福建地区膳食因素与牙龈癌的关系研究

Association between Dietary Factors and Gingival Carcinoma in Fujian Province

目的探讨福建地区膳食因素与牙龈癌的关系。方法选取2010年12月—2016年6月在福建医科大学附属第一医院口腔颌面外科就诊的牙龈癌患者133例,为病例组;另于同期在福州市西湖、罗星等社区选取与病例组性别、年龄(±3岁)匹配的健康成年人321例,为对照组。由经过统一培训的调查员,采用Inter CHANGE生活方式调查问卷对两组受试者进行面对面调查,主要内容包括一般情况、膳食习惯、口腔及卫生情况等。以一般情况、口腔及卫生情况为协变量,采用多因素Logistic回归分析探讨膳食因素对牙龈癌的影响,并进一步分析海鲜和饮茶的交互作用。结果两组畜肉类、鱼类、海鲜、绿叶蔬菜、非绿叶蔬菜、水果的摄入情况比较,差异有统计学意义(P<0.05);两组加工肉类、禽肉类、奶类及奶制品、蛋类、豆类及豆制品、腌制食品的摄入情况比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,畜肉类、鱼类、海鲜、绿叶蔬菜、非绿叶蔬菜、水果的摄入情况是牙龈癌的影响因素(P<0.05)。根据是否饮茶进行分层,在非饮茶者中海鲜摄入≥3次/周可以降低牙龈癌的发病风险〔调整OR=0.33,95%CI(0.17,0.66)〕。海鲜与饮茶存在正相乘交互作用〔调整OR=0.70,95%CI(0.49,0.98)〕。与不饮茶且海鲜摄入<3次/周者相比,不饮茶且海鲜摄入≥3次/周者〔调整OR=0.39,95%CI(0.21,0.74)〕、饮茶且海鲜摄入<3次/周者〔调整OR=0.45,95%CI(0.24,0.85)〕、饮茶且海鲜摄入≥3次/周者〔调整OR=0.35,95%CI(0.17,0.74)〕的牙龈癌发病风险均降低。结论膳食因素可以在一定程度上影响牙龈癌的发病,养成健康的饮食习惯,经常摄入新鲜蔬菜水果,适量进食鱼类和海鲜,可降低牙龈癌的发病风险。

Objective To explore the relationship between dietary factors and gingival carcinoma in Fujian. Methods A total of 133 patients with gingival carcinoma in Oral and Maxillofacial Surgery in the First Affiliated Hospital of Fujian Medical University from December 2010 to June 2016 were selected as the case group; in the same period,321 healthy adults whose gender and age（ ± 3 years） matched with those of the case group were selected from Xihu and Luoxing community of Fuzhou and taken as the control group. The investigators after unified training conducted a face- to- face survey to the subjects in two groups with the Inter CHANGE Lifestyle Questionnaire. The main survey contents included the general situation, dietary habits,oral and health conditions. The effects of dietary factors on gingival carcinoma were analyzed by multivariate Logistic regression analysis,and the interaction between seafood and tea was further analyzed by taking the general situation, dietary habits,oral and health conditions as covariates. Results The intake of meat, fish, seafood, green leafy vegetables, non-green leafy vegetables and fruits were significantly different between two groups（ P〈0. 05）. There was significant difference in the intake of processed meat,poultry meat,milk and dairy products,eggs,beans and soy products and pickled foods between two groups（ P〈0. 05）. Multivariate Logistic regression analysis showed that the intake of meat, fish, seafood, green leafy vegetables,non- green leafy vegetables and fruits was the influencing factor of gingival carcinoma（ P〈0. 05）. Stratify the subjects according to whether they drinking tea or not,and the result showed that the intake of seafood equal to or over 3 times a week among those who were not tea drinkers can reduce the risk of gingival carcinoma 〔adjusted OR = 0. 33,95% CI（ 0. 17,0. 66） 〕. There was a positive interaction between seafood and tea drinking 〔adjusted OR = 0. 70,95% CI（ 0. 49,0. 98） 〕.Compared with those non- tea drinkers whose intake of seafood less than 3 times a week,the risk of gingival carcinoma of those non- tea drinkers whose intake of seafood equal to or over 3 times a week 〔adjusted OR = 0. 39,95% CI（ 0. 21,0. 74） 〕,tea drinkers whose intake of seafood less than 3 times a week 〔adjusted OR = 0. 45,95% CI（ 0. 24,0. 85） 〕,and tea drinkers whose intake of seafood equal to or over 3 times a week 〔adjusted OR = 0. 35, 95% CI（ 0. 17, 0. 74） 〕 had all lowered. Conclusion Dietary factors can affect the incidence of gingival carcinoma to a certain degree, and healthy eating habits,regular intake of fresh vegetables and fruits,moderate consumption of fish and seafood can reduce the risk of gingival carcinoma.