Morse D E, Katz R V, Pendrys D G, Holford T R, Krutchkoff D J, Eisenberg E, Kosis D, Mayne S T
University of Connecticut Health Center School of Dental Medicine, Farmington 06030-3910, USA.
Cancer Epidemiol Biomarkers Prev. 1996 Oct;5(10):769-77.
Oral epithelial dysplasia (OED) is a histopathological diagnosis that is associated with an increased risk of oral cancer. The purpose of this case-control study was to measure the association between OED and the use of smoking tobacco and alcoholic beverages. Incident cases of OED (n = 127) were identified through two oral pathology laboratories. Controls, pair-matched 1:1 to cases on age (+/- 5 years), gender, appointment date (+/- 1 year), and surgeon, were identified through the office in which the respective case had been biopsied. Exposure information regarding smoking, drinking, and other potential risk factors was obtained through a standardized telephone interview. Conditional logistic regression was used to calculate measures of association and statistical significance. The odds ratio (OR) for current smoking adjusted for drinking, mouthwash use, denture status, and education was 4.1 (95% confidence interval, 2.1-7.9) relative to never/ex-smokers. The risk of OED increased with increasing levels of smoking and declined following smoking cessation, with ex-smokers of 15+ years demonstrating no excess risk relative to never smokers. Individuals drinking 7+ drinks/week, relative to less than that amount, had over twice the risk of OED (OR, 2.4; 95% confidence interval, 1.2-4.8) after controlling for smoking, mouthwash use, denture status, and education. Adjusted ORs tended to increase with increasing levels of alcohol intake. An exploratory analysis suggests that the joint effect of smoking and drinking may be more than additive as regards the risk of OED. The findings of this case-control study implicate smoking and drinking as important risk factors for OED.
口腔上皮发育异常（OED）是一种组织病理学诊断，与口腔癌风险增加相关。本病例对照研究的目的是测量OED与吸烟和饮用酒精饮料之间的关联。通过两个口腔病理实验室确定了OED的新发病例（n = 127）。对照与病例按年龄（±5岁）、性别、预约日期（±1年）和外科医生进行1:1配对，通过各自病例活检所在的办公室确定。通过标准化电话访谈获取有关吸烟、饮酒和其他潜在风险因素的暴露信息。使用条件逻辑回归计算关联度和统计学显著性指标。在调整了饮酒、漱口水使用、假牙状况和教育程度后，当前吸烟者相对于从不吸烟者/已戒烟者的优势比（OR）为4.1（95%置信区间，2.1 - 7.9）。OED的风险随着吸烟量的增加而增加，戒烟后风险下降，戒烟15年以上的人相对于从不吸烟者没有额外风险。每周饮用7杯以上饮料的人，相对于饮用较少饮料的人，在控制了吸烟、漱口水使用、假牙状况和教育程度后，患OED的风险是其两倍多（OR，2.4；95%置信区间，1.2 - 4.8）。调整后的OR值倾向于随着酒精摄入量的增加而增加。一项探索性分析表明，就OED风险而言，吸烟和饮酒的联合作用可能不仅仅是相加的。本病例对照研究的结果表明吸烟和饮酒是OED的重要风险因素。
