食道癌患者のリスクファクターとしての歯垢および唾液中の口腔感染細菌

Oral infectious bacteria in dental plaque and saliva as risk factors in patients with esophageal cancer.

抄録

背景:

食道癌患者の癌組織からは、Streptococcus anginosusだけでなく歯周病原性細菌が高濃度で検出された。口腔感染性細菌と食道がんとの関連性が報告されている。

BACKGROUND: High levels of periodontopathic bacteria as well as Streptococcus anginosus were detected in cancer tissue from patients with esophageal cancer. An association between oral infectious bacteria and esophageal cancer has been reported.

方法:

食道癌患者の臨床病理学的因子として、口腔内細菌叢の特徴と歯周病状態を検討した。対象は食道癌患者61名と癌のないマッチした62名である。歯肉縁下歯垢および非刺激唾液のサンプルを採取し、リアルタイムポリメラーゼ連鎖反応アッセイを用いて以下の口腔内細菌の有病率と存在量を評価した：Aggregatibacter actinomycetemcomitans、Fusobacterium nucleatum、Porphyromonas gingivalis、Prevotella intermedia、Tannerella forsythia、Treponema denticola、S. anginosus。

METHODS: Characteristics of the oral microbiota and periodontal conditions were studied as clinicopathologic factors in patients with esophageal cancer. The study included 61 patients with esophageal cancer and 62 matched individuals without any cancers. Samples of subgingival dental plaque and unstimulated saliva were collected to evaluate the prevalence and abundance of the following oral bacteria using a real-time polymerase chain reaction assay: Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Treponema denticola, and S. anginosus.

結果:

癌群では、歯垢中のF. nucleatumを除くすべての細菌の有病率、唾液中のA. actinomycetemcomitansの有病率、歯垢中のF. nucleatumおよびP. intermediaを除くすべての細菌の存在量、唾液中のA. actinomycetemcomitansおよびS. anginosusの存在量が有意に高かった。さらに、ロジスティック回帰分析の結果、歯垢中のT. forsythiaとS. anginosusの有病率、唾液中のA. actinomycetemcomitansの有病率、および飲酒習慣は、高いオッズ比をもって食道がんの高リスクと関連することが示唆された。

RESULTS: In the cancer group, the prevalence of all bacteria, with the exception of F. nucleatum, in dental plaque; the prevalence of A. actinomycetemcomitans in saliva; the abundance of all bacteria, with the exception of F. nucleatum and P. intermedia, in dental plaque; and the abundance of A. actinomycetemcomitans and S. anginosus in saliva were significantly higher. Furthermore, a logistic regression analysis suggested that the prevalence of T. forsythia and S. anginosus in dental plaque and of A. actinomycetemcomitans in saliva, as well as a drinking habit, were associated with a high risk of esophageal cancer, with a high odds ratio.

結論:

今回の知見は、食道癌の早期診断に役立つ可能性がある。

CONCLUSIONS: The current findings have potential implications for the early diagnosis of esophageal cancer.