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河南省安阳市文峰区某自然村居民牙齿脱落与食管癌风险前瞻性研究

Prospective Study on Tooth Loss and Risk of Esophageal Cancer Among Residents of A Natural Village in Wenfeng District, Anyang City, Henan Province

  • 摘要:
    目的 研究河南省安阳市文峰区某自然村牙齿脱落与食管癌发生的关系。
    方法 采用前瞻性队列研究方法,自2008年1月至2024年7月对该自然村无症状居民连续随访16年,观察居民牙齿脱落及食管癌发生的情况。资料统计采用卡方检验和二元Logistic回归及限制性立方样条图(RCS)。
    结果 总人群711人,失访136人,最终纳入统计575人,其中患食管癌者45人,牙齿有无脱落在食管癌患者中具有明显统计学差异(P<0.05)。Logistic回归分析表明牙齿脱落与食管癌发生有关(OR=3.977,95%CI:1.543~10.255),调整混杂因素后发现,牙齿脱落仍与食管癌发生有显著关系(OR=3.038,95%CI:1.035~8.914)。牙齿脱落颗数与食管癌发生存在非线性剂量-反应关系:当牙齿脱落<12颗时,患食管癌风险会随着牙齿脱落颗数增加而增大;当牙齿脱落≥12颗时,患食管癌风险会随着牙齿脱落颗数增加而降低。
    结论 该村牙齿脱落是食管癌发生危险因素。当牙齿脱落颗数<12时,随着牙齿脱落颗数增加,患癌风险增大。

     

    Abstract:
    Objective To investigate the relationship between tooth loss and the occurrence of esophageal cancer in a natural village in Wenfeng District, Anyang City, Henan Province.
    Methods A prospective cohort study was conducted to observe the occurrence of tooth loss and esophageal cancer among the asymptomatic residents of the natural village for 16 years from January 2008 to July 2024. Data were analyzed by chi-square test, binary logistic regression, and restricted cubic spline.
    Results Among the total population of 711 cases, 136 cases were lost to follow-up and 575 cases were included in the final statistics, including 45 cases with esophageal cancer. Significant statistical difference was found between esophageal cancer patients with and without tooth loss (P<0.05). Logistic regression analysis showed that tooth loss was associated with the occurrence of esophageal cancer (OR=3.977, 95%CI: 1.543-10.255). After the adjustment for confounders, tooth loss remained significantly associated with the occurrence of esophageal cancer (OR=3.038, 95%CI: 1.035-8.914). A nonlinear dose-response relationship was observed between the number of teeth lost and the incidence of esophageal cancer. When the number of teeth lost was less than 12, the risk of esophageal cancer increased with the number of teeth lost. When more than 12 teeth were lost, the risk of esophageal cancer decreased as the number of teeth lost increased.
    Conclusion Tooth loss is a risk factor for the occurrence of esophageal cancer in this natural village. When the number of teeth lost is less than 12, the risk of esophageal cancer increases with the number of teeth lost.

     

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