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Yang PY, Fang CY, Cho SC, Lee SP, Liao HY, Liao YW, Yu CC, Huang PH. Targeting histone deacetylase 9 represses fibrogenic phenotypes in buccal mucosal fibroblasts with arecoline stimulation. J Dent Sci 2024; 19:79-85. [PMID: 38303807 PMCID: PMC10829613 DOI: 10.1016/j.jds.2023.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/22/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose Oral submucosal fibrosis (OSF) is a premalignant disorder positively associated with betel nut chewing. Recent studies supported the promising benefits of histone deacetylase (HDAC) inhibitors for fibrosis treatment. Here we aim to clarify the pro-fibrogenic role of HDAC9 in regulating OSF. Materials and methods Healthy and OSF specimens were collected to investigate the clinical significance of HDAC9. Chronic arecoline treatment process was used to induce arecoline-mediated myofibroblasts-related activation of primary buccal mucosa fibroblasts (BMFs). Functional analysis of collagen gel contraction, transwell migration, and wound-healing assays were performed to assess the change in pro-fibrogenic properties of BMFs and fibrotic BMFs (fBMFs). Lentiviral-mediated HDAC9 knockdown was used to verify the role of HDAC9 in the pro-fibrogenic process. Results We found that arecoline significantly increased the mRNA and protein expression of HDAC9 of BMFs in a dose-dependent manner. Knockdown of HDAC9 in BMFs reversed the strengthened effects of arecoline on collagen gel contraction, cell migration, and wound-healing ability. We further demonstrated that knockdown of HDAC9 in fBMFs significantly attenuated its inherent pro-fibrogenic properties. Furthermore, we confirmed a significantly increased expression of HDAC9 mRNA in OSF compared to normal tissues, which suggested a positive correlation between the up-regulation of HDAC9 and OSF. Conclusion We demonstrated that silencing of HDAC9 inhibited arecoline-induced activation and inherent pro-fibrogenic properties, suggesting potential therapeutics by targeting HDAC9 in the OSF treatment.
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Affiliation(s)
- Po-Yu Yang
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chih-Yuan Fang
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shih-Chi Cho
- Department of Medical Research and Education, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Shiao-Pieng Lee
- School of Dentistry, Department of Dentistry of Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Heng-Yi Liao
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| | - Yi-Wen Liao
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Cheng-Chia Yu
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Pao-Hsien Huang
- Department of Dentistry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
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Tseng YA, Ou YL, Geng JH, Wang CW, Wu DW, Chen SC, Lu PL. The association between alcohol, betel nut, and cigarette use with hepatitis C virus infection in Taiwan. Sci Rep 2023; 13:23082. [PMID: 38155257 PMCID: PMC10754914 DOI: 10.1038/s41598-023-50588-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 12/21/2023] [Indexed: 12/30/2023] Open
Abstract
Hepatitis C virus (HCV) infection may cause chronic liver disease, liver cirrhosis, and liver cancer. It has been reported to associate with habits including alcohol, betel nut and cigarette use. We aimed to investigate the association between alcohol, betel nut, and cigarette use with HCV infection in Taiwan and to explore their effects. A total of 121,421 participants were enrolled from the Taiwan Biobank. They were stratified into two groups according to whether they had (n = 2750; 2.3%) or did not have (n = 118,671; 97.7%) HCV infection. All participants were also classified into four groups according to the number of habits, including a history of alcohol drinking, betel nut chewing, and cigarette smoking. There were 85,406 (no habit), 24,299 (one habit), 8659 (two habits), and 3057 (three habits) participants in the four groups, respectively. Multivariable analysis showed that the participants who had an alcohol drinking history (odds ratio [OR] 1.568; 95% confidence interval [CI] 1.388-1.773; p < 0.001), betel nut chewing history (OR 1.664; 95% CI 1.445-1.917; p < 0.001), cigarette smoking history (OR 1.387; 95% CI 1.254-1.535; p < 0.001), were significantly associated with HCV infection. Furthermore, the participants were classified into four groups according to the number of habits as follows: 85,406 (no habit), 24,299 (one habit), 8659 (two habits), and 3057 (three habits). The HCV infection rates in these four groups were 2.11%, 2.14%, 3.23%, and 4.78%, respectively. Compared to the participants with no or one habit, those with two habits had a higher HCV infection rate (all p < 0.001). In addition, compared to the participants who had no, one or two habits, those who had three habits also had higher HCV infection rates (all p < 0.001). The participants who had three habits had the highest prevalence of HCV infection. In an era when most HCV can be cured, understanding the epidemiology link between habits and HCV may help the case finding.
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Affiliation(s)
- Yuan-Ai Tseng
- Department of Post Baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan, ROC
| | - Yu-Lun Ou
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung, 812, Taiwan, ROC
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Jiun-Hung Geng
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 812, Taiwan, ROC
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan, ROC
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan, ROC
| | - Chih-Wen Wang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung, 812, Taiwan, ROC
- Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan, ROC
| | - Da-Wei Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung, 812, Taiwan, ROC
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan, ROC
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan, ROC
| | - Szu-Chia Chen
- Department of Post Baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan, ROC.
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung, 812, Taiwan, ROC.
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan, ROC.
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan, ROC.
| | - Po-Liang Lu
- Department of Post Baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan, ROC.
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, No.100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City, 80756, Taiwan, ROC.
- Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
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Lin C, Chen W, Shia B, Wu S. Statin use and its association with decreased risk of esophageal squamous cell carcinoma in betel nut chewers. Thorac Cancer 2023; 14:2241-2250. [PMID: 37395565 PMCID: PMC10423659 DOI: 10.1111/1759-7714.15009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Betel nut chewing involves the chewing of areca nuts or betel quid (areca nuts wrapped in betel leaves), which is associated with an increased risk of esophageal squamous cell carcinoma (ESCC). Statins have anticancer properties. We investigated the association between statin use and ESCC risk in betel nut chewers. METHODS The study included 105 387 betel nut chewers matched statin users and nonusers. Statin use was defined as the use of ≥28 cumulative defined daily doses (cDDDs) of statin. The primary outcome was incidence of ESCC. RESULTS The incidence rate of ESCC was significantly lower in statin users than in nonusers (2.03 vs. 3.02 per 100 000 person-years). Statin users had a lower incidence rate ratio of 0.66 for ESCC (95% confidence interval [CI]: 0.43-0.85) relative to nonusers. After potential confounders were adjusted for, statin use was determined to be associated with a reduced risk of ESCC (adjusted hazard ratio [aHR], 0.68; 95% CI: 0.51-0.91). A dose-response relationship was observed between statin use and ESCC risk; the aHRs for statin use at 28-182 cDDDs, 183-488 cDDDs, 489-1043 cDDDs, and > 1043 cDDDs were 0.92, 0.89, 0.66, and 0.64, respectively. CONCLUSION Statin use was revealed to be associated with a reduced risk of ESCC in betel nut chewers.
