CAJ | 학술논문

目的：探讨饮茶与非吸烟、非饮酒人群口腔癌的关系。方法采用病例-对照研究设计，收集2010年9月至2015年1月经病理确诊的非吸烟、非饮酒人群口腔癌新发病例203例和同期社区对照人群572名。调查研究对象的人口学特征、吸烟史、饮酒史、饮茶史、既往疾病史、肿瘤家族史、职业史等。应用非条件logistic回归模型估算饮茶与非吸烟、非饮酒人群口腔癌发病风险的调整OR （95%CI）值，并进一步对性别、年龄、居住地、被动吸烟进行分层分析，以及对饮茶与被动吸烟进行相乘交互作用分析；利用超额相对危险度（RERI）、归因比（AP）和交互作用指数（SI）对饮茶与被动吸烟进行相加交互作用分析。结果与不饮茶者相比，饮茶（OR=0.52,95%CI：0.34~0.81）、开始饮茶年龄≥18岁（OR=0.54,95%CI：0.34~0.85）、无论饮茶年限<20年（OR=0.49,95%CI：0.27~0.90）还是≥20年（OR=0.55,95%CI：0.32~0.95）、平均每日饮茶量<700 ml（OR=0.52,95%CI：0.32~0.86）、饮茶浓度适中（OR=0.56,95%CI：0.32~0.96）、饮淡茶（OR=0.35,95%CI：0.16~0.77）、饮绿茶（OR=0.48,95%CI：0.28~0.82）、饮温茶（OR=0.55,95%CI：0.31~0.98）可降低非吸烟、非饮酒人群口腔癌的风险。分层分析结果显示，在女性（OR=0.53,95%CI：0.30~0.94）、年龄<60岁（OR=0.53,95%CI：0.29~0.97）、居住在城市（OR=0.38,95%CI：0.20~0.69）、无被动吸烟（OR=0.47,95%CI：0.25~0.86）的非吸烟非饮酒人群中，饮茶具有保护作用；饮茶与被动吸烟之间不存在相乘交互作用（OR=0.95,95%CI：0.41～2.20）及相加交互作用(RERI=-0.15,95%CI：-0.92~0.62； AP=-0.16,95%CI：-1.06~0.73； SI=-0.18,95%CI：-1.44~0.87)。结论饮茶、开始饮茶年龄、平均每日饮茶量、饮茶类型、饮茶浓度及饮茶温度对非吸烟、非饮酒人群口腔癌的发生具有一定的影响。
목적：탐토음다여비흡연、비음주인군구강암적관계。방법채용병례-대조연구설계，수집2010년9월지2015년1월경병리학진적비흡연、비음주인군구강암신발병례203례화동기사구대조인군572명。조사연구대상적인구학특정、흡연사、음주사、음다사、기왕질병사、종류가족사、직업사등。응용비조건logistic회귀모형고산음다여비흡연、비음주인군구강암발병풍험적조정OR （95%CI）치，병진일보대성별、년령、거주지、피동흡연진행분층분석，이급대음다여피동흡연진행상승교호작용분석；이용초액상대위험도（RERI）、귀인비（AP）화교호작용지수（SI）대음다여피동흡연진행상가교호작용분석。결과여불음다자상비，음다（OR=0.52,95%CI：0.34~0.81）、개시음다년령≥18세（OR=0.54,95%CI：0.34~0.85）、무론음다년한<20년（OR=0.49,95%CI：0.27~0.90）환시≥20년（OR=0.55,95%CI：0.32~0.95）、평균매일음다량<700 ml（OR=0.52,95%CI：0.32~0.86）、음다농도괄중（OR=0.56,95%CI：0.32~0.96）、음담다（OR=0.35,95%CI：0.16~0.77）、음록다（OR=0.48,95%CI：0.28~0.82）、음온다（OR=0.55,95%CI：0.31~0.98）가강저비흡연、비음주인군구강암적풍험。분층분석결과현시，재녀성（OR=0.53,95%CI：0.30~0.94）、년령<60세（OR=0.53,95%CI：0.29~0.97）、거주재성시（OR=0.38,95%CI：0.20~0.69）、무피동흡연（OR=0.47,95%CI：0.25~0.86）적비흡연비음주인군중，음다구유보호작용；음다여피동흡연지간불존재상승교호작용（OR=0.95,95%CI：0.41～2.20）급상가교호작용(RERI=-0.15,95%CI：-0.92~0.62； AP=-0.16,95%CI：-1.06~0.73； SI=-0.18,95%CI：-1.44~0.87)。결론음다、개시음다년령、평균매일음다량、음다류형、음다농도급음다온도대비흡연、비음주인군구강암적발생구유일정적영향。
Objective To investigate the effect of tea on oral cancer in nonsmokers and nondrinkers. Methods A case-control study were performed between September 2010 and January 2015 including 203 oral cancer cases in nonsmokers and nondrinkers with pathologically confirmed and 572 community controls. The related information included socio-demographic characteristics, detailed information on tobacco smoking and alcohol and tea consumption, personal medical history, family history of cancer, and occupational history were collected from all subjects. Unconditional logistic regression analysis was used to calculate the odds ratios (OR) and 95%confidence intervals (95%CI) to examine the effect of tea on oral cancer and to assess multiplicative interactions between tea and passive smoking. We also stratified by age, sex, residence, and passive smoking to explore possible difference in association between subgroups. Additive interactions between tea and passive smoking were assessed using relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (SI). Results Compared with non-tea drinkers, tea consumption (OR=0.52, 95%CI:0.34-0.81), age of tea drinking initiation (years)≥18 (OR=0.54, 95%CI: 0.34-0.85), duration of tea consumption (years) <20 (OR=0.49, 95%CI: 0.27-0.90), duration of tea consumption (years)≥20(OR=0.55, 95%CI:0.32-0.95), average daily tea consumed<700 ml(OR=0.52,95%CI:0.32-0.86), moderate concentration of tea consumed (OR=0.56,95%CI:0.32-0.96), weak concentration of tea consumed(OR=0.35, 95%CI: 0.16-0.77), drinking green-tea(OR=0.48,95%CI: 0.28-0.82) and drinking moderate temperature of tea (OR=0.55,95%CI: 0.31-0.98) could reduce the risk of oral cancer; Stratified analysis indicated the protective effects of tea drinking on female (OR=0.53,95%CI:0.30-0.94), age<60 years old (OR=0.53,95%CI:0.29-0.97), live in the urban(OR=0.38,95%CI:0.20-0.69) and no passive smoking(OR=0.47,95%CI:0.25-0.86) population with nonsmoking and nondrinking was more obvious; Crossover analysis showed tea and passive smoking did not exist multiplication interaction relationship (OR=0.95,95%CI:0.41-2.20) and addition interaction relationship (RERI=-0.15,95%CI:-0.92-0.62;AP=-0.16,95%CI:-1.06-0.73;SI=-0.18, 95%CI:-1.44-0.87). Conclusion Tea consumption, age of tea drinking initiation, duration of tea consumption, average daily tea consumed, concentration of tea consumed, types of tea and temperature of tea might have impact on the incidence of oral cancer in nonsmokers and nondrinkers to a certain extent.