A composite oral hygiene score and the risk of oral cancer and its subtypes: a large-scale propensity score-based study

OBJECTIVE

This study aimed to investigate the potential relationship between oral hygiene and the risk of oral cancer and its subtypes after controlling the effects of several confounding factors.

MATERIALS AND METHODS

A large-scale case-control study was conducted from January 2010 to August 2019, recruiting a total of 1,288 oral cancer cases with newly diagnosed and 4,234 healthy controls. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were utilized to minimize confounding effects. Conditional logistic regression was used to evaluate the effects of oral hygiene indicators on oral cancer.

RESULTS

A composite oral hygiene score was developed based on five indicators selected based on PSM and IPTW analysis (including tooth loss, dentures wearing, the frequency of tooth brushing, regular dental visits, and recurrent dental ulcer). Participants with a higher score, compared with their lower counterparts, showed a 49% increased risk (the odds ratio (OR) was 1.49 (95% confidence interval (CI): 1.26-1.75). A similar association pattern was found following IPTW analyses (OR = 1.32; 95% CI: 1.22-1.42). Of note, the adverse effects of poor oral hygiene were more evident among the sites of gingival and buccal (PSM analysis: 2.03-fold and 2.68-fold increased risk; IPTW analysis: 1.57-fold and 2.07-fold increased risk, respectively). Additionally, a greater positive association was observed between poor oral hygiene and oral squamous cell carcinoma, compared with other pathological types.

CONCLUSION

This study establishes a composite oral hygiene score and provides supportive evidence of poor oral hygiene associated with a higher risk of oral cancer, particularly in the gingival and buccal mucosa sites and in the squamous cell carcinoma.

CLINICAL RELEVANCE

The data highlights the importance of improving poor oral hygiene habits, which has public health implications for the prevention of oral cancer.

Association between dietary inflammatory index and the risk of oral cancer in the southeast of China

BACKGROUND/OBJECTIVES

To evaluate the role of the potential inflammatory effects of diet using the Energy adjusted Dietary Inflammatory Index (E-DII) for oral cancer.

SUBJECTS/METHODS

A case-control study including 295 oral cancer cases and 425 controls from September 2010 to June 2018 was performed in Fujian Province, China. The E-DII was calculated based on the food frequency questionnaire (FFQ) and adjusted by total energy intake. The association between E-DII and the risk of oral cancer was estimated with unconditional logistic regression model.

RESULTS

Compared with E-DII score in the lowest quartile, those with E-DII score in the fourth quartile were at the higher risk of oral cancer (OR = 2.57; 95% CI: 1.54, 4.29, Ptrend = 0.013). When analyses were carried out using E-DII as a continuous variable, one-unit increase in E-DII increased the odds of having oral cancer by 3% (95% CI: 1.00, 1.06). Moreover, there was a significant interaction between the E-DII and oral hygiene for oral cancer (Pinteraction < 0.001, in those without and with poor hygiene, the OR (95% CI) were 1.96 (0.96, 4.00) and 4.23 (1.83, 9.81), respectively).

CONCLUSIONS

The present study suggests that the higher E-DII score, indicated a pro-inflammatory diet, may be a risk factor for oral cancer in southeast of China. More large samples and prospective studies need to validate our results and explore the prevention strategies of oral cancer via changing dietary habits.

[Association of single nucleotide polymorphisms of TBX5 gene and environmental exposure index with susceptibility to oral cancer]

Objective: To explore the association of TBX5 polymorphisms and environmental exposure index with susceptibility to oral cancer. Methods: A case-control study was conducted to collect 300 oral cancer patients hospitalized in the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University from September 2010 to December 2016. A total of 445 non-tumor patients were selected as the control group. Questionnaires were used to collect the information of all subjects and 5 ml peripheral blood was collected to detect single nucleotide polymorphisms (SNPs) of the rs10492336 locus of TBX5 gene. According to the environmental exposure index score, subjects were divided into two groups, low risk group (0-2.31) and high risk group (2.32-11.76). To analyze the association of TBX5 gene rs10492336 SNPs, environmental exposure index and oral cancer and its interactions. Results: The age of all subjects in the case group and control group were (56.19±13.10) years and (54.56±12.48) years old. Compared with CC genotype, the OR (95%CI) values of the co-dominant genetic model AC genotype and the dominant genetic model AC+AA genotype were 0.69 (0.49-0.98) and 0.70 (0.51-0.97), respectively. Compared with the low risk group, the OR (95%CI) risk of oral cancer in the high risk group was 3.72 (2.55-5.43). The results of gene-environment interaction analysis showed that compared with the group with CC genotype and high risk of environmental exposure index, the OR (95%CI) value of oral cancer in the group with AC+AA genotype and low risk of environmental exposure index was 0.18(0.10-0.31). Furthermore there was a multiplicative interaction between rs10492336 SNPs and environmental exposure index (β=-0.405, P<0.001). Conclusion: This study suggests that the TBX5 gene rs10492336 SNPs and environmental exposure index were associated with oral cancer. And there was a multiplication interaction between rs10492336 SNPs and environmental exposure index.