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Affiliation(s)
- Chih‐Lang Lin
- Liver Research Center, Department of Gastroenterology and HepatologyKeelung Chang Gung Memorial HospitalKeelungTaiwan
- Community Medicine Research CenterKeelung Chang Gung Memorial HospitalKeelungTaiwan
- College of MedicineChang Gung UniversityTaiwan
| | - Wan‐Ming Chen
- Graduate Institute of Business Administration, College of ManagementFu Jen Catholic UniversityTaipeiTaiwan
- Artificial Intelligence Development CenterFu Jen Catholic UniversityTaipeiTaiwan
| | - Ben‐Chang Shia
- Graduate Institute of Business Administration, College of ManagementFu Jen Catholic UniversityTaipeiTaiwan
- Artificial Intelligence Development CenterFu Jen Catholic UniversityTaipeiTaiwan
| | - Szu‐Yuan Wu
- Graduate Institute of Business Administration, College of ManagementFu Jen Catholic UniversityTaipeiTaiwan
- Artificial Intelligence Development CenterFu Jen Catholic UniversityTaipeiTaiwan
- Department of Food Nutrition and Health Biotechnology, College of Medical and Health ScienceAsia UniversityTaichungTaiwan
- Division of Radiation Oncology, Lo‐Hsu Medical FoundationLotung Poh‐Ai HospitalYilanTaiwan
- Big Data Center, Lo‐Hsu Medical FoundationLotung Poh‐Ai HospitalYilanTaiwan
- Department of Healthcare Administration, College of Medical and Health ScienceAsia UniversityTaichungTaiwan
- Cancer Center, Lo‐Hsu Medical FoundationLotung Poh‐Ai HospitalYilanTaiwan
- Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang HospitalTaipei Medical UniversityTaipeiTaiwan
- Department of Management, College of ManagementFo Guang UniversityYilanTaiwan
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Ko AMS, Tu HP, Ko YC. Systematic Review of Roles of Arecoline and Arecoline N-Oxide in Oral Cancer and Strategies to Block Carcinogenesis. Cells 2023; 12:1208. [PMID: 37190117 PMCID: PMC10137008 DOI: 10.3390/cells12081208] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/11/2023] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
Betel quid and areca nut are complex mixture carcinogens, but little is known about whether their derived single-agent arecoline or arecoline N-oxide (ANO) is carcinogenic, and the underlying mechanisms remain unclear. In this systematic review, we analyzed recent studies on the roles of arecoline and ANO in cancer and strategies to block carcinogenesis. In the oral cavity, flavin-containing monooxygenase 3 oxidizes arecoline to ANO, and both alkaloids conjugate with N-acetylcysteine to form mercapturic acid compounds, which are excreted in urine, reducing arecoline and ANO toxicity. However, detoxification may not be complete. Arecoline and ANO upregulated protein expression in oral cancer tissue from areca nut users compared to expression levels in adjacent normal tissue, suggesting a causal relationship between these compounds and oral cancer. Sublingual fibrosis, hyperplasia, and oral leukoplakia were diagnosed in mice subjected to oral mucosal smearing of ANO. ANO is more cytotoxic and genotoxic than arecoline. During carcinogenesis and metastasis, these compounds increase the expression of epithelial-mesenchymal transition (EMT) inducers such as reactive oxygen species, transforming growth factor-β1, Notch receptor-1, and inflammatory cytokines, and they activate EMT-related proteins. Arecoline-induced epigenetic markers such as sirtuin-1 hypermethylation, low protein expression of miR-22, and miR-886-3-p accelerate oral cancer progression. Antioxidants and targeted inhibitors of the EMT inducers used reduce the risk of oral cancer development and progression. Our review findings substantiate the association of arecoline and ANO with oral cancer. Both of these single compounds are likely carcinogenic to humans, and their mechanisms and pathways of carcinogenesis are useful indicators for cancer therapy and prognosis.
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Affiliation(s)
- Albert Min-Shan Ko
- Department of Biomedical Sciences, Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan 33302, Taiwan
- Cardiovascular Department, Chang Gung Memorial Hospital, Taoyuan 33302, Taiwan
- Health Aging Research Center, Chang Gung University, Taoyuan 33302, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Ying-Chin Ko
- Department of Medical Research, China Medical University Hospital, China Medical University, No. 2 Yu-Der Road, Taichung 40447, Taiwan
- Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei 106216, Taiwan
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5
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Yang HW, Sun YH, Fang CY, Ohiro Y, Liao HY, Liao YW, Kao YH, Yu CC. Downregulation of histone deacetylase 8 (HDAC8) alleviated the progression of oral submucous fibrosis. J Dent Sci 2023; 18:652-658. [PMID: 37021220 PMCID: PMC10068366 DOI: 10.1016/j.jds.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/07/2022] [Indexed: 04/07/2023] Open
Abstract
Background/purpose Oral submucous fibrosis (OSF) is a premalignant disorder that is associated with betel nut chewing. The purpose of the study was to establish the role of histone deacetylase (HDAC) 8, one of histone deacetylases, in the regulation of fibrotic conditions to provide a therapeutic potential for OSF. Materials and methods First, we examined the expression of HDAC8 in fibrotic buccal mucosal fibroblasts (fBMFs) and OSF tissues. Markers of myofibroblasts and TGF-β signaling were conducted in fBMFs with HDAC8 knockdown were examined. Furthermore, epithelial-mesenchymal transition (EMT) markers, collagen gel contraction and migration ability were also examined in fBMFs transfected with sh-HDAC8. HDAC8 inhibitor was used to analyze the collagen gel contraction and wound healing ability in fBMFs. Results We observed the mRNA expression of HDAC8 was significantly increased in fBMFs. Compared to normal tissues, the protein level of HDAC8 was upregulated in OSF. Next, mRNA and protein expression of HDAC8 was significantly decreased, accompanying downregulation of α-SMA and COL1A1 in fBMFs infected with sh-HDAC8. To determine the critical role of HDAC8 in OSF fibrogenesis, results revealed that TGF-β secretion and the expression of EMT transcription factor SNAIL and p-Smad were significantly decreased in HDAC8-knockdown fBMFs. We further demonstrated that collagen gel contraction and migration ability were significantly decreased in fBMFs transfected with sh-HDAC8. Last, results revealed that significantly reduced collagen gel contraction and wound healing ability in fBMFs with HDAC8 inhibitor treatment. Conclusion We concluded that downregulation of HDAC8 alleviated the activities of myofibroblasts and TGF-β/Smad signaling pathway in OSF.
