Abstract:
Objective: To investigate the effects between fish, seafood and pickled food intakes on oral squamous cell carcinoma (OSCC). Methods: A case-control study was carried out in Fujian area during September 2010 to December 2016, in which 604 newly diagnosed primary OSCC cases confirmed by pathological diagnosis were collected from hospital and 1 343 control subjects were enrolled from community and healthy hospital population. Demographic data, history of smoking drinking and tea drinking, oral hygiene status and dietary behaviors (fish, seafood and pickled food intakes) were collected by in-person interviews using a standard questionnaire.Using unconditional logistic regression to estimate adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) to assess the effects of fish, seafood and pickled food intakes on OSCC. Analysis stratified by smoking, alcohol drinking and bad prosthesis to explore the possible difference in association between subgroups. Multiplicative interactions and additive interactions between fish and bad prosthesis, seafood and alcohol drinking, pickled food and bad prosthesis were assessed by unconditional logistic regression, relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S). Results: The average age of case group and control group were separately (58.69±13.92) years old and (59.27±11.37) years old (χ(2)=4.75, P=0.191). The people whose fish and seafood intakes ≥3 times/week had the lower risk of OSCC, the adjusted OR (95%CI) values were 0.63 (0.52-0.77) and 0.51 (0.41-0.64); The stratified analysis indicated that the people having bad prosthesis had the lower risk of OSCC if they eating fish ≥3 times/week, and the adjusted OR (95%CI) values was 0.53 (0.39-0.71); the people having bad prosthesis had the higher risk of OSCC if they eating pickled food ≥3 times/week, the adjusted OR (95%CI) values was 1.37 (1.02-1.88). Regularly eating seafood can decrease the risk of OSCC for non-smokers, smokers, non-drinkers, drinkers, people without bad prosthesis and had bad prosthesis, the adjusted OR (95%CI) values were 0.49 (0.36-0.68), 0.52 (0.37-0.73), 0.41 (0.31-0.55), 0.77 (0.51-0.96), 0.49 (0.36-0.67), 0.59 (0.42-0.83). Crossover analysis showed fish and bad prosthesis exist multiplication interaction relationship (adjusted OR=0.66, 95%CI: 0.44-0.97) and additional interaction relationship (RERI=-0.81, 95%CI:-1.43--0.19; AP=-0.76, 95%CI:-1.35--0.17; S=0.08, 95%CI: 0.01-0.98); pickled food and bad prosthesis exist multiplication interaction relationship (adjusted OR=1.63, 95%CI: 1.06-2.51) and addition interaction relationship (RERI=0.65, 95%CI:0.08-1.22; AP=0.36, 95%CI:0.10-0.62; S=5.19, 95%CI:1.32-54.49). Conclusion: Reducing the consumption of pickled food, quitting smoking and limiting alcohol consumption, and regularly eating fish and seafood can prevent the occurrence of OSCC.
目的: 分析食用腌制食品、鱼肉、海鲜与口腔鳞状细胞癌(OSCC)的关系。 方法: 采用病例-对照研究方法,收集2010年9月至2016年12月在医院确诊的604例OSCC新发病例;同期收集来自社区和医院体检的健康人群为对照组,共1 343名。采用统一编制的问卷,调查人口学特征、吸烟史、饮酒史、饮茶史、口腔卫生情况、膳食情况(包括食用腌制食品、鱼肉和海鲜)等。采用多因素二分类非条件logistic回归模型分析鱼肉、海鲜、腌制食品与OSCC发病的关系;采用分层分析方法,对食用鱼肉、海鲜和腌制食品等因素按照吸烟、饮酒和不良修复体携带情况进行分层分析;采用非条件logistic回归模型并结合超额相对危险度、归因比和交互作用指数等指标,对鱼肉与不良修复体、海鲜与饮酒、腌制食品与不良修复体分别进行相乘、相加交互作用分析。 结果: 病例组对象的年龄为(58.69±13.92)岁,对照组对象的年龄为(59.27±11.37)岁(χ(2)=4.75,P=0.191)。食用鱼肉≥3次/周、食用海鲜≥3次/周者发生OSCC风险较低,调整OR(95%CI)值分别为0.63(0.52~0.77)和0.51(0.41~0.64)。分层分析发现,食用鱼肉≥3次/周的不良修复体携带者发生OSCC的风险较低,调整OR(95%CI)值为0.53(0.39~0.71);食用腌制食品的不良修复体携带者发生OSCC的风险增加,调整OR(95%CI)值为1.37(1.02~1.88);无论非吸烟和吸烟者、非饮酒和饮酒者、不携带不良修复体和携带者中,食用海鲜≥3次/周均与发生OSCC呈负相关,调整OR(95%CI)值分别为0.49(0.36~0.68)、0.52(0.37~0.73)、0.41(0.31~0.55)、0.77(0.51~0.96)、0.49(0.36~0.67)、0.59(0.42~0.83)。交互作用分析发现,鱼肉与不良修复体存在负相乘交互作用(调整OR=0.66,95%CI:0.44~0.97)和负相加交互作用(超额相对危险度为-0.81,95%CI:-1.43~-0.19;归因比为-0.76,95%CI:-1.35~-0.17;交互作用指数为=0.08,95%CI:0.01~0.98);腌制食品与不良修复体存在正相乘交互作用(调整OR=1.63,95%CI:1.06~2.51)和相加交互作用(超额相对危险度为0.65,95%CI:0.08~1.22;归因比为0.36,95%CI:0.10~0.62;交互作用指数为5.19,95%CI:1.32~54.49)。 结论: 减少食用腌制食品,戒烟限酒,及时根治不良修复体,规律地食用鱼肉、海鲜可能降低OSCC风险。.