福建省非吸烟人群口腔癌发病影响因素病例对照研究

Influencing factors of oral cancer in nonsmokers: a case-control study in Fujian province

目的了解福建省非吸烟人群口腔癌的发病影响因素，为口腔癌的防治提供科学依据。方法采用以医院为基础病例对照研究方法对2010年9月—2014年1月在福建医科大学附属第一医院收治的161例非吸烟新发口腔癌患者及同期在该医院进行健康体检和在其他科室就诊的547例非吸烟非口腔相关疾病患者进行问卷调查。结果病例组患者〈18岁被动吸烟史、≥18岁被动吸烟史、不良修复体、刷牙频率〉2次／天、有口腔溃疡、食水果频率〈1次／天的比例分别为37．27％、49．07％、53．42％、5．59％、8．70％、49．69％，均高于对照组患者的10．97％、29．62％、36．56％、5．30％、2．01％、43．69％（均P〈0．01）；病例组患者刷牙频率1～2次／天、食鱼类频率≥1次／天、食海鲜频率〈1次／天、食海鲜频率≥1次／天、食绿色蔬菜频率≥1次／天、食其他蔬菜频率≥1次／天、食水果频率≥1次／天的比例分别为84．47％、13．66％、53．42％、3．11％、83．23％、77．64％、25．47％，均低于对照组患者的92．87％、40．04％、55．94％、22．85％、97．26％、96．53％、47．90％（均P=0．000）；多因素条件logistic回归分析结果显示，〈18岁被动吸烟、≥18岁被动吸烟、有不良修复体、有口腔溃疡是福建省非吸烟人群口腔癌发病的危险因素，食鱼类频率≥1次／天、食其他蔬菜频率≥1次／天、食水果频率≥1次／天、食海鲜频率〈1次／天和≥1次／天是福建省非吸烟人群口腔癌发病的保护因素。结论被动吸烟、不良修复体、口腔溃疡及食鱼类、海鲜、其他蔬菜、水果是福建省非吸烟人群口腔癌发病的主要影响因素。

Objective To investigate influencing factors of oral cancer in nonsmokers in Fujian province and to provide evidences for prevention of oral cancer. Methods A case-control study was carried out in 161 nonsmoking oral cancer cases and 547 age- and gender-matched nonsmoking controls. The pathologically confirmed oral cancer cases were recruited from the First Affiliated Hospital of Fujian Medical University. Controls were selected from physical examinees and patients other than oral cancer at the same hospital. Eligible participants were personally interviewed using a questionnaire. Results Significantly higher ratios of secondhand smoking before the age 18 years （37.27% vs. 10. 97% ）, secondhand smoking after the age of 18 years （49.07% vs. 29.62% ）, bad prosthesis （53.42% vs. 36. 56% ）, with the frequency of brushing teeth 〉 2 times/day（ 5.59% vs ,5.30% ）, having dental ulcer（ 8. 70% vs. 2. 01% ）, and eating fruits 〈 1 time/day （49. 69 % vs. 43.69 % ）were observed in the cases compared to those in the controls （P 〈 0.01 for all） ;whereas the proportion of brushing teeth 1 - 2 times/day （ 84. 47% ）, eating fish ≥ 1 time/day （ 13.66% ）, eating seafood 〈 1 time/day （53.42 % ）, eating seafood ≥ 1 time/day （3. 11% ）, eating green vegetables ≥1 time/day （ 83. 23 % ）, eating other vegetables ≥ 1 time/day （77.64%）, and frequency of eating fruits≥ 1 time/day （25.47%）in case group were lower than those in the controls（92. 87% ,40. 04% ,55.94% ,22. 85% ,97.26% ,96. 53%, and 47.90%, respectively）. Multivariate unconditional logistic regression analysis indicated that secondhand smoking before age of 18 years, secondhand smoking after age of 18 years, bad prosthesis, and dental ulcer were risk factors of oral cancer in nonsmokers;eating fish, other vegetables, fresh fruits no less than once a day and eating seafood were the protective factors of oral cancer in nonsmokers. Conclusion Secondhand smoking, bad prosthesis, dental ulcer, and eating fish, seafood, other vegetables, and fruits are influencing factors of oral cancer in nonsmokers.