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Affiliation(s)
- Hui-Wen Yang
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yi-Hwa Sun
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chih-Yuan Fang
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yoichi Ohiro
- Oral and Maxillofacial Surgery, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Heng-Yi Liao
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| | - Yi-Wen Liao
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Hsun Kao
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Medical Education and Research, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Corresponding author. Department of Medical Education and Research, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan.
| | - Cheng-Chia Yu
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan
- Corresponding author. Institute of Oral Sciences, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., Taichung 40201, Taiwan. Fax: +886 4 24759065.
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Tsai YS, Chen YC, Chen TI, Lee YK, Chiang CJ, You SL, Hsu WL, Liao LJ. Incidence trends of oral cavity, oropharyngeal, hypopharyngeal and laryngeal cancers among males in Taiwan, 1980-2019: a population-based cancer registry study. BMC Cancer 2023; 23:213. [PMID: 36879234 PMCID: PMC9987053 DOI: 10.1186/s12885-023-10651-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/15/2023] [Indexed: 03/08/2023] Open
Abstract
In a country with a high prevalence of cigarette smoking, betel chewing, and alcohol drinking, cancers of the oral cavity, nasopharynx, and larynx were the fourth, twelfth and seventeenth leading causes of cancer death, respectively, for men in 2020. We analyzed patients with head and neck cancer from 1980 to 2019 from the Taiwan Cancer Registration Database and discussed the annual average percent change, average percent change, age period, and birth cohort. Obvious period effects and birth effects are seen in oral, oropharyngeal, and hypopharyngeal cancer; however, the most significant period effect was seen between 1990 and 2009, which mainly reflects the consumption of betel nuts per capita. In addition, the period effect lessens after 2010 in oral cancer and hypopharyngeal cancers, while oropharyngeal cancers remain an obvious period effect, which results from the rising prevalence of HPV. Due to the high prevalence rate of betel quid chewing and cigarette smoking in the 1990s, the government executed several acts. As a result, the age-adjusted incidence rates of oral, oropharyngeal, and hypopharyngeal cancers have flattened since 2010, which can be explained by the declining cigarette smoking rate. The strict policy indeed shows an obvious effect on the head and neck cancer incidence rates, and we expect to see a further decline in the future.
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Affiliation(s)
- Yu-Shiun Tsai
- School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei City, 242, Taiwan
| | - Yong-Chen Chen
- Master Program of Big Data Analysis in Biomedicine, College of Medicine, Fu Jen Catholic University, New Taipei City, 242, Taiwan.,Data Science Center, College of Medicine, Fu Jen Catholic University, New Taipei City, 242, Taiwan
| | - Tzu-I Chen
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, New Taipei City, 242062, Taiwan
| | - Yu-Kwang Lee
- Division of General Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, 100, Taiwan
| | - Chun-Ju Chiang
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, 10055, Taiwan
| | - San-Lin You
- School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei City, 242, Taiwan.,Data Science Center, College of Medicine, Fu Jen Catholic University, New Taipei City, 242, Taiwan
| | - Wan-Lun Hsu
- Master Program of Big Data Analysis in Biomedicine, College of Medicine, Fu Jen Catholic University, New Taipei City, 242, Taiwan. .,Data Science Center, College of Medicine, Fu Jen Catholic University, New Taipei City, 242, Taiwan.
| | - Li-Jen Liao
- Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan. .,Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan. .,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan.
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7
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Lai YH, Su CC, Wu SY, Hsueh WT, Wu YH, Chen HHW, Hsiao JR, Liu CH, Tsai YS. Impact of Alcohol and Smoking on Outcomes of HPV-Related Oropharyngeal Cancer. J Clin Med 2022; 11:6510. [PMID: 36362736 PMCID: PMC9655073 DOI: 10.3390/jcm11216510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND The aim of this study was to evaluate the impact of adverse lifestyle factors on outcomes in patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC). METHODS From 2010 to 2019, 150 consecutive non-metastatic OPSCC patients receiving curative treatment in our institution were retrospectively enrolled. HPV positivity was defined as p16 expression ≥75%. The effects of adverse lifestyle factors on overall survival (OS) and disease-free survival (DFS) on OPSCC patients were determined. RESULTS The median follow-up duration was 3.6 years. Of the 150 OPSCCs, 51 (34%) patients were HPV-positive and 99 (66%) were HPV-negative. The adverse lifestyle exposure rates were 74.7% (n = 112) alcohol use, 57.3% (n = 86) betel grid chewing, and 78% (n = 117) cigarette smoking. Alcohol use strongly interacted with HPV positivity (HR, 6.00; 95% CI, 1.03-35.01), leading to an average 26.1% increased risk of disease relapse in patients with HPV-positive OPSCC. Heavy smoking age ≥30 pack-years was associated with increased risk of death (HR, 2.05; 95% CI, 1.05-4.00) and disease relapse (HR, 1.99; 95% CI, 1.06-3.75) in OPSCC patients. In stratified analyses, the 3-year absolute risk of disease relapse in HPV-positive OPSCC patients reached up to 50% when alcohol use and heavy smoking for ≥30 pack-years were combined. CONCLUSIONS Alcohol acted as a significant treatment-effect modifier for DFS in HPV-positive OPSCC patients, diluting the favorable prognostic effect of HPV positivity. Heavy smoking age ≥30 pack-years was an independent adverse prognostic factor of OS and DFS in OPSCC patients. De-intensification treatment for HPV-related OPSCC may be avoided when these adverse lifestyle factors are present.
