Idris A M, Ahmed H M, Malik M O
Faculty of Dentistry, University of Khartoum, Sudan.
Int J Cancer. 1995 Nov 15;63(4):477-80. doi: 10.1002/ijc.2910630402.
To investigate the possible causal association between squamous-cell carcinomas of the oral cavity and use of toombak, we retrospectively compared the history of use of this substance in 375 patients with squamous-cell carcinomas of the lip, buccal cavity and floor of mouth, and 271 patients with squamous carcinomas of the tongue, palate and maxillary sinus, with 204 patients exhibiting non-squamous oral and non-oral malignant neoplasms and 2,820 individuals who had no malignancy, selected from the general population. The study revealed that the high prevalence of oral cancer in the Sudan is largely due to chronic use of toombak. The adjusted ORs associated with toombak dipping for the first case group, cancer of the lip, buccal cavity and floor of mouth in comparison with the hospital and population control groups, were 7.3 and 3.9 (95% confidence limits, 4.3-12.4 and 2.9-5.3) respectively and among long-term users the adjusted ORs were 11.0 and 4.3 (95% confidence limits, 4.8-25.1 and 2.9-6.3) respectively. The elevated risk found when investigating intra-oral cancers of sites in direct contact with toombak quid compared to those with little or no contact, confirms the hypothesis that direct contact with tissues is an important factor in tobacco carcinogenesis in the mouth. The increased risk associated with the use of toombak is of particular concern in view of its wide consumption in the Sudan.
为了研究口腔鳞状细胞癌与使用吐姆巴克之间可能存在的因果关系，我们进行了回顾性研究，比较了375例唇、颊部和口腔底部鳞状细胞癌患者、271例舌、腭和上颌窦鳞状细胞癌患者使用这种物质的历史，对照组为204例患有非鳞状口腔和非口腔恶性肿瘤的患者以及从普通人群中选取的2820名无恶性肿瘤的个体。研究表明，苏丹口腔癌的高发病率很大程度上归因于吐姆巴克的长期使用。与医院和人群对照组相比，第一组病例（唇、颊部和口腔底部癌症）中与蘸用吐姆巴克相关的校正比值比分别为7.3和3.9（95%置信区间，4.3 - 12.4和2.9 - 5.3），长期使用者中的校正比值比分别为11.0和4.3（95%置信区间，4.8 - 25.1和2.9 - 6.3）。与几乎没有接触或无接触的部位相比，在研究与吐姆巴克咀嚼块直接接触部位的口腔内癌症时发现风险升高，这证实了直接接触组织是口腔烟草致癌的一个重要因素这一假设。鉴于吐姆巴克在苏丹广泛消费，与使用吐姆巴克相关的风险增加尤其令人担忧。
