Periodontal Disease, Porphyromonas Gingivalis (P. gingivalis) Serum Antibody Levels and Orodigestive Cancer Mortality
Cette étude prospective évalue l'association entre une périodontite (12 605 cas), le niveau sérique d'anticorps anti Porphyromonas gingivalis ( 7 852 cas) et la mortalité par cancer des voies aéro-digestives supérieures et de l'appareil digestif (105 cas)
Periodontitis, the progressive loss of the alveolar bone around the teeth and the major cause of tooth loss in adults, is due to oral microorganisms, including Porphyromonas gingivalis (P gingivalis). Periodontitis is associated with a local overly aggressive immune response and a spectrum of systemic effects, but the role of this condition in orodigestive cancers is unclear. We prospectively examined clinically ascertained periodontitis (N=12,605) and serum IgG immune response to P gingivalis (N=7,852) in relation to orodigestive cancer mortality among men and women in the National Health and Nutrition Examination Survey (NHANES III). A detailed oral health exam was conducted from 1988-1994 in survey Phases I and II, while serum IgG for P gingivalis was measured from 1991-1994 in Phase II only. One-hundred and five orodigestive cancer deaths were ascertained through December 31, 2006. Periodontitis (moderate or severe) was associated with increased orodigestive cancer mortality (RR=2.28, 95%CI=1.17-4.45); mortality risks also increased with increasing severity of periodontal disease (p trend=0.01). Periodontitis-associated mortality was in excess for colorectal (RR=3.58; 95% CI=1.15-11.16) and possibly for pancreatic cancer (RR=4.56; 95%CI=0.93-22.29). Greater serum P gingivalis IgG tended to be associated overall with increased orodigestive cancer mortality (p trend=0.06); P gingivalis-associated excess orodigestive mortality was also found for healthy subjects not exhibiting overt periodontal disease (RR= 2.25; 95%CI=1.23-4.14). Orodigestive cancer mortality is related to periodontitis and to the periodontal pathogen, P gingivalis, independent of periodontal disease. P gingivalis is a biomarker for microbe-associated risk of death due to orodigestive cancer.
Carcinogenesis , résumé, 2012