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Affiliation(s)
- Yu-Hsuan Lai
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
- Clinical Innovation and Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Chien-Chou Su
- Clinical Innovation and Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Shang-Yin Wu
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Wei-Ting Hsueh
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Yuan-Hua Wu
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Helen H. W. Chen
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Jenn-Ren Hsiao
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Ching-Hsun Liu
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Yi-Shan Tsai
- Clinical Innovation and Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
- Department of Medical Imaging, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
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8
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Aye YM, Hong SA, Thepthien B, Tiraphat S. Betel quid chewing and its prevalence and determinants: data from Myanmar Demographic Health and Survey of 2015-2016. J Public Health (Oxf) 2022; 44:e181-e191. [PMID: 33791792 DOI: 10.1093/pubmed/fdab044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 01/15/2021] [Accepted: 02/12/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although betel quid chewing with tobacco use is one of the major behavioral risk factors for chronic diseases, the prevalence is rather on the increase in Myanmar. This study determined prevalence of betel quid chewing at the national and subnational levels and its associations with tobacco and sociodemographic factors. METHODS This study is a secondary data analysis of Myanmar demographic health survey 2015-2016 with a total of 11 773 women and 4251 men aged 18-49 years. Chi-square tests and multivariable logistic regression tests were performed. RESULTS Prevalence of betel quid chewing was 61.8% in men and 19.5% in women and by regions it ranged from 34 to 82.2% and from 5-8 to 52.9%, respectively. The prevalence of the concurrent use with tobacco was 25.8 and 2.3%, respectively. Women with older age, low education and low wealth and occupation and living with spouse were associated with betel quid chewing, while low education, living with spouse and Myanmar speaker were associated with men. Tobacco use was inversely and positively associated with betel quid chewing in men and women, respectively (P-interaction <0.0001). CONCLUSION Implementation of culturally sensitive intervention and policies including effective community awareness campaigns for anti-betel quid chewing is strongly recommended in Myanmar.
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Affiliation(s)
- Yin Min Aye
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand
| | - S A Hong
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand
- Institute for Health and Society, Hanyang University, Seoul 04763, Republic of Korea
| | - B Thepthien
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand
| | - S Tiraphat
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand
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Chen CY, Lin CC, Kao JT, Yeh WL, Lin CY, Tsai YF. Predicting Hazardous Alcohol Drinking Behaviors in Family Members of Hazardous Alcohol-Drinker Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095497. [PMID: 35564892 PMCID: PMC9105135 DOI: 10.3390/ijerph19095497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 12/04/2022]
Abstract
Family members of hazardous or harmful alcohol drinkers suffer many consequences of their relative’s alcohol-drinking behaviors and risk developing their own hazardous alcohol drinking behaviors. Studies of alcohol-related healthcare problems have mainly focused on patients, with few studies on their family members. This cross-sectional study explored factors predicting hazardous alcohol drinking behaviors in family members of hazardous alcohol-drinker patients. Participants were recruited from four randomly chosen hospitals in Taiwan. Data were collected using self-report questionnaires on family members’ alcohol use, perceived stress, coping mechanisms, social support, health, quality of life, protective factors against hazardous alcohol drinking, facilitative factors for hazardous alcohol drinking, and demographics. The 318 family members who participated in this study were divided by their Chinese-version Alcohol Use Disorders Identification Test scores into two groups: hazardous alcohol drinkers (score ≥ 8) and non-hazardous alcohol drinkers (score < 8). Significant factors predicting hazardous alcohol drinking behaviors were found by logistic regression to be the frequency of using general coping mechanisms (OR = 1.29, p < 0.01), the frequency of using strategies to cope with patients’ drinking-related behaviors (OR = 0.89, p < 0.01), factors protecting against hazardous alcohol drinking (OR = 0.76, p < 0.01) and factors facilitating hazardous alcohol drinking (OR = 1.52, p < 0.01). Interventions should be designed for family members of hazardous alcohol drinkers to address these four significant predictors.
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Affiliation(s)
- Ching-Yen Chen
- Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung City 204, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan; (C.-C.L.); (W.-L.Y.)
| | - Chen-Chun Lin
- College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan; (C.-C.L.); (W.-L.Y.)
- Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital at Linkou, Taoyuan City 333, Taiwan
| | - Jung-Ta Kao
- School of Medicine, College of Medicine, China Medical University, Taichung City 404, Taiwan;
- Division of Hepato-Gastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung City 404, Taiwan
| | - Wen-Ling Yeh
- College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan; (C.-C.L.); (W.-L.Y.)
- Department of Orthopedics, Lotung Poh-Ai Hospital, Luodong Township, Yilan County 265, Taiwan
| | - Chiao-Yun Lin
- Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan City 333, Taiwan;
| | - Yun-Fang Tsai
- Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung City 204, Taiwan;
- School of Nursing, College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Road, Taoyuan City 333, Taiwan
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City 333, Taiwan
- Correspondence: ; Tel.: +886-3-2118800 (ext. 3204); Fax: +886-3-2118868
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Chiang TE, Lin YC, Wu CT, Wu ST, Chen YW. Association between socioeconomic status and severity of oral epithelial dysplasia using a Taiwanese Nationwide Oral Mucosal Screening Program: a retrospective analysis. BMC Oral Health 2022; 22:56. [PMID: 35246076 PMCID: PMC8895639 DOI: 10.1186/s12903-022-02084-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background The study aimed to investigate the association between socioeconomic status and severity of oral epithelial dysplasia (OED) using current data from the Taiwanese Nationwide Oral Mucosal Screening Program (TNOMSP).
Methods This retrospective analysis was conducted in the Department of Oral and Maxillofacial Surgery at a general hospital in Taipei, Taiwan. A total of 134 participants were analysed from a previous study database of 150 patients. The inclusion criteria included age > 20 years and a history of either tobacco or betel nut use. Background information, including para-habits such as betel and tobacco use, was analysed using the Pearson chi-square (χ2) test; furthermore, the correlation of background information with OED severity was investigated using logistic regression (mild or moderate/severe). Results High school education level (P < 0.001), poor self-awareness (P = 0.002), current betel use (P < 0.001), and tobacco use (P = 0.003) were highly correlated with moderate- and severe OED (P < 0.05). The odds ratio (OR) of education status above senior high school was 0.03 (95% confidence interval [CI] 0.01–0.15, P < 0.001), while that of junior high school was 1. Current betel chewing (OR 6.57 [95% CI 1.17–37.0], P = 0.033) was significantly associated with OED severity compared with never or ex-use of betel. Conclusions We found a strong correlation between the severity of OED and current betel use and low education status. The current study revealed that the socioeconomic status, poor self-awareness, and para-habit history of the patients with OED should be evaluated to identify high-risk individuals using TNOMSP.
