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炎症生物标志物与口腔健康障碍作为头颈癌的预测指标:一项回顾性纵向研究

Inflammatory Biomarkers and Oral Health Disorders as Predictors of Head and Neck Cancer: A Retrospective Longitudinal Study.

作者信息

Ghanem Amr Sayed, Sipos Kitti, Tóth Ágnes, Nagy Attila Csaba

机构信息

Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, 4028 Debrecen, Hungary.

Department of Operative Dentistry and Endodontics, Faculty of Dentistry, University of Debrecen, 4032 Debrecen, Hungary.

出版信息

Int J Mol Sci. 2025 Mar 4;26(5):2279. doi: 10.3390/ijms26052279.

Abstract

Head and neck cancers (HNCs) are often diagnosed late, leading to poor prognosis. Chronic inflammation, particularly periodontitis, has been linked to carcinogenesis, but systemic inflammatory markers remain underexplored. This study was the first to examine whether elevated C-reactive protein (CRP) can serve as a cost-effective adjunct in HNC risk assessment, alongside oral health indicators. A retrospective cohort study analysed 23,742 hospital records (4833 patients, 2015-2022) from the University Hospital of Debrecen. HNC cases were identified using ICD-10 codes, with CRP and periodontitis as key predictors. Kaplan-Meier survival analysis, log-rank tests, and Weibull regression were used to assess risk, with model performance evaluated via AIC/BIC and ROC curves. Periodontitis was significantly associated with HNC (HR 5.99 [1.96-18.30]), while elevated CRP (>15 mg/L) independently increased risk (HR 4.16 [1.45-12.00]). Females had a significantly lower risk than males (HR 0.06 [0.01-0.50]). CRP may serve as a cost-effective, easily accessible biomarker for early HNC detection when combined with oral health screening. Integrating systemic inflammation markers into HNC risk assessment models could potentially improve early diagnosis in high-risk populations.

摘要

头颈癌(HNCs)往往在晚期才被诊断出来,导致预后不良。慢性炎症,尤其是牙周炎,与致癌作用有关,但全身炎症标志物仍未得到充分研究。本研究首次探讨了C反应蛋白(CRP)升高是否能作为一种经济有效的辅助手段,与口腔健康指标一起用于HNC风险评估。一项回顾性队列研究分析了德布勒森大学医院的23742份医院记录(4833例患者,2015 - 2022年)。使用ICD - 10编码确定HNC病例,将CRP和牙周炎作为关键预测指标。采用Kaplan - Meier生存分析、对数秩检验和威布尔回归来评估风险,通过AIC/BIC和ROC曲线评估模型性能。牙周炎与HNC显著相关(风险比5.99 [1.96 - 18.30]),而CRP升高(>15 mg/L)独立增加风险(风险比4.16 [1.45 - 12.00])。女性的风险显著低于男性(风险比0.06 [0.01 - 0.50])。当与口腔健康筛查相结合时,CRP可能作为一种经济有效、易于获取的生物标志物用于早期HNC检测。将全身炎症标志物纳入HNC风险评估模型可能会改善高危人群的早期诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/672f/11900271/508fbd9e701b/ijms-26-02279-g001.jpg

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