口腔機能障害は口腔がん治療後の栄養失調を引き起こす可能性があることを、単一施設の横断的研究で明らかにした

Oral functional impairment may cause malnutrition following oral cancer treatment in a single-center cross-sectional study.

抄録

口腔がん治療後の口腔機能障害や嚥下障害は、栄養状態の変化と関連する。栄養状態に関連する具体的な口腔機能を明らかにすることを目的とした．2019年9月から2021年12月まで横断研究を実施し、男性52名、女性23名の計75名（年齢中央値：72.0歳）を募集し、背景データを収集し、口腔機能を評価した。Mini Nutritional Assessment-Short Form（MNA-SF）スコアを3群（正常栄養状態、栄養失調リスクあり、栄養失調）に分け、各口腔機能測定（微生物、口腔乾燥、咬合力、舌圧、咀嚼機能、Eating Assessment Tool［EAT-10］）について多群比較を実施した。原発腫瘍部位は，舌が 31 例（41.3％），歯肉が 30 例（40.0％），その他が 14 例（18.7％）であった．多重比較により，術後の口腔機能障害をType I（輸送型），Type III（咬合型）に分類し，咬合力，舌圧，咀嚼機能，EAT-10値を各MNA-SF群間で有意に差をつけて示した．重回帰分析の結果，咀嚼機能およびEAT-10値は，Type Iに分類されるMNA-SFと統計的に有意な関連を示した．Type IとType IIIは栄養不良の危険因子であり，術後の口腔機能障害の種類によって独自の栄養指導が必要であることが確認された．

Oral dysfunction and dysphagia after oral cancer treatment are linked to altered nutritional status. We aimed to identify specific oral functions related to nutritional status. We conducted a cross-sectional study from September 2019 to December 2021, recruited 75 participants (median age: 72.0 years), including 52 males and 23 females, collected background data, and evaluated oral function. The Mini Nutritional Assessment-Short Form (MNA-SF) scores were divided into three groups (normal nutritional status, at risk of malnutrition, and malnourished), and a multi-group comparison was conducted for each oral function measurement (microorganisms, oral dryness, occlusal force, tongue pressure, masticatory function, and Eating Assessment Tool [EAT-10]). The primary tumor site was the tongue in 31 patients (41.3%), gingiva in 30 (40.0%), and others in 14 (18.7%). Multiple comparisons revealed significant differences in occlusal force, tongue pressure, masticatory function, and EAT-10 levels, categorized as Type I (Transport type) and Type III (Occlusion type) postoperative oral dysfunctions, between each MNA-SF group. Multiple regression analysis showed a statistically significant association with MNA-SF in terms of masticatory function and EAT-10 levels, categorized as Type I. Type I and Type III are risk factors for malnutrition, confirming that different types of postoperative oral dysfunction require unique nutritional guidance.