饮酒、吸烟及其交互作用与口腔癌关系的病例对照研究

The Case-control Study of the Relationship between Alcohol Drinking,Tobacco Smoking and Oral Cancer

目的探讨饮酒、吸烟与口腔癌的关系。方法采用病例对照研究收集相关资料，病例为福建医科大学附属第一医院口腔科经病理确诊的新发口腔癌病例206例，对照为体检人群及其他科室患者584例。每位研究对象进行面对面的问卷调查。采用非条件Logistic回归对资料进行分析，估算饮酒、吸烟与口腔癌发病风险的调整比值比（OR）及95％可信区间（95％CI），并分析饮酒与吸烟的交互作用。结果饮酒、吸烟可显著增加口腔癌的发病风险，调整OR值为2．06（95％CI：1．33～3．20），2．46（1．77～3．41）；开始饮酒年龄越早、平均每天饮酒精量的增加和饮酒年限的延长，饮酒者患口腔癌的危险性增大。其中平均每天饮酒精量超过60g者与口腔癌有显著关联（P〈0．05），调整OR值为5．98（95％CI：3．26～10．95）；吸烟且饮酒者患口腔癌的危险性是不吸烟且不饮酒者的4．77倍（95％CI：2．71～8．39），烟酒乘积项的调整OR值为3．58（95％CI：2．45～5．24），调整后相对超危险度比（RERI）为2．87（95％CI：0．73～5．02）、归因比（AP）为0．60（95％CI：0．33～0．87）、交互作用指数（S）为4．20（95％CI：0．95～18．66）。结论饮酒、吸烟是口腔癌的危险因素，饮酒与吸烟二者有协同作用，可增加口腔癌的发病风险。

Objective To investigate the association between alcohol drinking, tobacoo smoking and oral cancer. Methods We conducted a case-control study with 205 cases and 584 population-based controls. Patients were recruited from the First Clinical Medical College with pathologic confirmation. Control subjects were enrolled from hospital visitors and community population. Eligible participants were personally interviewed using a questionnaire. Unconditional logistic regression model and single factor analysis was performed to calculate to alcohol drinking and oral cancer risk odds ratios （ORs） and 95% confidence intervals （CIs）, and to analysis the interaction of alcohol drinking and smoking. Results Al- cohol drinking can significantly increase the risk of oral cancer, ORs and CIs were 2.06（95% CI. 1.33- 3.01）. As the earlier start drinking age, the increasion of average alcohol consumption one day, the extension of drinking years, drinkers increase risk of oral cancer. Among them, drinkers who one day on average alcohol consumption more than 60 g has significant correlation on oral cancer （P〈0.05）, ORs were 5.98 （95% CI. 3.26-10.95）; The risk of oral cancer with both smoking and drinking were 4.77 times more than one neither smoking nor drinking （95% CI. 2. 71-8. 39）. Using Logistic regression model, the ORs were 3.58（95% CI.2.45-5.24）of cross-product term of smoking and drinking. Adjusted RERI, AP and S were 2.87（95% CI. 0. 73-5.02）, 0.60（95% CI. 0. 33-0.87）, 4.20（95% CI. 0. 95 -18.66）. Alcohol drinking have multiplication and addition interaction with smoking, they could increase the risk of oral cancer. Oonclusions There is synergistic effect between drinking and smoking, they could increase the risk of oral cancer.