Betel quid chewing and oral potential malignant disorders and the impact of smoking and drinking:A meta-analysis

BACKGROUND Oral potential malignant disorders(OPMDs)are a precancerous condition of oral disease.Several studies have found that betel quid chewing,smoking and alcohol drinking might be the risk factors of OPMDs.But the relationships of them,especially their interaction are still inconclusive.AIM To evaluate the relationship between betel quid chewing and OPMDs and to explore the interaction of smoking and alcohol drinking on the relationship.METHODS We searched Pub Med,Web of Science,Embase and the Cochrane Library databases with items complete until January 2021 for relevant studies.The research data were extracted according to the inclusion criteria.The pooled odds ratios(ORs)and 95%confidence intervals(CIs)were used to evaluate the effect size.Subgroup analysis was performed to assess interactions between exposures and OPMDs.Relative excess risk of interaction(RERI)was used to estimate the size of interaction.RESULTS Nine articles were selected in the final meta-analysis.The results showed that betel quid chewing(pooled OR:8.70,95%CI:5.18-14.61),alcohol consumption(pooled OR:1.95,95%CI:1.5-2.55),and smoking(pooled OR:4.35,95%CI:3.06-6.2)could significantly increase the risk of OPMDs compared to individuals without these behaviors.Smoking and alcohol drinking synergistically increased the association between betel quid chewing and OPMDs(pooled OR;:14.38,95%CI:7.14-28.95;pooled OR;:11.12,95%CI:8.00-15.45,respectively).The RERI;and RERI;were 2.33 and 1.47,respectively.CONCLUSION The synergistic effects between smoking/drinking and betel quid highlights the importance of focusing on individuals with multiple exposures.Further study should be conducted to confirm these interactions.

Gene expression profile of esophageal cancer in North East India by cDNA microarray analysis

AIM： To identify alterations in genes and molecular functional pathways in esophageal cancer in a high incidence region of India where there is a widespread use of tobacco and betel quid with fermented areca nuts. METHODS： Total RNA was isolated from tumor and matched normal tissue of 16 patients with esophageal squamous cell carcinoma. Pooled tumor tissue RNA was labeled with Cy3-dUTP and pooled normal tissue RNA was labeled with Cy5-dUTP by direct labeling method. The labeled probes were hybridized with human 10K cDNA chip and expression profiles were analyzed by Genespring GX V 7.3 （Silicon Genetics）. RESULTS： Nine hundred twenty three genes were differentially expressed. Of these, 611 genes were upregulated and 312 genes were downregulated. Using stringent criteria （P ≤ 0.05 and ≥ 1.5 fold change）, 127 differentially expressed genes （87 upregulated and 40 downregulated） were identified in tumor tissue. On the basis of Gene Ontology, four different molecular functional pathways （HAPK pathway, G-protein coupled receptor family, ion transport activity, and serine or threonine kinase activity）were most significantly upregulated and six different molecular functional pathways （structural constituent of ribosome, endopeptidase inhibitor activity, structural constituent of cytoskeleton, antioxidant activity, acyl group transferase activity, eukaryotic translation elongation factor activity）were most significantly downregulated. CONCLUSION： Several genes that showed alterations in our study have also been reported from a high incidence area of esophageal cancer in China. This indicates that molecular profiles of esophageal cancer in these two different geographic locations are highly consistent.