Mediation analysis of erythrocyte lipophilic index on the association between BMI and risk of oral cancer

AIMS

To explore the relationship between the fatty acid lipophilic index (LI) of the erythrocyte membrane and oral cancer risk, as well as to evaluate the possibility of LI acting as a mediator of the association between body mass index (BMI) and oral cancer.

METHOD

Twenty-three fatty acids (FAs) of the erythrocyte membrane were measured using gas chromatography in 380 patients with oral cancer and 387 control subjects. The LI was calculated based on the FA proportion and FA melting points. The association of BMI and erythrocyte LI with oral cancer risk was analysed using logistic regression. The mediation effect of LI on the association between BMI and oral cancer risk was evaluated using mediation analysis.

RESULTS

Among the control group, 46.0% were overweight or obese, which was significantly higher than that of oral cancer patients (29.5%). Significant differences in erythrocyte membrane saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) were observed between the patient and control groups. The proportion of C18:1 n-9 from the MUFA family increased in oral cancer patients (12.67%) compared with controls (12.21%). While the total proportion of n-3 PUFAs decreased in oral cancer patients compared with controls, with C20:5 n-3 decreasing from 0.66 to 0.47%, and C22:6 n-3 decreasing from 5.82 to 4.86%. The LI was lower in the control participants (M = 27.6, IQR: 27.3-27.9) than in the oral cancer patients (M = 28.2, IQR: 27.9-28.5). BMI was inversely associated with oral cancer risk with a fully adjusted OR of 0.59 (95% CI: 0.43-0.83), while LI was positively associated with oral cancer risk with a fully adjusted OR of 1.99 (95% CI:1.36-2.94). LI explained 7% of the variance in the relationship between BMI and oral cancer risk.

CONCLUSIONS

The distribution of the FA profile in erythrocyte membranes differed between the oral cancer patients and the control group. The LI derived from the profile of FAs was positively associated with the risk of oral cancer, and the associations between BMI and oral cancer risk can be explained, at least in part, by LI.

Path analysis of factors influencing length of stay and hospitalisation expenses for oral cancer patients in tertiary hospitals in southeastern China: a cross-sectional study

AIMS

To investigate the associations between influencing factors with length of stay (LOS) and hospitalisation expenses in oral cancer (OC) patients, and to explore the potential pathways through which these factors influence hospitalisation expenses using path analysis.

DESIGN

Cross-sectional.

SETTING

A comprehensive tertiary hospital in southeastern China.

PARTICIPANTS

A total of 810 patients with histologically confirmed primary OC admitted to the First Affiliated Hospital of Fujian Medical University, Fujian Province, between 2015 and 2020.

MAIN OUTCOME MEASURES

LOS and hospitalisation expenses for OC patients.

RESULTS

The median hospitalisation expenses and LOS for OC patients in southeastern China were substantial, amounting to $6330 and 29 days, respectively. Treatment and surgery fees constituted the largest proportion of total expenses (28.59%), followed by inspection and laboratory test fees (20.63%), comprehensive medical service fees (19.27%), drug fees (18.09%) and medical consumables fees (11.69%). LOS was significantly associated with tumour site, surgery and chemotherapy. Factors such as longer LOS, poor oral hygiene, advanced tumour stage (II-IV), larger tumour size (>2 cm3), surgery and bilateral neck dissection were strongly linked to higher hospitalisation expenses. Path analysis revealed that neck dissection had the highest total effect on hospitalisation expenses (β=0.307), while surgery exerted an indirect effect on expenses via LOS (β=0.021).

CONCLUSION

This study highlights the significant economic burden imposed by OC on patients and healthcare systems. While prevention and early diagnosis remain critical, our findings underscore several modifiable factors, including improving oral hygiene and optimising surgical protocols, such as chemotherapy and lymph node dissection, that present opportunities to reduce costs and enhance cost-effectiveness. These insights provide actionable targets for mitigating financial burdens and improving patient outcomes.

The role of rare earth elements and dietary intake in tongue cancer: a mediation analysis in southeast China

OBJECTIVE

The current research aimed to examine how dietary intake and rare earth elements may affect the development of tongue cancer.

