钪与口腔癌的关联:基于倾向性评分匹配法的病例对照研究  

Scandium and oral cancer:A case-control study based on propensity score matching

作　　者：汪靖[1,2] 林菁 陈林 陈青 林李嵩[4] 包晓丹[2,3] 王瑞 刘少杰 施斌 邱宇[4] 郑晓燕[4] 潘丽珍[4] 蔡琳[2,3] 鄢灵君[2,3] 刘凤琼 陈法 何保昌[2,3] WANG Jing;LIN Jing;CHEN Lin;CHEN Qing;LIN Li-song;BAO Xiao-dan;WANG Rui;LIU Shao-jie;SHI Bin;QIU Yu;ZHENG Xiao-yan;PAN Li-zhen;CAI Lin;YAN Ling-jun;LIU Feng-qiong;CHEN Fa;HE Bao-chang(Laboratory Center,School of Public Health,Fujian Medical University,Fuzhou,Fujian 350122,China;Fujian Provincial Key Laboratory of Environment Factors and Cancer,School of Public Health,Fujian Medical University,Fuzhou,Fujian 350122,China;Department of Epidemiology and Health Statistics,School of Public Health,Fujian Medical University,Fuzhou,Fujian 350122,China;Department of Oral and Maxillofacial Surgery,The First Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian 350004,China)

机构地区：[1]福建医科大学公共卫生学院实验中心,福建福州350122 [2]福建医科大学公共卫生学院福建省环境因素与肿瘤重点实验室,福建福州350122 [3]福建医科大学公共卫生学院流行病与卫生统计学系,福建福州350122 [4]福建医科大学附属第一医院口腔颌面外科,福建福州350004

出　　处：《环境与职业医学》2020年第5期421-426,共6页Journal of Environmental and Occupational Medicine

基　　金：福建省自然科学基金项目(2019J01314);福建省高等学校新世纪优秀人才支持计划(2018B029);福建省科技创新联合资金项目(2017Y9103);福建省卫生计生中青年骨干人才培养项目(2017-ZQN-57);福建省卫生计生科研人才培养项目(2018-1-71)。

摘　　要：[背景]目前国内外鲜见钪(Sc)与口腔癌发病风险关联的报道,且微量元素与肿瘤关系的研究也多为未匹配组间协变量的回顾性研究。[目的]运用倾向性评分匹配法(PSM)均衡组间协变量,探讨Sc与口腔癌发病风险之间的关联。[方法]采用病例对照研究方法,收集2010年1月—2018年11月,于福建医科大学附属第一医院口腔颌面外科经手术后病理确诊的390例口腔癌新发患者及同期社区体检1 219例健康人群信息。采用PSM1:1最邻近匹配法,以病例为基准组,匹配病例与健康对照,平衡两组间一般人口学特征与生活方式等,最终成功匹配300例病例与300例健康对照作为病例组和对照组,用于后续研究。用微波消解法消解血清样品,并通过电感耦合等离子体质谱法检测血清中Sc。利用χ^2检验对匹配后病例组及对照组的一般人口学特征及生活方式各因素进行均衡性检验;应用Wilcoxon秩和检验比较病例组与对照组之间血清中Sc水平。同时,按对照组血清中Sc水平的三分位数将其分成低、中、高水平,采用条件logistic回归计算血清中Sc水平与口腔癌发病风险关系的OR值及其95%CI。另外,采用Cochran-Armitage趋势检验分析Sc水平与口腔癌发病风险之间的关系。[结果]病例组Sc水平的M(P25~P75)为5.56(3.71~6.94)μg·L^-1,低于对照组Sc水平7.21(6.14~8.83)μg·L^-1(P <0.001)。条件logistic回归分析显示,血清中Sc水平与口腔癌的发病风险存在负相关,中水平组与高水平组的口腔癌发病风险均低于低水平组,其OR(95%CI)分别为0.29(0.18~0.45)和0.14(0.08~0.25)。随着Sc水平的增高,口腔癌发病风险也随之降低(P趋势<0.001)。[结论]血清Sc水平越高,口腔癌的发病风险越低。[Background]Limited data on potential association between scandium(Sc)and the risk of developing oral cancer are available from both domestic and international sources,and studies on the relationship between trace elements and tumors are mainly retrospective without covariance matching.[Objective]This study explores the association of Sc with oral cancer risk based on propensity score matching(PSM).[Methods]The subjects in this case-control study consisted of 390 oral cancer patients who were histologically confirmed in the First Affiliated Hospital of Fujian Medical University between January 2010 and November 2018 and 1219 cancer-free subjects who were community residents and ordered health examination.A 1:1 PSM was used to match the case group to the healthy control group for selected potential factors such as demographic characteristics and lifestyles,and 300 patients with oral cancer and 300 healthy controls were selected for final analysis.Serum samples were digested by microwave and detected for Sc concentrations by inductively coupled plasma mass spectrometry.The distributions of demographic characteristics and lifestyles between the case and control groups were compared by chi-square test.The difference in serum Sc between the cases and controls was assessed by Wilcoxon rank sum test.The odds ratios(OR)and corresponding 95%confidence intervals(95%CI)for the association of serum Sc level with oral cancer risk using tertiles of serum Sc level of the control group were estimated by conditional logistic regression model.The association between Sc level and the risk of oral cancer was also analyzed by Cochran-Armitage trend test.[Results]The median(P25-P75)of serum Sc concentration in the oral cancer patients[5.56(3.71-6.94)μg·L-1]was lower than that in the controls[7.21(6.14-8.83)μg·L-1](P<0.001).The results of conditional logistic regression model showed medium and high levels of serum Sc versus low level of serum Sc were associated with a decreased risk of oral cancer,and the adjusted ORs were 0.29(95%

关 键 词：口腔癌 钪元素 倾向性评分 病例对照研究 

分 类 号：R126[医药卫生—环境卫生学]