-Wallis tests confirmed associations with dysplasia.
Betel year is a pioneering tool for assessing lifetime betel quid exposure, similar to pack years for smoking. It could aid in risk stratification, targeted interventions and shaping public health policies. Despite limitations, betel year holds promise for revolutionizing oral health risk assessment, and future research can expand its scope globally, considering diverse betel quid compositions.
咀嚼槟榔在东南亚和南亚很普遍，其中包含槟榔叶、槟榔果、熟石灰，有时还有烟草。本研究旨在评估咀嚼槟榔者的口腔黏膜变化，开发一种评估暴露的临床工具，并研究其在预测异型增生中的可用性。
在获得伦理批准和知情同意后，我们从印度政府医学院的门诊部门招募了患者。计算出目标样本量为 200。数据包括咀嚼槟榔的历史、通过口腔细胞学获得的口腔黏膜细胞，以及病理学家评估的幻灯片中异型增生的严重程度。我们利用主成分分析（PCA）和验证性因子分析（CFA）来验证反映核形态计量参数（NMPs）的新结果变量。根据槟榔暴露和添加剂，为槟榔年开发了乘法回归模型。Spearman 相关性和 Kruskal-Wallis 检验用于检查槟榔年与异型增生之间的关联。
不同咀嚼槟榔组之间的 NMP 存在显著差异。我们得出了槟榔年的乘法回归模型。在对数转换方法中，槟榔年=0.05×槟榔暴露×0.09×熟石灰使用×0.11×烟草使用。在原始变量方法中，槟榔年=5.05×槟榔暴露^0.00048×熟石灰使用^0.18133×烟草使用^1.47513。Spearman 相关性和 Kruskal-Wallis 检验证实了与异型增生的关联。
槟榔年是评估终生咀嚼槟榔暴露的开创性工具，类似于吸烟的包年。它可以帮助进行风险分层、有针对性的干预和制定公共卫生政策。尽管存在局限性，但槟榔年有望彻底改变口腔健康风险评估，未来的研究可以在全球范围内扩大其范围，考虑到不同的槟榔组成。