METHODS

The serum levels of 10 rare earth elements (REEs) in 171 cases and 171 healthy matched controls were measured by inductively coupled plasma mass spectrometry (ICP-MS). The conditional logistic regression was used to examine the relationship between dietary intake, serum levels of 10 REEs, and tongue cancer. Mediation effect and multiplicative interaction analysis were then performed to estimate the potential contribution of REEs in dietary intake associated with tongue cancer.

RESULTS

Compared with the control group, patients with tongue cancer consumed significantly less fish, seafood, fruit, green leafy vegetables, and non-green leafy vegetables, with higher serum praseodymium (Pr), dysprosium (Dy), and lanthanum (La) levels, and lower serum cerium (Ce) and scandium (Sc) levels. The interaction effect was observed between some REEs and food categories. Green vegetables' impact on the risk of tongue cancer is partially attributed to the La and Thorium (Th) elements (P < 0.05, the mediated proportion were 14.933% and 25.280%, respectively). The effect of non-green leafy vegetables for tongue cancer mediated via Pr, Dy, and Th (P < 0.05, the mediated proportion were 0.408%, 12.010%, and 8.969%, respectively), and the Sc components in seafood (P < 0.05, the mediated proportion was 26.120%) is partly responsible for their influence on the risk of tongue cancer.

CONCLUSION

The correlation between REEs and dietary intakes for tongue cancer is compact but intricate. Some REEs interact with food intake to influence tongue cancer, while others act as a mediator.

Combined Exposure to 33 Trace Elements and Associations With the Risk of Oral Cancer: A Large-Scale Case-Control Study

BACKGROUND

Trace elements exist widely in the natural environment and mostly enter the human body through drinking water or various types of food, which has raised increasing health concerns. Exposure to a single or a few trace elements has been previously reported to be associated with oral cancer risk, but studies on other elements and combined effects are limited. This study aimed to comprehensively evaluate the independent and joint effects of 33 trace elements on oral cancer risk.

METHODS

The concentrations of 33 trace elements from the serum samples of 463 cases and 1,343 controls were measured using inductively coupled plasma mass spectrometry (ICP-MS). Propensity score matching was used to minimize the impact of potential confounders. Conditional logistic regression was utilized to evaluate the association of each element individually with oral cancer risk. Quantile g-computation and Bayesian kernel machine regression (BKMR) models were used to assess the joint effect of the overall element mixture and interactions.

RESULTS

In single-element models, essential elements (Cu, Se, Zn, Sr, and Cr) and non-essential elements (As, Li, Th, Ce, Ti, and Sc) showed significant association with oral cancer risk. In multiple-element models, a quartile increase in overall non-essential elements was observed for a significant inverse association with oral cancer risk (β = -3.36, 95% CI: -4.22 to -2.51). The BKMR analysis revealed a potential beneficial joint effect of essential metals on the risk of oral cancer. Among these, higher levels of serum Zn and V exhibited an adverse effect, while serum Sr, Se, and Cu displayed favorable effects when all other essential elements were fixed at 25th or 50th percentiles. Of note, Se performed complex interactions among essential metals. As for non-essential elements, there were greater effect estimates for serum Th, Li, and Y when all other elements were held at the 75th percentile.

CONCLUSION

This study provides supportive evidence that the overall mixture effect of essential and non-essential elements might be associated with oral cancer risk, especially for serum Zn, V, Cu, Sr, Se, Th, Li, and Y. Extensive prospective studies and other experiments are warranted to confirm our findings.

Development of a core competence model for improving medical college students' ability in respond to public health emergencies

Background

Core competences has been developed for public health professionals worldwide. However, there is no core competences framework as to how to evaluate public health professionals and undergraduate students' ability to respond to public health emergencies.

Objectives

To develop a framework of core competences in public health emergencies for education of medical college student who majored in public health. To assess the knowledge and skill level of undergraduate students with public health background in respond to health emergency event and get to known the training needs.

Methods

The Delphi method was applied to develop an agreed list of competences, which was followed by the construction of a competences framework in public health emergencies. A questionnaire consists of items that was derived from the list of competency statements developed by Delphi scoring to quantitatively report the knowledge and practical skill level and training needs of medical college students of public health background in public health emergencies.

Results

An agreed set of core competences containing 43 statements was derived from the first and second Delphi scoring steps which can be grouped into four domains: intellectual competences, practical competences, behavioral competences, personnel and motivation. A total of 441 undergraduate students with public health background participated in the survey. The average performance of intellectual and practical competences is 3 in a 5-point scale, which equals 60 converted to 100 points. A better performance was observed in indicators of behavioral competences and personnel and motivation with an average score of 4 for most of the items, which equals 80 converted to 100 points. Admission year and sex are significantly related to competency performance of all domains with β value of -0.141 (p = 0.003) and - 0.237 (p < 0.001) for the overall performance.

