血清叶酸与口腔癌发病关联的病例对照研究

Relationship between serum folate and risk of oral cancer: a case-control study

目的探讨血清叶酸与口腔癌发病的关系。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2010年9月―2018年1月经病理确诊的口腔癌新发病例225例为病例组,收集同时期社区和医院体检的健康人群225例为对照组。采用非条件Logistic回归分析模型,分析血清叶酸与口腔癌发病风险的OR及其95%CI值,并进行分层分析和相乘交互作用分析。结果病例组血清叶酸中位数为5.7 ng/ml,低于对照组的8.2 ng/ml(P<0.001),差异有统计学意义;无论性别、吸烟与否及摄入蔬菜水果的频次多少,血清叶酸水平与口腔癌的发病风险均存在负相关;叶酸与性别、吸烟、摄入蔬菜、水果在口腔癌的发生中存在相乘交互作用。结论高血清叶酸水平与口腔癌的发病风险呈负相关,保证适量叶酸摄入、减少烟草消耗和适量增加蔬菜水果可能降低口腔癌的发病风险。

Objective To explore the association between serum folate and the risk of oral cancer. Methods A case-control study were performed with 225 cases of newly diagnosed primary oral cancer from the First Affiliated Hospital of Fujian Medical University and 225 controls from the same hospital and nearby community. Unconditional Logistic regression and stratification analysis were used to explore the association between serum folate and oral cancer. Adjusted OR and corresponding 95% CI were calculated. Addition-ally, interaction analysis was conducted between serum folate and gender, smoking status, vegetables and fruit intake Results The level of serum folate was 5.7 ng/ml in the case group, which was lower than 8.2 ng/ml in control(P<0.001). There was a negative correlation between serum folate level and the risk for oral cancer regardless of gender and smoking status, and vegetables and fruits intake frequencies. Multiplicative interaction was observed between serum folate level and gender, smoking status, vegetable intake and fruit intake. Conclusions High serum folic acid levels are negatively associated with the risk of oral can-cer. Adequate folate intake, reducing tobacco use and increasing the intake of vegetables and fruits can reduce the risk of oral cancer to some extent.