CAJ | 학술논문

目的：探讨口腔卫生状况及慢性病与口腔鳞状细胞癌的关系。方法采用病例-对照研究方法，收集2010年9月至2015年1月经病理确诊的口腔鳞状细胞癌新发病例414例，同期收集来自社区的对照870例。采用统一编制的调查表，面访收集研究对象的人口学特征、吸烟史、饮酒史、饮茶史、口腔卫生、饮食习惯、肿瘤家族史、既往疾病史等，应用非条件logistic回归模型分析口腔卫生习惯及慢性病与口腔鳞状细胞癌发病风险的调整OR(95%CI)值；按照吸烟状况、饮酒状况及性别进行分层，分析不良修复体、复发性口腔溃疡及高血压与口腔鳞状细胞癌的关联。结果多因素分析发现，口腔鳞状细胞癌的危险因素有目前牙齿数为20~27颗及<20颗（以目前牙齿数≥28颗为参照）、不良修复体、复发性口腔溃疡，其调整OR(95%CI)值分别为2.01(1.49~2.73)、3.51(2.39~5.15)、2.33(1.79~3.04)、3.96(2.11~7.44)；而刷牙频率为1次/d、刷牙频率>1次/d、看牙医周期≥5年/次是口腔鳞状细胞癌的保护因素，其调整OR(95%CI)值分别为0.24(0.13~0.43)、0.13(0.07~0.24)、0.37(0.26~0.53)。分层分析发现，复发性口腔溃疡可增加非吸烟者和非饮酒者口腔鳞状细胞癌的发病风险，调整OR(95%CI)值分别为5.21(2.42~11.18)和4.71(2.37~9.36)；在非吸烟者和非饮酒者中，高血压与口腔鳞状细胞癌的发生存在关联，调整OR(95%CI)值分别为1.70(1.10~2.61)和1.58(1.07~2.34)。结论口腔卫生状况及慢性病对口腔鳞状细胞癌的发生有一定影响。
목적：탐토구강위생상황급만성병여구강린상세포암적관계。방법채용병례-대조연구방법，수집2010년9월지2015년1월경병리학진적구강린상세포암신발병례414례，동기수집래자사구적대조870례。채용통일편제적조사표，면방수집연구대상적인구학특정、흡연사、음주사、음다사、구강위생、음식습관、종류가족사、기왕질병사등，응용비조건logistic회귀모형분석구강위생습관급만성병여구강린상세포암발병풍험적조정OR(95%CI)치；안조흡연상황、음주상황급성별진행분층，분석불량수복체、복발성구강궤양급고혈압여구강린상세포암적관련。결과다인소분석발현，구강린상세포암적위험인소유목전아치수위20~27과급<20과（이목전아치수≥28과위삼조）、불량수복체、복발성구강궤양，기조정OR(95%CI)치분별위2.01(1.49~2.73)、3.51(2.39~5.15)、2.33(1.79~3.04)、3.96(2.11~7.44)；이쇄아빈솔위1차/d、쇄아빈솔>1차/d、간아의주기≥5년/차시구강린상세포암적보호인소，기조정OR(95%CI)치분별위0.24(0.13~0.43)、0.13(0.07~0.24)、0.37(0.26~0.53)。분층분석발현，복발성구강궤양가증가비흡연자화비음주자구강린상세포암적발병풍험，조정OR(95%CI)치분별위5.21(2.42~11.18)화4.71(2.37~9.36)；재비흡연자화비음주자중，고혈압여구강린상세포암적발생존재관련，조정OR(95%CI)치분별위1.70(1.10~2.61)화1.58(1.07~2.34)。결론구강위생상황급만성병대구강린상세포암적발생유일정영향。
Objective To investigate the association between oral hygiene, chronic diseases, and oral squamous cell carcinoma. Methods We performed a case-control study with 414 cases and 870 controls in Fujian during September 2010 to January 2015. Patients were newly diagnosed oral squamous cell carcinoma cases according to the pathologic diagnoses, control subjects were enrolled from community population. Epidemiological data were collected by in-person interviews using a standard questionnaire . The contents of the questionnaire included demography character, history of tobacco smoking and alcohol drinking, dietary habits, oral hygiene status, family history of cancer, etc. Using unconditional logistic regression analysis to estimate adjusted odds ratios (OR) and corresponding 95% confidence intervals (CI) for oral hygiene and chronic diseases. We also stratified by sex, smoking and drinking to explore possible difference in association between subgroups. Results The multivariate logistic regression analysis indicated that number of teeth(20-27 and<20), bad prosthesis, recurrent oral ulceration were the risk factors of oral squamous cell carcinoma, the adjusted OR(95%CI) values were 2.01(1.49-2.73), 3.51(2.39-5.15), 2.33(1.79-3.04), 3.96(2.11-7.44), respectively;brushing tooth once per bay,brushing tooth more than once per day, regular oral health examination at least 5 years per time were the protective factors of oral squamous cell carcinoma, the adjusted OR(95%CI) values were 0.24 (0.13-0.43),0.13 (0.07-0.24), 0.37 (0.26-0.53), respectively. The stratification analysis indicated that recurrent oral ulceration could increase the risk of oral squamous cell carcinoma for non-smokers and non-drinking, the adjusted OR(95%CI) value was 5.21(2.42-11.18) and 4.71(2.37-9.36);and a risky effect of hypertension on risk of oral squamous cell carcinoma was observed for non-smokers and non-drinking, the adjusted OR(95%CI) values were 1.70 (1.10-2.61) and 1.58 (1.07-2.34) . Conclusions Oral hygiene and chronic diseases could affect the incidence of oral squamous cell carcinoma.