Conclusion

A framework of 43 core competences was developed, which covered both technical and general competencies in public health emergencies and represent the current competence demands of public health work force to be qualified for their job roles in public health emergencies for the local government in Fujian province. The concordance rate regarding to score of importance of the core competences are all >80% in both the first and second round Delphi survey, suggesting considerable reliability of the framework.

Development and validation of a model for the prediction of disease-specific survival in patients with oral squamous cell carcinoma: based on random survival forest analysis

OBJECTIVE

To establish a model for predicting the disease-specific survival (DSS) of patients with oral squamous cell carcinoma (OSCC).

METHODS

Patients diagnosed with OSCC from the Surveillance, Epidemiology, and End Results (SEER) database were enrolled and randomly divided into development (n = 14,495) and internal validation cohort (n = 9625). Additionally, a cohort from a hospital located in Southeastern China was utilized for external validation (n = 582).

RESULTS

TNM stage, adjuvant treatment, surgery, tumor sites, age, grade, and gender were used for RSF model construction based on the development cohort. The effectiveness of the model was confirmed through time-dependent ROC curves in different cohorts. The risk score exhibited an almost exponential increase in the hazard ratio of death due to OSCC. In development, internal, and external validation cohorts, the prognosis was significantly worse for patients in groups with higher risk scores (all log-rank P < 0.05).

CONCLUSION

Based on RSF, a high-performance prediction model for OSCC prognosis was created and verified in this study.

The role of peripheral white blood cell counts in the association between central adiposity and glycemic status

AIMS

Although central adiposity is a well-known risk factor for diabetes, the underlying mechanism remains unclear. The aim of this study was to explore the potential mediation role of circulating WBC counts in the association between central adiposity and the risk of diabetes.

MATERIALS AND METHODS

A cross-sectional study was conducted using data from the Fuqing cohort study, which included 6,613 participants aged 35-75 years. Logistic regression analysis and Spearman's rank correlation analysis were used to examine the relationships between waist-to-hip ratio, WBC counts and glycemic status. Both simple and parallel multiple mediation models were used to explore the potential mediation effects of WBCs on the association of waist-to-hip ratio with diabetes.

RESULTS

The study revealed a positive relationship between waist-to-hip ratio and risk of prediabetes (OR = 1.53; 95% CI, 1.35 to 1.74) and diabetes (OR = 2.89; 95% CI, 2.45 to 3.40). Moreover, elevated peripheral WBC counts were associated with both central adiposity and worsening glycemic status (P < 0.05). The mediation analysis with single mediators demonstrated that there is a significant indirect effect of central adiposity on prediabetes risk through total WBC count, neutrophil count, lymphocyte count, and monocyte count; the proportions mediated were 9.92%, 6.98%, 6.07%, and 3.84%, respectively. Additionally, total WBC count, neutrophil count, lymphocyte count, monocyte count and basophil count mediated 11.79%, 11.51%, 6.29%, 4.78%, and 1.76%, respectively, of the association between central adiposity and diabetes. In the parallel multiple mediation model using all five types of WBC as mediators simultaneously, a significant indirect effect (OR = 1.09; 95% CI, 1.06 to 1.14) were observed, with a mediated proportion of 12.77%.

CONCLUSIONS

Central adiposity was independently associated with an elevated risk of diabetes in a Chinese adult population; levels of circulating WBC may contribute to its underlying mechanisms.

Postoperative dynamic survival of gastric cancer patients: A multi-institutional, international analysis of 22 265 patients

BACKGROUND

How to best evaluate the disease-specific survival (DSS) of gastric cancer (GC) survivors over time is unclear.

METHODS

Clinicopathological data from 22 265 patients who underwent curative intend resection for GC were retrospectively analyzed. Changes in the patients' 3-year conditional disease-specific survival (CS3) were analyzed. We used time-dependent Cox regression to analyze which variables had long-term effects on DSS and devised a dynamic predictive model based on the length of survival.

RESULTS

Based on 1-, 3-, and 5-year survivorships, the CS3 of the population increased gradually from 62% to 68.1%, 83.7%, and 90.6%, respectively. Subgroup analysis showed that the CS3 of patients who had poor prognostic factors initially demonstrated the greatest increase in postoperative survival time (eg, N3b: 26.6%-84.1%, Δ57.5% vs N0: 84.1%-93.3%, Δ9.2%). Time-dependent Cox regression analysis showed the following predictor variables constantly affecting DSS: age, the number of examined lymph nodes (LNs), T stage, N stage, and site (P < .05). These variables served as the basis for a dynamic prediction model.

