AUTORES
André Willian Ikert
Cirurgião-dentista – Centro Universitário Unifacvest.
Orcid: 0000-0002-0437-8321.
Laís Cardoso Pinto
Acadêmica – Centro Universitário Unifacvest.
Orcid: 0000-0002-6667-883X.
Alexia Catarina Carpes
Acadêmica – Centro Universitário Unifacvest.
Orcid: 0000-0003-4849-0515.
Carla Cioato Piardi
Mestra em Clínica Odontológica/Periodontia – Universidade Federal do Rio Grande do Sul; Professora – Centro Universitário Unifacvest.
Orcid: 0000-0001-6040-8153.
RESUMO
Objetivo: revisar a literatura sobre a relação entre periodontite e o risco de câncer. Material e métodos: foram realizadas buscas em bases de dados eletrônicas (PubMed, BVS, Scielo, Embase e Google Scholar) entre 1985 e 2020, sobre a associação entre câncer e periodontite, nos idiomas português, inglês, espanhol e italiano, usando uma combinação booleana de descritores MeSH. Resultados: das 83 referências iniciais, apenas 17 foram selecionadas, sendo nove estudos coorte (2.323.853 pacientes) e oito casos-controle (2.123 pacientes). A qualidade dos estudos ficou entre 6 e 9 (Escala NewCastle-Ottawa). Nos estudos coorte, os órgãos acometidos foram: pulmão, pâncreas, mama, esôfago, vesícula biliar, pele, estômago, cavidade oral, próstata e tecidos hematopoiéticos. Já nos estudos de caso-controle, foram realizadas análises com câncer de língua, carcinoma espinocelular de cabeça e pescoço, carcinoma oral de células escamosas, vias aerodigestivas superiores, mama e orofaríngeo. Esses estudos demonstraram associação positiva entre a presença de periodontite e o risco de câncer, sendo estatisticamente significante para as neoplasias de pulmão, pâncreas, mama, esôfago, vesícula biliar, próstata, câncer colorretal, hematológico, oral e de estômago nos estudos de coorte. Já nos estudos de caso-controle, houve relação positiva entre a presença de periodontite e o câncer orofaríngeo de vias aéreas superiores, de mama, de língua, hepatocelular e carcinoma espinocelular. Conclusão: os achados deste estudo mostram uma associação entre as duas doenças aqui estudadas. No entanto, a literatura revisada sugere que mais estudos com tempos maiores de acompanhamento sejam realizados.
Palavras-chave – Câncer; Doença periodontal; Periodontite; Carcinoma; Doenças sistêmicas.
ABSTRACT
Objective: to review the literature on the relationship between periodontitis and cancer risk. Material and methods: searches were carried out in electronic databases (PubMed, VHL, Scielo, Embase and Google Scholar) between 1985 and 2020, about the association between cancer and periodontitis, in Portuguese, English, Spanish and Italian, using a Boolean combination of MeSH descriptors. Results: of the 83 initial references, only 17 were selected – 9 cohort studies (2,323,853 patients), 8 case-control (2,123 patients). The quality of the studies was between 6 and 9 (NewCastle-Ottawa scale). In the cohort studies, the organs affected were: lung, pancreas, breast, esophagus, gall bladder, skin, stomach, oral, prostate and hematological tissues. For case-control studies, analyses were made regarding tongue, head and neck, oral squamous cell carcinoma, upper aerodigestive tract, breast, and oropharyngeal cancer. These studies showed a positive association between the presence of periodontitis and the risk of cancer. This association was statistically significant for lung, pancreas, breast, esophagus, gall bladder, prostate, colorectal, hematological, oral and stomach cancer in cohort studies, while in case-control studies, there was a positive relationship between the presence of periodontitis and oropharyngeal cancer, from upper, breast, tongue, hepatocellular areas and squamous cell carcinoma. Conclusion: the findings of this study show an association between the two diseases studied here. However, the reviewed literature suggests that more studies with longer follow-up times should be carried out.
Key words – Cancer; Periodontal disease; Periodontitis; Carcinoma; Systemic diseases.
Recebido em jan/2021
Aprovado em fev/2021
Referências
- Inca – Instituto Nacional de Câncer [On-line]. Disponível em <www.inca.gov.br>. Acesso em: 22-7-2020.
- Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394-424.
- Briceño J, Cavagnola D, Candia J, Somarriva C, Fernández A. Influencia de la periodontitis en el carcinoma oral de células escamosas: revisión narrativa. Odontol Vital 2018;29(2):69-76.
- Cortelli JR, Cortelli SC. Periodontite crônica e agressiva: prevalência subgengival e freqüência de ocorrência de patógenos periodontais. Rev Biociênc 2003;9(2):91-6.
- Ministério da Saúde. Secretaria de Atenção à Saúde. Secretaria de Vigilância em Saúde. SB Brasil 2010: Pesquisa Nacional de Saúde Bucal: resultados principais. Brasília, 2012. p.116.
- Oppermann RV. An overview of the epidemiology of periodontal diseases in Latin America. Braz Oral Res 2007;21(Spec Iss 1):8-15.
- Moore WEC, Moore LVH. The bacteria of periodontal diseases. Periodontol 2000 1994;5(1):66-77.
- Coussens LM, Werb Z. Inflammation and cancer. Nature 2002;420(6917):860-7.
- Karin M, Lawrence T, Nizet V. Innate immunity gone awry: linking microbial infections to chronic inflammation and cancer. Cell 2006;124(4):823-35.
- Sahingur SE, Yeudall WA. Chemokine function in periodontal disease and oral cavity cancer. Front Immunol 2015;6:214.