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Affiliation(s)
- Tien-En Chiang
- Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, No. 325, Cheng-Kung Rd., Sec. 2, Neihu District, Taipei City, 11490, Taiwan, ROC.,School of Dentistry, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City, 11490, Taiwan, ROC
| | - Yu-Chun Lin
- Department of Pathology, Tri-Service General Hospital, No. 325, Sec. 2, Chenggong Rd., Neihu District, Taipei City, 11490, Taiwan, ROC
| | - Chi-Tsung Wu
- Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, No. 325, Cheng-Kung Rd., Sec. 2, Neihu District, Taipei City, 11490, Taiwan, ROC.,School of Dentistry, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City, 11490, Taiwan, ROC
| | - Sheng-Tang Wu
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City, 11490, Taiwan, ROC
| | - Yuan-Wu Chen
- Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, No. 325, Cheng-Kung Rd., Sec. 2, Neihu District, Taipei City, 11490, Taiwan, ROC. .,School of Dentistry, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City, 11490, Taiwan, ROC.
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11
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Lee CY, Wang WH, Lee CH, Ho MC. Betel Quid Dependence Effects on Working Memory and Remote Memory in Chewers with Concurrent Use of Cigarette and Alcohol. Subst Use Misuse 2022; 57:105-113. [PMID: 34678114 DOI: 10.1080/10826084.2021.1990338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The current study asked whether BQ dependence level could affect working memory (WM) and remote memory for the chewers with concurrent use of cigarettes and alcohol, a common phenomenon in Taiwan. METHODS The standardized neuropsychological tests (Wechsler Memory Scale III (WMS-III) and Remote Memory Test) were adopted to address the BQ chewers' verbal WM, spatial WM and remote memory. The Spatial Span Test and the Digit Span Test from WMS-III and the Remote Memory Test were adopted. The Betel Nut Dependency Scale (BNDS), the Fagerstrom Test for Nicotine Dependence (FTND), and the Alcohol Use Disorders Identification Test (AUDIT) were adopted to measure the dependence levels. RESULTS The BQ dependence level and Last BQ did not affect spatial WM, verbal WM, and remote memory. Last Cigarette is critical in affecting WM; namely, longer interval led to worse performance. Finally, higher alcohol dependence level could lead to better remote memory. CONCLUSIONS To our knowledge, there are no BQ studies addressing the effects of concurrent use of cigarettes and alcohol on memory. The current results suggest that cigarette smoking and alcohol drinking, rather than BQ chewing, are critical for memory performance.
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Affiliation(s)
- Chih-Ying Lee
- Clinical Psychology Department, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
| | - Wei-Han Wang
- Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chien-Hung Lee
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Chou Ho
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan.,Clinical Psychological Room, Chung Shan Medical University Hospital, Taichung, Taiwan
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12
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Kung LY, Li TI, Chung CH, Lee SP, Chen GS, Chien WC, Tzeng NS. Risk of depression in patients with oral cancer: a nationwide cohort study in Taiwan. Sci Rep 2021; 11:23524. [PMID: 34876632 PMCID: PMC8651796 DOI: 10.1038/s41598-021-02996-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/22/2021] [Indexed: 01/01/2023] Open
Abstract
This study investigates an association between oral cancers and the risk of developing depression. We conducted a total of 3031 patients with newly diagnosed oral cancers and 9093 age-, sex-, and index year-matched controls (1:3) from 2000 to 2013 were selected from the National Health Insurance Research Database (NHIRD) of Taiwan. After adjusting for confounding factors, multivariate Cox proportional hazards analysis was used to compare the risk of depression over a 13-year follow-up. Of the patients with oral cancer, 69 (2.28%, or 288.57 per 105 person-years) developed depression compared to 150 (1.65%, 135.64 per 105 person-years) in the control group. The Cox proportional hazards regression analysis showed that the adjustment hazard ratio (HR) for subsequent depression in patients with oral cancer diagnosed was 2.224 (95% Confidence Interval [CI] 1.641–3.013, p < 0.001). It is noteworthy that in the sensitivity analysis is the adjusted HR in the group with depression diagnosis was 3.392 and in the oral cancer subgroup of “Tongue” was 2.539. This study shows oral cancer was associated with a significantly increased risk for developing subsequent depression and early identification and treatment of depression in oral cancer patients is crucial.
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Affiliation(s)
- Ling-Yu Kung
- Department of Family Dentistry and Oral Diagnosis, Tri-Service General Hospital, Taipei, Taiwan, ROC.,School of Dentistry, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Tsung-I Li
- Department of Family Dentistry and Oral Diagnosis, Tri-Service General Hospital, Taipei, Taiwan, ROC.,School of Dentistry, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No. 325, Section 2, Cheng-Gung Road, Nei-Hu District, Taipei, 11490, Taiwan, ROC.,Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), Taipei, Taiwan, ROC
| | - Shiao-Pieng Lee
- School of Dentistry, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Oral and Maxillofacial Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Gunng-Shinng Chen
- School of Dentistry, National Defense Medical Center, Taipei, Taiwan, ROC. .,Department of Orthodontics and Pediatrics Dentistry, School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Section 2, Cheng-Gung Road, Nei-Hu District, Taipei, Taiwan, ROC.
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC. .,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No. 325, Section 2, Cheng-Gung Road, Nei-Hu District, Taipei, 11490, Taiwan, ROC. .,Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), Taipei, Taiwan, ROC. .,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.
| | - Nian-Sheng Tzeng
- Department of Psychiatry, School of Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Gung Road, Nei-Hu District, Taipei, Taiwan, ROC. .,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, ROC.
