口腔健康状况与胃肠道癌的相关性研究

Study on the Correlation between Oral Health Status and Gastrointestinal Cancer

摘要: 目的：本研究的目的是通过唾液褪黑激素(Melatonin hormone, MT)、龈沟液白介素-10 (interleukin-10, IL-10)及白介素-6 (interleukin-6, IL-6)水平改变分析胃肠道癌与慢性牙周炎的相关性。方法：通过比较健康组(H组)、胃肠道癌组(Gastrointestinal cancer, GIC组)、慢性牙周炎组(Chronic periodontitis, CP组)、胃肠道癌伴慢性牙周炎组(GIC + CP组)四组之间的唾液MT水平、龈沟液IL-10及IL-6水平，同时记录四组临床牙周状况及评估OHIP-14得分，探究慢性牙周炎与胃肠道癌之间的相关性。结果：四组受试者的龈沟液IL-10及IL-6、OHIP-14得分水平差异均具有统计学意义(P < 0.05)；唾液MT在CP组和GIC + CP组中比较，差异无统计学意义(采用Mann-Whitney U检验，P = 0.071)；GIC患者龈沟液中IL-6水平与牙周临床指标(BI、CI、PD、AL)呈正相关(r = 0.422, 0.572, 0.652, 0.674, P < 0.05)；唾液中MT水平与牙周临床指标(BI、CI、PD、AL)呈负相关(r = −0.582, −0.643, −0.823, −0.843, P < 0.05)；龈沟液中IL-10水平与牙周临床指标(BI、CI、PD、AL)呈负相关(−0.343, −0.397, −0.649, −0.650, P < 0.05)；IL-6、IL-10、牙龈出血、牙结石存在、OHIP-14、吸烟是GIC患者发生CP的影响因素，MT、PD、AL、OHIP-14是CP患者发生GIC的影响因素。结论：口腔健康状况与胃肠道癌之间存在相关性，胃肠道癌与慢性牙周炎呈相互促进关系；健康人群需注重口腔健康特别是牙周状况的维护；唾液及GCF有希望作为对于CP、GIC新的评估监测辅助手段。GIC患者唾液MT水平与慢性牙周炎临床表现呈相关性，临床上可通过检测唾液MT水平作为动态评估体内炎症因子水平的新方法。

Abstract: Objective: The purpose of this study was to analyze the association of gastrointestinal cancer with chronic periodontitis by examining changes in salivary melatonin (MT), interleukin-10 (IL-10) and interleukin-6 (IL-6) levels in the gingival crevicular fluid. Methods: The levels of salivary MT, as well as IL-10 and IL-6 in gingival crevicular fluid, were compared among four groups: the healthy group (H Group), the gastrointestinal cancer group (GIC Group), the chronic periodontitis group (CP Group), and the group with both gastrointestinal cancer and chronic periodontitis (GIC + CP Group). Additionally, the clinical periodontal status and the scores of OHIP-14 were recorded to investigate the correlation between chronic periodontitis and gastrointestinal cancer. Results: The levels of IL-10 and IL-6 in gingival crevicular fluid and the OHIP-14 scores among the four groups of subjects were significantly different (P < 0.05). The levels of MT in saliva between the CP group and the GIC + CP group were not significantly different (Mann-Whitney U test, P = 0.071). In patients with GIC, the levels of IL-6 in GCF were positively correlated with periodontal clinical indices (BI, CI, PD, AL) (r = 0.422, 0.572, 0.652, 0.674, P < 0.05). The levels of MT in saliva were negatively correlated with periodontal clinical indices (BI, CI, PD, AL) (r = −0.582, −0.643, −0.823, −0.843, P < 0.05). The levels of IL-10 in GCF were negatively correlated with periodontal clinical indices (BI, CI, PD, AL) (r = −0.343, −0.397, −0.649, −0.650, P < 0.05). IL-6, IL-10, gingival bleeding, calculus presence, OHIP-14, and smoking were identified as influencing factors for the occurrence of CP in GIC patients. MT, PD, AL, and OHIP-14 were identified as influencing factors for the occurrence of GIC in CP patients. Conclusion: There is a correlation between oral health status and gastrointestinal cancer, with chronic periodontitis and gastrointestinal cancer exhibiting a mutually reinforcing relationship. Healthy individuals should prioritize the maintenance of oral health, particularly periodontal status. Saliva and GCF hold promise as new auxiliary tools for evaluating and monitoring CP and GIC. The salivary MT level in GIC patients correlates with the clinical manifestations of chronic periodontitis. Clinically, detecting salivary MT levels can serve as a novel method for dynamically assessing inflammatory factor levels in vivo.