CA：小小牙周病竟是结直肠癌和淋巴瘤的高危因素！

2017-03-11 应雨妍奇点网

今天，影响因子高达 137.6 的神级医学杂志《CA： A Cancer Journal for Clinicians》上刊登了一篇报告：越来越多的证据证明，牙周病是引起结直肠癌和非霍奇金淋巴瘤（NHL）的一个危险因素 [1]！在报告中，作者 Mary Kay Barton 博士总结了 2016 年 11 月的《International Journal of Cancer》杂志上发表的两篇研究，

今天，影响因子高达 137.6 的神级医学杂志《CA： A Cancer Journal for Clinicians》上刊登了一篇报告：越来越多的证据证明，牙周病是引起结直肠癌和非霍奇金淋巴瘤（NHL）的一个危险因素 [1]！

在报告中，作者 Mary Kay Barton 博士总结了 2016 年 11 月的《International Journal of Cancer》杂志上发表的两篇研究，分别阐述了牙周病与这两种癌症之间的相关性。牙周病是牙齿支持组织的一种慢性炎症，支持组织包括牙龈、牙周韧带、牙骨质等。牙周病是最常见的口腔疾病之一，通常分为牙龈炎和牙周炎，而牙周病也是导致我们“失去牙齿”的主要原因之一。

牙周病虽然看似只是影响口腔健康，但是过去的研究已经确定它和许多种癌症，包括肺癌、胰腺癌、乳腺癌和胃癌等等都有关系。然而，两种常见且很重要的恶性肿瘤——结直肠癌和非霍奇金淋巴瘤（NHL）与牙周病的关联却很少有研究者关注。其中结直肠癌是第三大常见的癌症，杀伤力在所有癌种中位列第四，NHL 在我国也是比较常见的一种肿瘤，处于常见恶性肿瘤前 10 位以内，这两种癌症的患者与牙周病患者之间的重合率想必也是很高的。

第一个研究覆盖了来自美国 11 个州的 121700 名女护士，从 1992 年开始，研究人员每 2 年对她们进行一次随访调查，直到 2010 年研究结束。通过多变量 Cox 比例风险回归模型的分析，他们发现，与 25-32 颗牙齿的女性（正常人的牙齿数量通常为 28 颗加 0 - 4 颗智齿）相比，牙齿少于 17 颗的患结直肠癌的风险比（Hazard Ratio，HR）为 1.2，意味着牙齿少于 17 颗且患结直肠癌的女护士的数量是 25-32 颗牙齿的 1.2 倍。而患有中度至重度牙周病的女护士群体的风险比为 1.22[2]。对于这个结果，研究的通讯作者，布莱根妇女医院的流行病学家 Xuehong Zhang 博士说：“牙周病会影响口腔健康，增加全身性炎症，导致免疫失调，改变肠道微生物群，从而可能使得结直肠癌的风险提高，我们的队列研究支持这个理论的可行性”。

另一个研究是由美国波士顿大学斯隆流行病学中心的研究人员领导的，这项研究持续的时间更长一些，从 1986 年一直到 2012 年，共有 51529 名男性参与了研究，其中有 875 人被确诊为 NHL。同样使用 Cox 模型进行分析，有牙周病病史的志愿者的风险比为 1.26。根据研究通讯作者 Kimberly Bertrand 教授的介绍，他们发现患牙周病会使 NHL 的风险增加 30%[3]，他们的研究首次提供了一个有力的证据——牙周病是 NHL 的一个新的高风险因素。以这两个研究为例，Barton 博士认为，尽管研究的人群存在局限性，但是如此大规模、长时间的研究仍然为研究结果增加了可信度，牙周病增加癌症风险的“阵营”中又多了两位“重量级选手”。接下来的研究中，研究人员应该进一步确定这其中的生物学机制。而且研究也提示我们良好的口腔健康十分重要，Barton 博士建议，我们应该保持每天刷牙的习惯，定期看牙医，防止牙周病的发生，从而降低癌症的风险。

与牙周相关的拓展阅读：

有关牙周更多资讯

参考文献：

[1]Mary Kay Barton. Evidence accumulates indicating periodontal disease as a risk factor for colorectal cancer or lymphoma.CA: A Cancer Journal for Clinicians,2017,doi: 10.3322/caac.21367

[2]Fatemeh Momen-Heravi,Ana Babic,Shelley S. Tworoger,et al. Periodontal disease， tooth loss and colorectal cancer risk： Results from the Nurses’ Health Study.Int. J. Cancer,23 November 2016,DOI: 10.1002/ijc.30486View/save citation

[3] Andrew M. Evens,Janki Shingala,Evangelos Papathanasiou,et al.Periodontal disease and risk of non-Hodgkin lymphoma in the Health Professionals Follow-Up Study.Blood 2015 126:5024;DOI: https://doi.org/

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2019-05-29 2460c931m

学习

130 0
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2017-03-13 1e1263e3m20(暂无匿称)

小小的一颗牙，居然能引发大问题，学习了

133 0
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createdName=飛歌, createdTime=Sat Mar 11 12:28:09 CST 2017, time=2017-03-11, status=1, ipAttribution=)]
2017-03-13 虈亣靌

很好的学习资料，谢谢了。

98 0
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createdName=飛歌, createdTime=Sat Mar 11 12:28:09 CST 2017, time=2017-03-11, status=1, ipAttribution=)]
2017-03-13 linagood

#牙周病#

57 0
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2017-03-13 liuyong2982

#牙周#

52 0
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createdName=飛歌, createdTime=Sat Mar 11 12:28:09 CST 2017, time=2017-03-11, status=1, ipAttribution=)]
2017-03-13 crystal0564

#结直肠#

53 0
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createdName=飛歌, createdTime=Sat Mar 11 12:28:09 CST 2017, time=2017-03-11, status=1, ipAttribution=)]
2017-03-12 蔬菜

这样也能上神级杂志？

110 0
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createdName=飛歌, createdTime=Sat Mar 11 12:28:09 CST 2017, time=2017-03-11, status=1, ipAttribution=)]
2017-03-11 Chongyang Zhang

签到学习了很多。

83 0
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createdName=飛歌, createdTime=Sat Mar 11 12:28:09 CST 2017, time=2017-03-11, status=1, ipAttribution=)]
2017-03-11 cqykthl

看来人类口腔也不可小看哦！

61 0
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2017-03-11 飛歌

这样也会，这么厉害

67 0