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Genetic and Proteinic Linkage of MAO and COMT with Oral Potentially Malignant Disorders and Cancers of the Oral Cavity and Pharynx. Cancers (Basel) 2021; 13:cancers13133268. [PMID: 34209963 PMCID: PMC8268107 DOI: 10.3390/cancers13133268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary The prevention and treatment of cancers of the oral cavity and pharynx are currently important issues for national health. Currently, the incidence of oral cavity and pharynx cancers is globally the highest in Taiwanese men. Regarding the occurrence of oral cavity and pharynx cancers and oral potentially malignant disorders (OPMD), no report has ascertained how betel quid (BQ) can induce the expression of monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT). We aimed to explore the role and clinical significance of specific markers of BQ exposure and human susceptibility to MAO and COMT. Our findings highlight the association of MAO and COMT biomarkers to risks of oral and pharyngeal cancers and OPMD. These novel findings will provide important strategies for disease prevention, early clinical diagnosis, and treatment effectiveness, and will offer a strong foundation to reduce BQ-related cancers of the oral cavity and pharynx and OPMD. Abstract Betel quid (BQ), a group I human carcinogen, strongly contributes to an increased risk of oral potentially malignant disorders (OPMD) and cancers of the oral cavity and pharynx. This study was conducted to discover whether monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT) variants play a potential role in the risk assessment of oral cavity and pharynx cancers and OPMD, particularly among BQ users. We applied a case–control study to confirm the polymorphism of MAO and COMT using single-nucleotide polymorphisms. We used qRT-PCR, Western blotting, and immunohistochemistry (IHC) to determine MAO and COMT expression. Carriers of the MAOA rs6323 G-allele, MAOB rs6324 G-allele, and COMT rs4633 C/C-genotype had a prominently increased risk of oral cavity and pharynx cancers (AOR = 56.99; p < 0.001). Compared to adjacent noncancerous tissues, a significant downregulation of MAO and COMT expression was exhibited in cancerous tissues (p < 0.01). Furthermore, in different cell models, MAO and COMT expression was significantly downregulated with an increased dose of arecoline (p < 0.01). In personalized preventive medicine for oral and pharyngeal cancers, our findings are the first to demonstrate the potential role of lower MAO and COMT expression levels, with the risk polymorphisms utilized as clinical biomarkers.
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14
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Athukorala IA, Tilakaratne WM, Jayasinghe RD. Areca Nut Chewing: Initiation, Addiction, and Harmful Effects Emphasizing the Barriers and Importance of Cessation. JOURNAL OF ADDICTION 2021; 2021:9967097. [PMID: 34123457 PMCID: PMC8192186 DOI: 10.1155/2021/9967097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/22/2021] [Accepted: 05/25/2021] [Indexed: 12/05/2022]
Abstract
Areca nut is a highly addictive substance with carcinogenic properties and causes many harmful effects to the human body. Alkaloids are the major chemicals found in areca nut, and their mechanism of action has been studied for several years. About 600 million people around the world use areca nut, and its usage is higher in Asian countries. Areca nut chewers get used to the habit mainly due to social influence, stress, or lack of awareness. Some studies have reported a dependence syndrome related to areca nut chewing. Even though there are many ongoing research studies regarding tobacco addiction, less concern has been given to the areca nut addiction. There are only few studies related to areca nut cessation, and even those few cessation programs are mainly designed using tobacco cessation methodology. Sociocultural influence, behavioral factors, and accessibility are the main barriers to cessation. Behavior changing interventions proved to be more effective in areca nut cessation, but recently studies on pharmacological therapies are also emerging.
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Affiliation(s)
- I. A. Athukorala
- Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - W. M. Tilakaratne
- Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - R. D. Jayasinghe
- Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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15
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Lorenzatti Hiles G, Chang KP, Bellile EL, Wang CI, Yen WC, Goudsmit CM, Briggs HL, Thomas TB, Peters L, Afsari MA, Pinatti LM, Morris AC, Jawad N, Carey TE, Walline HM. Understanding the impact of high-risk human papillomavirus on oropharyngeal squamous cell carcinomas in Taiwan: A retrospective cohort study. PLoS One 2021; 16:e0250530. [PMID: 33891627 PMCID: PMC8064583 DOI: 10.1371/journal.pone.0250530] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 04/08/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma (OPSCC) is increasing globally. In Taiwan, HPV-positive OPSCC is obscured by tobacco, alcohol, and betel quid use. We investigated the role of high-risk HPV (hrHPV) in a large retrospective Taiwan OPSCC cohort. METHODS AND RESULTS The cohort of 541 OPSCCs treated at Chang Gung Memorial Hospital from 1998-2016 consisted of 507 men (94%) and 34 women (6%). Most used tobacco (81%), alcohol (51%), and betel quid (65%). Formalin-fixed, paraffin-embedded tissue was used for p16 staining (a surrogate marker for HPV) and testing for HPV DNA presence and type by Multiplex HPV PCR-MassArray. HPV DNA and/or p16 staining (HPV-positive) was found in 28.4% (150/528) tumors. p16 and HPV DNA were strongly correlated (F < 0.0001). HPV16 was present in 82.8%, and HPV58 in 7.5% of HPV-positive tumors. HPV was associated with higher age (55.5 vs. 52.7 years, p = 0.004), lower T-stage (p = 0.008) better overall survival (OS) (hazard ratio [HR] 0.58 [95% CI 0.42-0.81], p = 0.001), and disease-free survival (DFS) (HR 0.54 [95% CI 0.40-0.73], p < 0.0001). Alcohol was strongly associated with recurrence and death (OS: HR 2.06 [95% CI 1.54-2.74], p < 0.0001; DFS: HR 1.72 [95% CI 1.33-2.24], p < 0.0001). OS and DFS in HPV-positive cases decreased for alcohol users (p < 0.0001). Obscured by the strong alcohol effect, predictive associations were not found for tobacco or betel quid. CONCLUSIONS As with HPV-positive OPSCC globally, HPV is an increasingly important etiological factor in Taiwanese OPSCC. HPV-positive OPSCC has considerable survival benefit, but this is reduced by alcohol, tobacco, and betel quid use. hrHPV is a cancer risk factor in males and females. Vaccinating both sexes with a multivalent vaccine including HPV58, combined with alcohol and tobacco cessation policies will be effective cancer-prevention public health strategies in Taiwan.
