| Summary: | 碩士 === 高雄醫學大學 === 口腔衛生科學研究所碩士在職專班 === 95 === Background: Helicobacter pylori is one of the most common pathogens worldwide, Helicobacter pylori infection is via oral-oral and fecal-oral transmission. It is documented that Helicobacter pylori Infection is related with gastritis, peptic ulcer, gastric mucosa-associated lymphoid tissue (MALT) lymphomas and gastric cancer. Recent studies suggest Helicobacter pylori infection is a protective factor for gastro-esophagus regurgitation disease and esophagus cancer. Previous studies also documented oral cancer is associated with smoking, alcohol and betel nut. It was reported Helicobacter pylori could be found on the oral muscosa and dental plaque. Helicobacter pylori is also known related with the severity of periodontal disease. However,very few studies have investigated the relationship between oral cancer and Helicobacter pylor infection.
Purpose: 1. To investigate the demogrphy of oral squamous cell carcinoma (SCC) patients.
2. To investigate the relationship between oral squamous cell carcinoma and Helicobacter pylori infection from the population of Taiwan.
3. To investigate the mechanism of carcinogenesis, the association of chronic inflammation and their relationship with Helicobacter pylori infection.
Methods: During April 2004 to May 2005, 181 patients (171 males and 11 females) with oral squamous cell carcinoma, pathologically proven in the department of oral surgery, Kaohsiung Medical University Hospital, were recruited in the study. The healthy controls were the subjects who received the routine healthy examintion in the Department of Preventive Medicine, Kaohsiung Medical University Hospital, during the same period. The healthy controls, 335 cases in total (317 males, 18 females), were interviewed by trained interviewers using a standardized questionnaire. The infection of Helicobacter pylori was diagnosed with an enzyme-linked immunosorbent assay, measuring the IgG in the plasma. All of the results were analyzed with Chi-Square test and logistic regression analyses, by the commercial software, JMP, version 5.1.
Results: Totally, 88 study cases (48.6%) and 194 control cases (57.9%), disclosed serum IgG positive. Chi-Square test showed the infection of Helicobacter pylori had a significant protective effect in the group of oral squamous cell carcinoma patients with cigarette smoking and betel quid chewing. Further study with multiple logistic regression models to test male oral SCC patients with adjusted known risk factors (such as age, education, alcohol drinking, cigarette smoking and betel quid chewing), AOR:1.3 (95%CI:0.4~4.3) in the cases with cigarette smoking and Helicobacter pylori infection; however, the AOR: 0.9 (95%CI:0.2~3.7) in the cases with cigarette smoking but without Helicobacter pylori infection. These results showed no statistically significant. It means that, in the cigarette smoking oral SCC patients, there was no significant relationship between the oral SCC and Helicobacter pylori infection after the other covariates were adjusted.However, in male oral SCC cases with betel quid chewing, the AOR:37.2 (95% CI:15.9~95.9) with Helicobacter pylori infection; and AOR:69.5 (95% CI:26.6~205.9) without Helicobacter pylori infection. These results were statistically significant. It demonstrated, in the oral SCC patients with betel quid chewing, there was an inverse association between the oral SCC and Helicobacter pylori infection, after the covariates were adjusted.
Conclusion: We concluded that Helicobacter pylori infection could be found in oral SCC patients and Helicobacter pylori infection disclosed an inverse association in oral squamous cell carcinoma with betel quid chewing.
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