台灣地區慢性牙周病與肺癌風險相關性研究

肺癌為全球癌症相關死亡的首位主因，慢性牙周病則為一種常見的慢性發炎性疾病，可能與肺癌風險增加相關，但其關聯性尚未獲得充分證實。本研究旨在利用臺灣全民健保資料庫，探討慢性牙周病與肺癌發生風險之關聯，並進一步分析可能的危險因子。本研究為一項回溯性世代研究，資料取自2001年至2012年間之臺灣全民健康保險研究資料庫(National Health Insurance Research Database)。本研究共納入86,886名新診斷之慢性牙周病個案，並以1:1傾向分數配對方式，從一般人群中選取無任何牙周病診斷之對照組。以Cox比例風險模型及子群分析，評估慢性牙周病與肺癌發生風險之間的關聯性。在慢性牙周病組與對照組中，分別有639人與614人被診斷為肺癌。整體而言，慢性牙周病與肺癌風險間僅呈邊緣統計學顯著（相對風險：1.01，95%信賴區間：0.90–1.12）。進一步分層分析結果顯示，性別為顯著交互作用因子(P for interaction=0.009)，其中女性慢性牙周病患者之肺癌風險，較無牙周病女性顯著上升（相對風險：1.23，95%信賴區間：1.01–1.48，P = 0.036）。本研究結果顯示，臺灣女性慢性牙周病患者較無慢性牙周病者具有顯著較高之肺癌發生風險，顯示口腔慢性發炎可能在女性肺癌發展中扮演潛在的角色。

Lung cancer remains the leading cause of cancer-related mortality worldwide. Chronic periodontitis (CP), a prevalent inflammatory oral disease, has been proposed as a potential risk factor for lung cancer; however, the evidence supporting this association remains inconclusive. This study aimed to investigate the relationship between CP and lung cancer incidence using data from Taiwan's National Health Insurance Research Database (NHIRD), with a focus on identifying relevant risk factors. A retrospective cohort study was conducted using the NHIRD from 2001 to 2012. A total of 86,886 patients newly diagnosed with CP were included and matched 1:1 via propensity score matching with individuals without any periodontal disease from the general population. Cox proportional hazards regression and subgroup analyses were performed to evaluate the association between CP and the risk of developing lung cancer. Among both CP and non-CP cohorts (n = 86,886 each), 639 and 614 individuals, respectively, were newly diagnosed with lung cancer. The overall hazard ratio for lung cancer in CP cohort showed borderline significance (HR: 1.01; 95% CI: 0.90–1.12). Subgroup analysis revealed a significant sex-specific interaction (P for interaction = 0.009). Female patients with CP had a significantly higher risk of lung cancer compared to females without CP (HR: 1.23; 95% CI: 1.01–1.48, P = 0.036). This nationwide population-based cohort study suggests that Taiwanese female patients with chronic periodontitis are at a significantly increased risk of developing lung cancer compared to their non-periodontitis counterparts. These findings imply that chronic oral inflammation may play a contributory role in lung carcinogenesis among women and highlight the importance of periodontal health in the prevention,of systemic disease.