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Affiliation(s)
- Guadalupe Lorenzatti Hiles
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Kai-Ping Chang
- Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital (Linkou Medical Center), Taoyuan, Taiwan, Republic of China
- College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Emily L. Bellile
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Chun-I Wang
- Radiation Biology Research Center, Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
| | - Wei-Chen Yen
- Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital (Linkou Medical Center), Taoyuan, Taiwan, Republic of China
| | - Christine M. Goudsmit
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Hannah L. Briggs
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Trey B. Thomas
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Lila Peters
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Macy A. Afsari
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Lisa M. Pinatti
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
- Cancer Biology Program, Rackham Graduate School, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Anna C. Morris
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Nadine Jawad
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Thomas E. Carey
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Heather M. Walline
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
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Lin YP, Tsai KZ, Chang CY, Su FY, Han CL, Lin GM. Tobacco Smoking and Association between Betel Nut Chewing and Metabolic Abnormalities Among Military Males: The CHIEF Study. Endocr Metab Immune Disord Drug Targets 2021; 21:298-304. [PMID: 32811419 DOI: 10.2174/1871530320999200818164616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/17/2020] [Accepted: 07/21/2020] [Indexed: 11/22/2022]
Abstract
AIM To investigate the effect of smoking and alcohol intake on the association between betel nut chewing and each metabolic abnormality. BACKGROUND Betel nut chewing has been associated with metabolic syndrome. OBJECTIVE Whether the association is affected by tobacco or alcohol use is not clarified so far. METHODS The authors conducted a cross-sectional study using 6,657 military males, aged 18-50 years in eastern Taiwan in 2013-2014. Metabolic syndrome was defined according to the International Diabetes Federation's ethnic criteria for Asians. The population was classified as non-betel nut chewers (N =5,749), current chewers with both tobacco and alcohol use (N =615), and current chewers without tobacco and/or alcohol use (N =293). Multiple logistic regression analyses were stepwise adjusted for the confounders including alcohol and tobacco use to determine the association of betel chewing with the metabolic abnormalities. RESULTS As compared to the non-current chewers, the current chewers with both tobacco/alcohol use and those without had a higher risk of metabolic syndrome (odds ratios (OR) and 95% confidence intervals: 2.46 (2.00-3.02), and 2.04 (1.53-2.73), respectively) after controlling for age, service specialty, total cholesterol levels ≥200 mg/dL and exercise frequency (model 1). The association did not change much in the two chewing groups after additionally adjusting for alcohol consumption (model 2) (OR: 2.49 (1.99-3.12), and 2.04 (1.52-2.73), respectively), whereas the relationship reduced significantly in the chewers with both tobacco/alcohol use rather than those without after further adjusting for smoking (model 3) (OR: 2.18 (1.71-2.78) and 2.02 (1.51-2.71), respectively). This was in parallel with the pattern for the association of betel nut chewing with serum triglycerides >150 mg/dL in the chewers with both tobacco/alcohol use and those without in model 1 (OR: 2.90 (2.40-3.51) and 1.90 (1.45-2.49), respectively, p =0.011), in model 2 (OR: 2.82 (2.30-3.46) and 1.89 (1.44-2.49), respectively, p =0.040), and in model 3 (2.26 (1.81-2.81) and 1.87 (1.42-2.45), respectively, p =0.76). CONCLUSION Our findings suggest that tobacco smoking but not alcohol intake could increase the relationship of betel nut chewing with metabolic syndrome, which is likely mediated by a synergic effect on increasing serum triglycerides levels.
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Affiliation(s)
- Yen-Po Lin
- Department of Critical Care Medicine, Taipei Tzu Chi Hospital, New Taipei City, Taiwan
| | - Kun-Zhe Tsai
- Department of Internal Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan
| | - Chih-Yu Chang
- Departments of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan; 5Songshan branch, National Defense Medical Center, Taipei, Taiwan
| | - Fang-Ying Su
- Institute of Statistics, National Chiao Tung University, Hsinchu City, Taiwan
| | - Chih-Lu Han
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Gen-Min Lin
- Department of Internal Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan
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The Association between Metabolic Syndrome and Elevated Alanine Aminotransferase Levels in an Indigenous Population in Northern Taiwan: A Community-Based and Cross-Sectional Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2020:6612447. [PMID: 33488746 PMCID: PMC7787776 DOI: 10.1155/2020/6612447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/18/2020] [Accepted: 11/26/2020] [Indexed: 01/26/2023]
Abstract
Our study aims to determine the prevalence of metabolic syndrome (MetS) among the Northern Taiwanese indigenous population and to explore the relationship between MetS and liver enzyme, especially serum alanine transaminase (ALT). This is an observational and cross-sectional study that was conducted in remote villages of an indigenous community in Northern Taiwan between 2010 and 2015. MetS was defined based on the revised NCEP/ATPIII criteria from Taiwan Health Promotion Administration. A total of 454 participants were included in the analysis. There were 277 people with MetS and 177 people without. The prevalence of MetS was 61.01%. The average age was 49.50 years. People with MetS had a significantly higher liver enzyme (ALT) level than those without MetS. In addition, the study showed that participants with higher ALT had a tendency towards a higher prevalence of MetS (76.7% vs. 57.3%, p = 0.001). The adjusted odds ratio (OR) of ALT levels >36 U/L for MetS was 2.79 (95% CI = 1.24–6.27, p = 0.01). The area under the ROC curve (AUC) of the ALT level was 0.63 (95% CI = 0.58–0.68, p < 0.001), which showed that the ALT level was positively associated with MetS. The overall prevalence of MetS was 61.01% in the highland indigenous population in Northern Taiwan; this study indicated that higher serum ALT levels were associated with an increased risk of MetS.
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Chen PH, Chung CM, Wang YY, Huang HW, Huang B, Lee KW, Yuan SS, Wu CW, Lin LS, Chan LP. CYP26A1 Is a Novel Biomarker for Betel Quid-Related Oral and Pharyngeal Cancers. Diagnostics (Basel) 2020; 10:diagnostics10110982. [PMID: 33233443 PMCID: PMC7700252 DOI: 10.3390/diagnostics10110982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/06/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022] Open
Abstract
Betel quid (BQ) has been classified as a Group I human carcinogen in light of evidence demonstrating an association with an elevated risk of oral and pharyngeal cancers. To date, the incidence rate of oral and pharynx cancers among Taiwanese men ranks the highest worldwide. However, no study has yet confirmed variants of CYP26A1 was associated with the risks of oral and pharyngeal cancers. A case-control study was conducted (n = 339). CYP26A1 polymorphism was performed using SNP assay. Real-time qRT-PCR and Western blotting were used to determine the levels of CYP26A1 expression. The cancer cell model involved treatment with arecoline. Our findings showed that the downregulation of CYP26A1 mRNA and protein expression are more frequently observed in cancerous tissues than adjacent normal tissues in patients with oral and pharynx cancers (p < 0.01). We found that CYP26A1 was downregulated as the arecoline dose increased. We hypothesized that lower levels of CYP26A1 mRNA expression can be utilized a clinically biomarker causes oral and pharynx cancers. Arecoline appears to modulate CYP26A1 expression through specific pathways. Carriers of CYP26A1 SNP, rs2068888 (G/G)/rs4418728 (G/G) and who have lower levels of CYP26A1 expression are associated with an increased risk of oral and pharyngeal cancers.