CONCLUSIONS

The influence of prognostic factors on DSS and CS3 changed dramatically over time. We developed an effective model for predicting the DSS of patients with GC based on the length of survival time.

Preoperative Serum Selenium Concentrations and Disease-Specific Survival in Patients With Oral Cancer: A Long-Term Follow-Up Study

BACKGROUND

Serum selenium (Se) concentration has been reported to be associated with the incidence of oral cancer. The association between serum Se and long-term survival in oral cancer patients is still unclear.

PURPOSE

The purpose of this study is to measure the association between serum Se and disease-specific survival (DSS).

STUDY DESIGN, SETTING, AND SAMPLE

This was a single-center, prospective cohort study conducted at the First Affiliated Hospital of Fujian Medical University (Fujian Province, China) from September 2011 to December 2018. The inclusion criteria were patients with newly diagnosed primary oral cancer confirmed by histology. The exclusion criteria were patients with recurrent oral cancer or metastatic cancer.

PREDICTOR VARIABLE

The predictor variable is the preoperative serum Se concentration measured using inductively coupled plasma-mass spectrometry.

MAIN OUTCOME VARIABLE(S)

The primary outcome variable is DSS calculated from the date of diagnosis to the date of death due to oral cancer or the end of follow-up, whichever occurred first.

COVARIATES

The covariates were age, sex, occupation, education level, body mass index, surgery therapy, adjuvant therapy, tumor node metastasis stage, and pathological grading.

ANALYSES

Kaplan-Meier survival analysis, Cox proportional hazards regression, and restricted cubic spline regression were utilized. P value < .05 was significant.

RESULTS

The sample was composed of 235 subjects with a median age of 59 years (ranged from 20 to 80 years) and 142 (60.43%) were male. The median follow-up was 54.90 months (interquartile range: 35.47). Se levels were associated with DSS (unadjusted hazard ratio [HR] = 0.70; 95% confidence interval [CI]: 0.54-0.91) suggesting that higher levels of Se are associated with longer or improved DSS. After adjustment of age, sex, occupation, education level, residence, tumor node metastasis stage, pathological grading, surgery therapy, radiotherapy, and chemotherapy, patients with higher serum Se had a better DSS (aHR = 0.67; 95% CI: 0.49-0.92). Of note, we found that the association between serum Se and DSS was observed only in patients with radiotherapy (aHR = 0.49; 95% CI: 0.33-0.73). And the protective effect of radiotherapy on survival was only observed in patients with higher Se concentrations (aHR = 0.36; 95% CI: 0.20-0.63). Additionally, there was a multiplicative interaction between Se and radiotherapy on the prognosis of oral cancer patients (Pinteraction<0.01).

CONCLUSION AND RELEVANCE

Our findings suggest that a high Se concentration might contribute to better DSS among oral cancer patients, and the effect may partly depend on radiotherapy treatment. Given these findings, additional research should focus on the role of Se in DSS among oral cancer patients and the interaction with radiotherapy.

Identification of novel serum lipid metabolism potential markers and metabolic pathways for oral cancer: a population-based study

OBJECTIVE

This study aims to identify potential lipid biomarkers and metabolic pathways associated with oral cancer (OC). Then to establish and evaluate disease classification models capable of distinguishing OC patients from healthy controls.

METHODS

A total of 41 OC patients and 41 controls were recruited from a hospital in Southeast China to examine the serum lipidomics by Ultra-high Performance Liquid Chromatography Q Exactive Mass Spectrometry (UHPLC-QE-MS).

RESULTS

The total serum lipid profile showed that triglycerides accounted for the highest proportion of total metabolites, reaching 35.90% of the total. A total of 74 different metabolites were screened (12 up-regulated and 62 down-regulated), mainly enriched in the glycerophospholipid metabolism pathway. The three most significant changes in lipid metabolites were phosphatidylcholine (PC(18:3e/17:2)), acylcarnitine (ACar(14:2)), and glucuronosyldiacylglycerol (GlcADG(14:1/14:1)). The disease classification model, constructed using a KNN algorithm with 13 metabolites selected through LASSO screening, achieved the best performance, with an AUC of 0.978 (0.955-1.000).

CONCLUSION

Lipid metabolic biomarkers identified in this study exhibit potential as candidate biomarkers for OC diagnosis. Further validation through prospective studies is required to confirm their clinical utility in early detection.

