硒元素与口腔癌发病关联的病例对照研究

Relationship between selenium and the risk for oral cancer:a case-control study

目的探讨硒元素与口腔癌发病的关联。方法采用病例对照的研究方法,收集福建医科大学附属第一医院口腔颌面外科经手术病理确诊的口腔癌新发患者325例作为病例组,同期经性别、年龄频数匹配的医院的体检人群和社区健康人群共650名作为对照组。应用非条件logistic回归计算硒元素与口腔癌发病风险的aOR及其95%CI,并进行分层分析和相乘交互作用分析。结果病例组血清硒水平[112.42(80.98~145.06)μg/L]低于对照组[164.85(144.44~188.53)μg/L],差异有统计学意义(P<0.01)。无论是否吸烟、是否饮酒及摄入水果、鱼类的频次多少,血清硒与口腔癌的发病风险均存在负相关关系(P<0.05)。血清硒与吸烟、饮酒、摄入水果、鱼类之间在口腔癌的发生中存在相乘交互作用。结论高水平血清硒是口腔癌发病的保护因素,且血清硒与吸烟、饮酒、摄入水果和摄入鱼类存在相乘交互作用,故减少烟酒消耗和适量增加水果鱼类的摄入可一定程度降低口腔癌的发病风险。

Objective To explore the relationship between selenium and the risk for oral cancer. Methods We performed a case-control study in 325 cases of newly diagnosed primary oral cancer from the First Affiliated Hospital of Fujian Medical University and 650 controls from the same hospital and community. Unconditional logistic regression and stratification analyses were used to explore the association between selenium and oral cancer. Adjusted OR and corresponding 95%CI were calculated. The analyses on multiple interactions between selenium and smoking or drinking status, and fruit or fish intake frequencies were conducted. Results The level of serum selenium was 112.42 (80.98-145.06)μg/L in the case group, which was lower than 164.85 (144.44-188.53)μg/L in control group, the difference was statistical significant (P < 0.01). There was a negative correlation between serum selenium level and the risk for oral cancer regardless of smoking and drinking status, and fruits and fish intake frequencies (P < 0.05). There were multiple interactions between serum selenium level and smoking or drinking status, and fruit and fish intakes. Conclusions The high level of serum selenium is a protective factor for the incidence of oral cancer, and serum selenium has multiple interactions with smoking or drinking status, and fruit and fish intakes. Therefore, reducing tobacco use and alcohol consumption and increasing the intakes of fruit and fish can reduce the risk for oral cancer to some extent.