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CANCER EPRDEM BIOMAR:6.6万人随访8年发现,「小小」牙周病竟能让食管癌风险增加228%

2017-08-08 王鑫英 奇点网

他们发现:与没有牙周病的女性比,具有牙周病史的女性,患癌症的总体风险增加了14%(HR 1.14;95%CI,1.08-1.20),胆囊癌的风险增加了73%(HR, 1.73; 95% CI, 1.01–2.95)食管癌的风险更是增加了228%(HR 3.28;95% CI, 1.64–6.53)!此外,牙周病还与女性乳腺癌、肺癌和黑色素癌风险相关!

纽约州立大学布法罗分校研究人员开展的一项涉及约6.6万名女性(54-86岁),平均随访时间8.32年的研究结果显示——牙周病真是个大问题!

他们发现:与没有牙周病的女性比,具有牙周病史的女性,患癌症的总体风险增加了14%(HR 1.14;95%CI,1.08-1.20),胆囊癌的风险增加了73%(HR, 1.73; 95% CI, 1.01–2.95)食管癌的风险更是增加了228%(HR 3.28;95% CI, 1.64–6.53)!此外,牙周病还与女性乳腺癌肺癌和黑色素癌风险相关!

本研究的通讯作者,法罗分校公共卫生学院院长,Jean Wactawski-Wende教授表示:“这是第一项主要针对女性、尤其是老年女性的研究。我们的研究规模足够大、研究内容足够细致,不仅可以评估有牙周病史的老年女性患癌症的总体风险,还可以提供有关癌症特定发病部位的有用信息!”

该研究的第一作者,Ngozi Nwizu博士表示:“我们的研究是第一个报告牙周病与胆囊癌风险之间关系的研究!”

相关的研究结果,于本月初刊登在美国癌症研究协会杂志《癌流行病学:生物标记与预防》上。

值得一提的是,这项研究结果与2008年刊登在《柳叶刀肿瘤学》杂志上的研究结果不谋而合:一项涉及4.8万名男性(40-75岁)的研究也表明,与没有牙周病史的男性比,具有牙周病史的男性患癌症的总体风险增加了14%(HR 1.14;95%CI,1.07-1.22)!牙周病与男性肺癌、肾癌、胰腺癌、血癌风险相关。

今年3月份,在神级医学期刊CA上刊登的报告也显示:牙周病是引起结直肠癌和非霍奇金淋巴瘤的一个危险因素!(详见 神级医学期刊CA:小小牙周病竟是结直肠癌和淋巴瘤的高危因素!丨临床大发现)

牙周病是指发生在牙周组织的疾病,是人类口腔中最常见的疾病,也是成年人失牙的首位原因,主要包括累及牙龈组织的牙龈病和累及深层牙周组织的牙周炎。


左侧为正常牙齿(健康的牙龈、牙骨质),右侧为牙周病的牙齿(牙龈发炎、牙菌斑、牙周袋)

牙周病是人群中最广泛流行的慢性感染性疾病,患病率会随着年龄增加而增加。根据第三次全国口腔健康流行病学调查,当前我国有80%-97%的成年人患有不同程度的牙周病。在美国,65岁以上人群中,牙周病患病率也高达70%。

牙周病作为多因素疾病,其始动因子是菌斑微生物及其产物的侵袭。研究表明,口腔中约有30种细菌与牙周病的发生和发展有关。口腔中的细菌可以通过唾液进入到食管或结肠中,也可以通过牙菌斑经呼吸进入肺部,还可以通过病变的牙周组织经血液循环转移到远端器官。

已经有许多研究报道,从不同组织器官中分离出了牙周病致病菌,如淋巴结、肺、食管、结直肠]等。

进一步的研究表明,导致牙周病的牙龈卟啉单胞菌(P. gingivalis)和具核梭杆菌(F. nucleatum)能通过口腔上皮表面的蛋白(Toll样受体)刺激肿瘤发生;具核梭杆菌还能通过招募肿瘤浸润性免疫细胞,产生促炎微环境,利于结肠直肠癌的形成和发展!


不过,关于牙周病和癌症总体风险之间的流行病学研究还很少,2008年的研究也只是关注了牙周病和男性癌症风险的关系。那么,牙周病与女性癌症风险之间的关系又如何呢?

鉴于牙周病在高龄人群中的患病率更高,Wactawski-Wende教授带领团队,从一项全国性的前瞻性研究,妇女健康倡议观察研究(WHI-OS),这项研究旨在调查影响老年女性发病率和死亡率的风险因素。

根据一定的入组标准,研究人员选择了65869名54-86岁的女性,通过1999-2003年期间这些女性的自我报告问卷调查,获得了她们的牙周病史及相关信息;并进行了平均8.32年的随访,根据在2013年9月确定的癌症发生结果,研究人员对相关的数据进行了分析。


参与调查的女性中,共有7149例癌症,其中最主要的是乳腺癌(n=2416) ,其次是肺癌和支气管癌(n=855)、结直肠癌(n=639)。牙周病与癌症总体风险增加有关(HR 1.14;95%CI,1.08-1.20)。即便是排除了吸烟,这个与牙周病或癌症相关的干扰因素后,牙周病与癌症总体风险的关系也依然如此(HR 1.12;95%CI,1.04-1.22)!

