歯周病は口腔癌のリスクファクターか？

Is periodontal disease a risk factor for oral cancer?

抄録

本研究の目的は、歯周病が口腔癌の非遺伝的危険因子であることを明らかにすることである。組織学的に口腔扁平上皮癌（OSCC）と確認された患者100名を症例群とし、対照群は口腔癌のない患者100名とした。方法 社会経済的リスク因子とライフスタイルのリスク因子を得るための多変量解析を両群の質問票を用いて行い、統計的に比較検討した。また，両群の口腔状態（歯周病期，臨床的付着力喪失，歯周ポケット深さ，プロービング時の出血，Silness-Loe プラーク指数，虫歯・欠損・充填歯 [DMFT] 指数）を記録し，統計的に比較した． 結果 年齢，性別と口腔がん発症の間に有意な相関がみられた．また、アルコール摂取量と口腔がん発症の間に有意な相関が認められた。意外なことに、症例群では喫煙習慣および受動喫煙と口腔癌の発生との間に相関は認められなかった。歯周炎は，症例群では 72.1%が Stage 4 であったが，対照群では 51.6%が Stage 2 であった．結論 本研究の結果は、歯周炎が口腔癌の独立したリスクファクターであるという仮説を支持するものであった。

Aim This study aimed to investigate periodontal disease as a non-genetic risk factor for oral cancer.Design Case-control study.Patient population Two hundred patients, regardless of periodontal and adverse habits (smoking and alcohol) status, in the age group of 18-90 years were included in this institutional study. One hundred patients with histologically confirmed oral squamous cell carcinoma (OSCC) were included in the case group, while the control group had 100 patients without any oral cancer.Methods Multivariable examination to obtain socioeconomic and lifestyle risk factors was performed with a questionnaire for both the groups and compared statistically. Additionally, oral status (periodontal stage, clinical attachment loss, periodontal pocket depth, bleeding on probing, Silness-Loe plaque index, and decayed, missing, and filled teeth [DMFT] index) of both the groups was recorded and compared statistically.Results A significant correlation was found between age, gender and development of oral cancer. There was a significant co-relation between alcohol intake and oral cancer development. Surprisingly, there was no correlation between smoking habits and passive smoking with oral cancer development in the case group. Overall, 72.1% of case group patients had Stage 4 periodontitis, whereas 51.6% of control group patients had Stage 2 periodontitis. A significant correlation was found between the incidence of oral cancer and the stage of periodontitis.Conclusion The findings of the study support the hypothesis that periodontitis is an independent risk factor for oral cancer.