- Wells G, Shea B, O’Connel D, Robertson J, Peterson J, Welch V et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses [On-line]. Disponível em <http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp>. Acesso em: 16-12-2020.
- Wen BW, Tsai CS, Lin CL, Chang YJ, Lee CF, Hsu CH et al. Cancer risk among gingivitis and periodontitis patients: a nationwide cohort study. QJM 2014;107(4):283-90.
- Dizdar O, Hayran M, Guven DC, Yılmaz TB, Taheri S, Akman AC et al. Increased cancer risk in patients with periodontitis. Curr Med Res Opin 2017;33(12):2195-200.
- Chang JS, Tsai CR, Chen LT, Shan YS. Investigating the association between periodontal disease and risk of pancreatic cancer. Pancreas 2016;45(1):134-41.
- Hujoel PP, Drangsholt M, Spiekerman C, Weiss NS. An exploration of the periodontitis-cancer association. Ann Epidemiol 2003;13(5):312-6.
- Michaud DS, Lu J, Peacock-Villada AY, Barber JR, Joshu CE, Prizment AE et al. Periodontal disease assessed using clinical dental measurements and cancer risk in the ARIC study. J Natl Cancer Inst 2018;110(8):843-54.
- Heikkilä P, But A, Sorsa T, Haukka J. Periodontitis and cancer mortality: register-based cohort study of 68,273 adults in 10-year follow-up. Int J Cancer 2018;142(11):2244-53.
- Nwizu NN, Marshall JR, Moysich K, Genco RJ, Hovey KM, Mai X et al. Periodontal disease and incident cancer risk among postmenopausal women: results from the women’s health initiative observational cohort. Cancer Epidemiol Biomarkers Prev 2017;26(8):1255-65.
- Tezal M, Sullivan MA, Hyland A, Marshall JR, Stoler D, Reid ME et al. Chronic periodontitis and the incidence of head and neck squamous cell carcinoma. Cancer Epidemiol Biomarkers Prev 2009;18(9):2406-12.
- Tamaki N, Takaki A, Tomofuji T, Endo Y, Kasuyama K, Ekuni D et al. Stage of hepatocellular carcinoma is associated with periodontitis. J Clin Periodontol 2011;38(11):1015-20.
- Moergel M, Kämmerer P, Kasaj A, Armouti E, Alshihri A, Weyer V et al. Chronic periodontitis and its possible association with oral squamous cell carcinoma – a retrospective case control study. Head Face Med 2013;9(1):39.
- Sfreddo CS, Maier J, De David SC, Susin C, Moreira CHC. Periodontitis and breast cancer: a case-control study. Community Dent Oral Epidemiol 2017;45(6):545-51.
- de Moraes RC, Dias FL, Figueredo CMS, Fischer RG. Association between chronic periodontitis and oral/oropharyngeal cancer. Braz Dent J 2016;27(3):261-6.
- Tezal M, Sullivan MA, Reid ME, Marshall JR, Hyland A, Loree T et al. Chronic periodontitis and the risk of tongue cancer. Arch Otolaryngol Head Neck Surg 2007;133(5):450-4.
- Shin YJ, Choung HW, Lee JH, Rhyu IC, Kim HD. Association of periodontitis with oral cancer: a case-control study. J Dent Res 2019;98(5):526-33.
- Gupta B, Kumar N, Johnson NW. Periodontitis, oral hygiene habits, and risk of upper aerodigestive tract cancers: a case-control study in Maharashtra, India. Oral Surg Oral Med Oral Pathol Oral Radiol 2020;129(4):339-46.
- Chung SD, Tsai MC, Huang CC, Kao LT, Chen CH. A population-based study on the associations between chronic periodontitis and the risk of cancer. Int J Clin Oncol 2016;21(2):219-23.
- Tai SH, Chen JP, Chang HS, Kuo HC. Periodontitis as a risk factor for lung cancer among women: a nationwide matched cohort study. Kaohsiung J Med Sci 2019;35(2):123-4.
- Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol 2018;45(suppl.20):68-77.
- Salvi GE, Brown CE, Fujihashi K, Kiyono H, Smith FW, Beck JD et al. Inflammatory mediators of the terminal dentition in adult and early onset periodontitis. J Periodontal Res 1998;33(4):212-25.
- Moutsopoulos NM, Madianos PN. Low-grade inflammation in chronic infectious diseases: paradigm of periodontal infections. Ann N Y Acad Sci 2006;1088:251-64.
- Emingil G, Tervahartiala T, Mãntylã P, Määttä M, Sorsa T, Atilla G. Gingival crevicular fluid matrix metalloproteinase (MMP)-7, extracellular MMP inducer, and tissue inhibitor of MMP-1 levels in periodontal disease. J Periodontol 2006;77(12):2040-50.
- Joshipura KJ, Wand HC, Merchant AT, Rimm EB. Periodontal disease and biomarkers related to cardiovascular disease. J Dent Res 2004;83(2):151-5.
- Oppermann RV, Rosing CK. Periodontia Laboratorial e Clínica: Série Abeno Odontologia Essencial (1a ed.). Porto Alegre: Artes Médicas, 2013.
- Van Der Weijden GA, De Siegte C, Timmerman MF, Van Der Velden U, Van Der Weijden F. Periodontitis in smokers and non-smokers: intra-oral distribution of pockets. A retrospective study. J Clin Periodontol 2001;28(10):955-60.
- Preber H, Bergström J. Occurrence of gingival bleeding in smoker and non-smoker patients. Acta Odontol Scand 1985;43(5):315-20.