Hospitalization costs of oral cancer patients in Southeast of China: a quantile regression analysis

BACKGROUND

Scant research has systematically examined the hospitalization costs of oral cancer patients in China. Therefore, this study aims to systematically analyze the hospitalization costs and identify the factors influencing these costs among oral cancer inpatients.

METHODS

Basic information and cost data for oral cancer patients who were admitted to the hospital for the first time between July 2015 and May 2022 were collected from one grade-A tertiary hospital in Fuzhou city of Southeastern China. Quantile regression (QR) model was used to evaluate the relationship between oral cancer patients and hospitalization costs.

RESULTS

A total of 1114 patients with oral cancer were included in this study. The median (interquartile range (IQR)) of total hospitalization costs was ¥42.73 (¥22.92-¥71.41) thousand. Overall, the distribution of total hospitalization costs (discounted in accordance with the Consumer Price Index) was flat during the study period (P = 0.437). According to the QR results, oral cancer patients' hospitalization costs were considerably affected by TNM stage, surgery, adjuvant therapy, length of stay (LOS) and tumor location. Among the above influencing factors, the highest ranking of importance was surgery, followed by TNM staging, LOS and tumor location.

CONCLUSIONS

This study analyzed the hospitalization costs of oral cancer patients using a large sample of data for consecutive 8 years. Study results suggests that TNM stage, surgery, adjuvant therapy, LOS and tumor location were significant factors influencing hospitalization costs. Policymakers may use these findings to develop cost-control strategies for surgical interventions or advanced-stage treatments.

Prognostic value of pretreatment lymphocyte percentage in oral cancer: A prospective cohort study

OBJECTIVE

To assess the prognostic role of pretreatment lymphocyte percentage (LY%) for patients with oral squamous cell carcinoma (OSCC).

METHODS

A large-scale prospective cohort study between July 2002 and March 2021 was conducted. Propensity score-matched (PSM) analysis and inverse probability of treatment weighting (IPTW) analysis were performed to adjust for potential confounders. Using random survival forest (RSF), the relative importance of pretreatment LY% in prognosis prediction was also assessed.

RESULTS

A total of 743 patients were enrolled and followed up (median: 2.75 years, interquartile range: 1.25-4.42 years). A high pretreatment LY% was significantly associated with better disease-specific survival of patients with OSCC (Hazard ratio [HR] = 0.60, 95% confidence interval [CI]: 0.42, 0.84). The same tendency was observed in PSM (HR = 0.57, 95% CI: 0.38, 0.85) and IPTW analysis (HR = 0.57, 95% CI: 0.40, 0.82). RSF showed that LY% ranked the fifth among importance ranking of all prognostic factors.

CONCLUSION

Pretreatment LY% showed a moderate predictive ability, suggesting it might be a valuable tool to predict prognosis for patients with OSCC.

Association between mir-24 and mir-378 in formalin-fixed paraffin-embedded tissues of breast cancer

BACKGROUND

MiR-24/378 is thought to be onco-miRNAs for their ability of enhancing tumor growth. The objective of this study was to evaluate the potential predictive value of miR-24/378 expression in formalin-fixed paraffin-embedded tissues of breast cancer patients.

METHODS

The expression of miR-24/378 was examined in 101 breast cancer patients and 40 controls using real-time quantitative PCR. All statistical analyses were performed using SPSS16.0.

RESULTS

We found that miR-24 and miR-378 were significantly up-regulated in breast cancer patients compared with controls (all P < 0.01). The expression levels of the two miRNAs were highly correlated with each other in breast cancer patients, with r = 0.778 between miR-24 and miR-378. Moreover, the two miRNAs exhibited great capability of discriminating between cancer patients and controls by ROC analysis. MiR-24 and miR-378 showed 0.79 and 0.807 AUC values respectively.

CONCLUSIONS

Over-expression of miR-24 and miR-378 in FFPE tissue of breast cancer patients might conduct as an ideal source for biomarker discovery and validation in breast cancer patients.

The effect of formal statistical courses attitudes on learning outcomes in a cohort of undergraduate dental students

INTRODUCTION

Whilst statistical knowledge is essential for dental students' academic or professional careers, only a few studies have measured the attitudes of these students towards statistics courses. This study aimed to investigate the attitudes of a cohort of dental students towards a formal statistical course and explore the factors that are potentially related to these attitudes.

METHODS

A survey was performed amongst dental students of 2017 entry at Fujian Medical University, China. The questionnaire covers three aspects: demographic characteristics, educational background and attitudes towards formal statistics courses.

