背景:这项研究的主要目的是确定众所周知的口腔癌危险因素之间的联系,包括吸烟(香烟和烟草),酒精消费,槟榔咀嚼,在口腔的刺激,头颈癌病史,和室外工作超过4天/周的历史,以及泰国人口中OPMD的存在。
方法:招募349,318名受试者进行初步筛查,随后,1,483名至少有1个危险因素且有可疑病变的受试者接受了全面的口腔检查,随后进行了临床诊断,然后接受了口腔外科医生或口腔医学专家的初步治疗.在这些科目中,具有至少1个危险因素且临床诊断为OPMD的个体被分类为病例,而那些至少有1个危险因素但没有OPMD的被归类为对照。病例组共有487名受试者,而对照组由996名受试者组成。排除标准是目前患有口腔癌或OPMD的已知病例。
结果:多变量分析的结果显示,在评估的变量中,槟榔(调整后OR5.12[3.93-6.68],p<0.001)和吸烟(调整后OR1.46[1.08-1.97],p=0.013),与OPMD的存在有关。相反,饮酒,在口腔有刺激,有头颈部癌症史,并且每周在户外工作超过4天的历史与OPMD的存在无关。此外,我们还研究了饮酒的协同作用,在口腔的刺激,头颈癌病史,和使用亚组分析在户外工作超过4天/周的历史。分析表明,饮酒与吸烟或嚼槟榔相结合,表明OPMD的风险显着增加,从1.46到2.03(OR2.03[1.16-3.56],p=0.014)和从5.12到7.20(OR7.20[3.96-13.09],p<0.001)。
结论:吸烟和接触槟榔是OPMD存在的重要危险因素。在泰国东北部人口中,酒精与吸烟或槟榔咀嚼的结合也会增加OPMD的风险。
BACKGROUND: The principal objective of this study is to ascertain the connections between well-known risk factors of oral cancer, including smoking (cigarette and tobacco), alcohol consumption, betel quid chewing, irritations in the oral cavity, history of head and neck cancer, and history of working outdoor more than 4 days/week, and the presence of OPMDs within the Thai population.
METHODS: 349,318 subjects were recruited for initial screening, then 1,483 subjects who had at least 1 risk factor and a suspicious lesion underwent comprehensive oral examinations followed by a clinical diagnosis and then received initial treatment from either oral surgeons or oral medicine specialists. Among these subjects, individuals with at least 1 risk factor and with a clinical diagnosis of OPMDs were classified as cases, while those with at least 1 risk factor but without OPMDs were categorized as controls. The case group comprised a total of 487 subjects, whereas the control group consisted of 996 subjects. Exclusion criteria were known cases of currently having oral cancer or OPMDs.
RESULTS: The outcomes of the multivariate analysis revealed that among the variables assessed, betel quid (adjusted OR 5.12 [3.93-6.68], p < 0.001) and smoking (adjusted OR 1.46 [1.08-1.97], p = 0.013), there were an association with the presence of OPMDs. Conversely, alcohol drinking, having irritations in the oral cavity, a history of head and neck cancer, and a history of working outdoors more than 4 days/week were not associated with the presence of OPMDs. Furthermore, we also study the synergistic effect of alcohol drinking, irritations in the oral cavity, history of head and neck cancer, and history of working outdoors more than 4 days/week using subgroup analysis. The analysis showed that alcohol consumption combined with smoking or betel quid chewing expressed a significantly increased risk of OPMDs, from 1.46 to 2.03 (OR 2.03 [1.16-3.56], p = 0.014) and from 5.12 to 7.20 (OR 7.20 [3.96-13.09], p < 0.001).
CONCLUSIONS: Smoking and exposure to betel quid were a significant risk factors for the presence of OPMDs. The combination of alcohol with smoking or betel quid chewing was also found to increase the risk of OPMDs in this Thai northeastern population.