其中,有牙周病史的女性,其食管癌的风险最高(HR 3.28;95%CI,1.64-6.53),其次是胆囊癌(HR 1.73;95%CI,1.01-2.95)。牙周病还与乳腺癌、肺癌和黑色素瘤风险有关。

Nwizu博士表示:“食管癌是最致命的癌症之一,其病因虽尚不清楚,但慢性炎症牵涉其中。”

针对这一结果,Wende教授认为“食管靠近口腔,因此牙周病原体可能更容易获得和感染食管粘膜并促进该部位的癌症风险。”

看到这样的数据,奇点糕忍不住去查询了我国的癌症数据。权威统计数据显示,2015年,我国癌症新发病例约有429万、癌症死亡病例约有281万。其中,食管癌居男性最常见癌症的第3位、女性最常见癌症的第5位;并且,食管癌是男女因癌症死亡的第4大死因!

2015年中国癌症死亡率及癌症估计死亡人数


看来这项研究对我国人民也有重要参考意义啊!

这项研究还有一个重要的意义,在于选择的人群是老年女性,人口老龄化已经让老年人口不断增加,这项研究也为老年人的疾病研究开启了一扇窗!

虽然研究人员还没有进行牙周病与癌症风险的因果关系研究,但是,研究人员表示需要开展牙周病治疗的干预研究,以确定这种干预是否可以降低癌症总体风险或特定癌症的风险!
原始出处:
Jean Wactawski-Wende,Michael J. LaMonte,James R. Marshall.et al.Periodontal Disease and Incident Cancer Risk among Postmenopausal Women: Results from the Women's Health Initiative Observational Cohort.Cancer Epidemiology, Biomarkers & Prevention

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    2018-06-28 sunylz
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    2017-08-19 sjq027
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    2017-09-06 海之蓝

    学习

    0

  4. 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target=_blank style='color:#2F92EE;'>#牙周#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67495, encryptionId=f0476e49582, topicName=牙周)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab585558129, createdName=liuyong2982, createdTime=Wed Aug 09 23:48:00 CST 2017, time=2017-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=231763, encodeId=09a3231e634c, content=学习了谢谢了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Aug 09 10:24:10 CST 2017, time=2017-08-09, status=1, ipAttribution=), 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    2017-08-09 linagood
  5. 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GetPortalCommentsPageByObjectIdResponse(id=231421, encodeId=8309231421ba, content=怎么防治呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Tue Aug 08 09:58:23 CST 2017, time=2017-08-08, status=1, ipAttribution=)]
    2017-08-09 zhouqu_8
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  7. 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target=_blank style='color:#2F92EE;'>#牙周#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67495, encryptionId=f0476e49582, topicName=牙周)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab585558129, createdName=liuyong2982, createdTime=Wed Aug 09 23:48:00 CST 2017, time=2017-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=231763, encodeId=09a3231e634c, content=学习了谢谢了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Aug 09 10:24:10 CST 2017, time=2017-08-09, status=1, ipAttribution=), 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    2017-08-09 186****0580(小山羊)

    学习了谢谢了。

    0

  8. 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target=_blank style='color:#2F92EE;'>#牙周#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67495, encryptionId=f0476e49582, topicName=牙周)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab585558129, createdName=liuyong2982, createdTime=Wed Aug 09 23:48:00 CST 2017, time=2017-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=231763, encodeId=09a3231e634c, content=学习了谢谢了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Aug 09 10:24:10 CST 2017, time=2017-08-09, status=1, ipAttribution=), 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GetPortalCommentsPageByObjectIdResponse(id=231421, encodeId=8309231421ba, content=怎么防治呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Tue Aug 08 09:58:23 CST 2017, time=2017-08-08, status=1, ipAttribution=)]
    2017-08-09 changjiu

    学习了,谢谢

    0

  9. 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    2017-08-08 zhixue

    治疗牙周炎的重要性!

    0

  10. 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createdName=sjq027, createdTime=Sat Aug 19 07:48:00 CST 2017, time=2017-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241036, encodeId=cc3b24103636, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJpBl6xwMmnsKibwxcAIltOH3nnCEQbNE6TDbYtCKe8hYI0oJrbduNqnJraM1PyyjPKU1suAzicYPaA/132, createdBy=eeaf2031798, createdName=海之蓝, createdTime=Wed Sep 06 12:53:33 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1282251, encodeId=8769128225194, content=<a href='/topic/show?id=46a06e5220c' target=_blank style='color:#2F92EE;'>#牙周病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67522, encryptionId=46a06e5220c, topicName=牙周病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1376173, createdName=linagood, createdTime=Wed Aug 09 23:48:00 CST 2017, time=2017-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437232, encodeId=e7cf143e23269, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed Aug 09 23:48:00 CST 2017, time=2017-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1450589, encodeId=1ca5145058979, content=<a href='/topic/show?id=f0476e49582' target=_blank style='color:#2F92EE;'>#牙周#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67495, encryptionId=f0476e49582, topicName=牙周)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab585558129, createdName=liuyong2982, createdTime=Wed Aug 09 23:48:00 CST 2017, time=2017-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=231763, encodeId=09a3231e634c, content=学习了谢谢了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Aug 09 10:24:10 CST 2017, time=2017-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=231661, encodeId=070f2316618f, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Wed Aug 09 05:53:16 CST 2017, time=2017-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=231553, encodeId=5b74231553e3, content=治疗牙周炎的重要性!, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25101619573, createdName=zhixue, createdTime=Tue Aug 08 17:23:04 CST 2017, time=2017-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=231421, encodeId=8309231421ba, content=怎么防治呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Tue Aug 08 09:58:23 CST 2017, time=2017-08-08, status=1, ipAttribution=)]
    2017-08-08 lyh994

    怎么防治呢?

    0

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