RESULTS

A total of 103 dental students enrolled for the survey, and the response rate was 100.0%. 44.7% of dental students had positive attitudes towards formal statistics courses with an overall average of 25.7 (SD = 2.2, out of 30). Students' computer skills, expectations of course achievement, attention in class and learning atmosphere of the class were significantly associated with the attitudes towards formal statistics courses. Moreover, students with positive attitudes experienced a greater improvement in the statistical cognition and application ability of statistical methods after the course than those with negative/neutral attitudes. Additionally, a positive correlation was observed between students' attitudes and achievement in the examination.

CONCLUSION

These results suggest that attitudes are critical to the learning effectiveness in formal statistics courses amongst undergraduate dental students. All the educators involved should monitor the students' attitudes in the teaching process and make effective interventions to improve students' attitudes towards formal statistics courses.

Utility of gamma-glutamyl transpeptidase to lymphocyte count ratio in predicting prognosis of patients with oral cancer: A prospective cohort study in Southeastern China

BACKGROUND

To assess the prognostic role of gamma-glutamyl transpeptidase to lymphocyte count ratio (GLR) and develop a prognostic nomogram for patients with oral cancer.

METHODS

A prospective cohort (n = 1011) was conducted during July 2002 to March 2021 in Southeastern China.

RESULTS

The median follow-up time was 3.5 years. Multivariate Cox regression (OS: HR = 1.51, 95% CI: 1.04, 2.18) and Fine-Gray model (DSS: HR = 1.68, 95% CI: 1.14, 2.49) both showed that high GLR could act as an indicator of poor prognosis. A nonlinear dose-response relationship was observed between continuous GLR and the risk of all-cause mortality (p for overall = 0.028, p for nonlinear = 0.048). Compare with TNM stage, time-dependent ROC curve proved that GLR-based nomogram model performs better in predicting prognosis (the area under curve for 1-, 3-, and 5-years mortality: 0.63, 0.65, and 0.64 vs. 0.76, 0.77, and 0.78, p < 0.001).

CONCLUSION

GLR might be a useful tool in predicting prognosis for patients with oral cancer.

Over-expression of miR-98 in FFPE tissues might serve as a valuable source for biomarker discovery in breast cancer patients

The miR-98 is thought to be associated with various cancers. This study was to evaluate the potential predictive value of miR-98 expression in formalin-fixed paraffin-embedded tissue of breast cancer patients. The expression levels of miR-98 were examined in 98 breast cancer patients and 40 cancer-free controls using real-time quantitative PCR. The comparison of miR-98 expression levels between patient and control was performed using the Mann-Whitney test. The miR-98 showed higher expression levels in breast cancer patients compared with cancer free controls (p<0.01). The expression levels of miR-98 were highly correlated with miR24/93/378 in breast cancer patients. The miR-98 exhibited great capability of discriminating between cancer patients and controls by the Receiver-operator characteristic (ROC) curve analysis. The miR-98 was found highly correlated with breast cancer by Univariable logistic regression analysis. These results suggest that over-expression of miR-98 in formalin-fixed paraffin-embedded tissues might serve as a valuable source for biomarker discovery in breast cancer patients.

Effects of diets on risks of cancer and the mediating role of metabolites

Research on the association between dietary adherence and cancer risk is limited, particularly concerning overall cancer risk and its underlying mechanisms. Using the UK Biobank data, we prospectively investigate the associations between adherence to a Mediterranean diet (MedDiet) or a Mediterranean-Dietary Approaches to Stop Hypertension Diet Intervention for Neurodegenerative Delay diet (MINDDiet) and the risk of overall and 22 specific cancers, as well as the mediating effects of metabolites. Here we show significant negative associations of MedDiet and MINDDiet adherence with overall cancer risk. These associations remain robust across 14 and 13 specific cancers, respectively. Then, a sequential analysis, incorporating Cox regression, elastic net and gradient boost models, identify 10 metabolites associated with overall cancer risk. Mediation results indicate that these metabolites play a crucial role in the association between adherence to a MedDiet or a MINDDiet and cancer risk, independently and cumulatively. These findings deepen our understanding of the intricate connections between diet, metabolites, and cancer development.

Predictive value of preoperative pan-immune-inflammation value index in the prognosis of oral cancer patients undergoing radical resection

BACKGROUND

To evaluate the prognostic role of the preoperative pan-immune-inflammation value (PIV) index in patients with oral squamous cell carcinoma (OSCC) after undergoing radical resection and to develop a prognostic prediction model for these patients.

METHODS

A large cohort study was conducted between January 2015 and March 2022. Univariate and multivariate Cox regression was used to assess the prognostic value of PIV, and propensity score matching (PSM) analysis was used to adjust for potential confounders. Randomized survival forest (RSF) was used to assess the relative importance of preoperative PIV in prognostic prediction. Finally, a Nomogram model was plotted to predict the prognosis of oral cancer patients.

RESULTS

A total of 779 patients were enrolled and followed up (mean follow-up time 34.14 ± 24.39). High PIV was significantly associated with worse survival in OSCC patients (hazard ratio [HR] = 1.62, 95% confidence interval [CI]: 1.15-2.29, P = 0.006). The same trend was observed in PSM (HR = 1.55,95% CI: 1.03-2.23, P = 0.035). RSF showed that PIV ranked third in the importance ranking of all prognostic factors. The calibration curves indicated that the Nomogram model was superior in predicting the prognostic 1-, 3-, and 5-year survival of oral cancer patients.

CONCLUSIONS

PIV is an independent predictor of prognosis in patients with oral squamous cell carcinoma, and a column-line graphical model based on PIV can effectively predict prognosis.

Relationship Between Dietary Fiber and Vitamin C Intake and Oral Cancer

BACKGROUND

Dietary fiber and vitamin C has been reported to play a possible role in tumorigenesis. However, few studies have estimated their association with oral cancer risk. In this project, we investigated the relationship between dietary fiber and vitamin C and oral cancer risk in adults in Southern China.

METHODS

382 patients newly diagnosed with oral cancer were matched to 382 hospital derived controls by frequency matching in age and sex. Pre-diagnostic consumption of dietary fiber and vitamin C intake were measured through food frequency questionnaire. Association between nutrients intake and oral cancer risk were evaluated by logistic regression. OR value and 95% confidence interval was calculated.

RESULTS

Intake of dietary fiber and vitamin C was significantly lower in oral cancer patients (8.15 g/day) than in control participants (8.88 g/day). Increased dietary fiber or vitamin C intake was linked to a decreased incidence of OC after adjustment of age, marital status, residence, BMI, occupation, education, tobacco smoking, alcohol consumption and family history of cancer Ptrend < 0.001). Compared with the lowest tertile, the adjusted OR of the top tertile of dietary fiber was 0.47 (95 % CI 0.32, 0.68). While the adjusted OR of the highest tertile was 0.60 (95 % CI 0.42, 0.87) compared with the lowest tertile of vitamin C.

CONCLUSIONS

Dietary intake of fiber and vitamin C were lower in oral cancer patients than in control participants. Dietary fiber and vitamin C were inversely related to risk of oral cancer risk.

Associations of exposure to arsenic species and endogenous sex hormones with oral cancer: a hospital-based study in Southeastern China

The effects of arsenic species and endogenous sex hormones on oral cancer risk, particularly their molecular interactions, have been infrequently reported. This study aimed to assess the individual and combined effects of arsenic species and endogenous sex hormones on oral cancer risk and elucidate the association between hormones, arsenic species, and arsenic metabolism. A case-control study (comprising 144 cases and 144 controls) was conducted from January 2020 to January 2024 in Southeastern China. Serum levels of six arsenic species and nine endogenous sex hormones were measured using High-Performance Liquid Chromatography Inductively Coupled Plasma Mass Spectrometry (HPLC-ICP-MS) and ultra-high performance liquid chromatography-high resolution mass spectrometry (UPLC-HRMS), respectively. After adjusting for potential confounders, Logistic regression showed that high exposure levels of inorganic arsenic (IAs) (adjusted OR [aOR] and 95 %CI: 0.00[0.00,0.44] and 0.45[0.25,0.78]) and Cortisone (aOR and 95 %CI: 0.16[0.07,0.35] and 0.19[0.10,0.37]) were associated with reduced oral cancer risk, both as continuous and categorical variables. Serum Melatonin, Cortisone, and Testosterone levels correlated with partial arsenic species, while Cortisone and Melatonin were linked to arsenic methylation metabolic indexes (spearman's test P < 0.05). Quantile g-computation analysis revealed that Corticosterone and Cortisone had the largest positive and negative weights on oral cancer risk, respectively (weights = 0.640 and 0.525). The combined effect of arsenic species and hormones on oral cancer was protective (β and 95 %CI: 0.36(-0.05,-0.67)), with slight gender differences. Independent of other arsenic species and hormone levels, Cortisone exhibited a protective effect against oral cancer in BKMR analysis. Additionally, an interaction effect between Melatonin and other arsenic species was also observed. In summary, Serum IAs and Cortisone were negatively associated with oral cancer, while Corticosterone showed a positive association. Further cohort studies are needed to confirm and elucidate these mechanisms.