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Affiliation(s)
- Ping-Ho Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (P.-H.C.); (Y.-Y.W.)
- Institute of Biomedical Sciences, National Sun Yat-sen University, No. 70 Lienhai Road, Kaohsiung 80424, Taiwan;
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Cohort Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Chia-Min Chung
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung 406040, Taiwan;
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 406040, Taiwan
| | - Yen-Yun Wang
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (P.-H.C.); (Y.-Y.W.)
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Hurng-Wern Huang
- Institute of Biomedical Sciences, National Sun Yat-sen University, No. 70 Lienhai Road, Kaohsiung 80424, Taiwan;
| | - Bin Huang
- Department of Biomedical Science and Environmental Biology, College of Life Science, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Ka-Wo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Kaohsiung Municipal Ta-Tung Hospital and Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan;
| | - Shyng-Shiou Yuan
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Translational Research Center, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Che-Wei Wu
- Cohort Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Otorhinolaryngology-Head and Neck Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Lee-Shuan Lin
- Laboratory of Veterinary Diagnostic Imaging, Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung 912301, Taiwan;
| | - Leong-Perng Chan
- Cohort Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Otorhinolaryngology-Head and Neck Surgery, Kaohsiung Municipal Ta-Tung Hospital and Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan;
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: ; Tel.: +886-7-312-1101; Fax: +886-7-315-7024
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19
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Sex Differences in the Heterogeneous Dynamic Incidence of Oral Cancer: A Comparison between Taiwan and Thailand. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9321246. [PMID: 33015186 PMCID: PMC7512095 DOI: 10.1155/2020/9321246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/03/2020] [Indexed: 12/24/2022]
Abstract
Background This study aims at investigating differences in oral cancer (OC) incidence trends between two populations in Taiwan and Thailand. Methods We used the population-based cancer registry data from Taiwan (1979-2016) and Khon Kaen (KK), Thailand (1985-2016). We performed joinpoint analyses to detect the trend change points for the OC incidence and to quantify the time trends in both sexes and regions. Age-period-cohort curves were plotted to explain the incidence trends. Results In Taiwan, the estimated annual increases in OC were approximately 6.0% in males, although the increase slowed after 2009, and 2.6% in females. In KK, the OC incidence steadily decreased by -2.5% per year in females, but there was no obvious change in males. A strong period effect observed in those aged 45-69 years in Taiwanese males resulted in a peak incidence in the middle age group. Decreased period and cohort effects were observed in females in KK. Conclusions Taiwanese males are the predominant sex affected by OC in Taiwan, and the trend has decelerated since 2009. Age, period, and cohort effects were different between males and females in the two regions.
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20
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Hsieh YH, Syu RJ, Lee CC, Lin SH, Lee CH, Cheng CW, Tsai JP. Arecoline induces epithelial mesenchymal transition in HK2 cells by upregulating the ERK-mediated signaling pathway. ENVIRONMENTAL TOXICOLOGY 2020; 35:1007-1014. [PMID: 32441858 DOI: 10.1002/tox.22937] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/16/2020] [Accepted: 04/22/2020] [Indexed: 06/11/2023]
Abstract
Arecoline, a component of betel nuts, is a known carcinogen that causes oral cancers among those who chew betel nuts. Betel nut chewing is also associated with an increased risk of chronic kidney disease (CKD), but the role of arecoline in this association is unclear. This in vitro study investigates the effects of arecoline on cultured human kidney (HK2) cells. We observed that arecoline had no effect on cell viability but increased cell migration in a dose-dependent manner. Western blot analysis showed that arecoline treatment caused a dose-dependent decrease in E-cadherin expression and dose-dependent increases in N-cadherin, vimentin, α-SMA, and collagen expression; reverse transcriptase-polymerase chain reaction analysis revealed dose-dependent increases in α-SMA and collagen mRNA. Arecoline treatment upregulated the expression of phosphorylated extracellular signal-regulated kinase through epithelial mesenchymal transition and renal fibrosis in HK2 cells. These findings demonstrate that arecoline plays a role in inducing the epithelial mesenchymal transition and fibrogenesis in renal tubule cells and suggest that arecoline promotes the progression of CKD.
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Affiliation(s)
- Yi-Hsien Hsieh
- Department of Biochemistry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Clinical laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ru-Jiang Syu
- Division of Nephrology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Chu-Che Lee
- Department of Medicine Research, Buddhist Dalin Tzu Chi Hospital, Chiayi, Taiwan
| | - Shin-Huey Lin
- Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
| | - Chien-Hsing Lee
- Division of Pediatric Surgery, Department of Surgery, Children's Hospital of China Medical University, Taichung, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Chun-Wen Cheng
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
| | - Jen-Pi Tsai
- Division of Nephrology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
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21
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Chen TC, Wu CT, Ko JY, Yang TL, Lou PJ, Wang CP, Chang YL. Clinical characteristics and treatment outcome of oropharyngeal squamous cell carcinoma in an endemic betel quid region. Sci Rep 2020; 10:526. [PMID: 31949181 PMCID: PMC6965138 DOI: 10.1038/s41598-019-57177-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 12/24/2019] [Indexed: 12/12/2022] Open
Abstract
The clinical characteristics of oropharyngeal squamous cell carcinoma (OPSCC) may be different between endemic and non-endemic regions of betel nut chewing. The impact of combined alcohol drinking/betel quid chewing/cigarette smoking (ABC) exposure on the survival of OPSCC remains unclear. We reviewed the medical records of OPSCC patients between 1999 and 2013. Immunohistochemical staining of p16 and HPV genotype detection by DNA Polymerase chain reaction were both performed for each tumor. A total of 300 eligible patients including 74 HPV+ OPSCC patients and 226 HPV− OPSCC patients were enrolled. The 5-year disease-free survival rates for the HPV−, HPV+ OPSCC with and without ABC patients were 49.8%, 58.4% and 94%, respectively. The 5-year overall survival rates for the patients with HPV−, HPV+ OPSCC with and without ABC patients were 46%, 57.4% and 86%, respectively. Advanced locoregionally disease (T3/T4, N2/N3), HPV- OPSCC, combined 2 or all ABC exposure were the independent adverse prognostic factors for disease-free and overall survival. Therefore, our data suggest that in an endemic region of betel quid chewing, HPV− OPSCC comprises the majority of OPSCC and has a worse survival. Combined 2 or all ABC exposure had a significant negative impact on disease-free and overall survival.
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Affiliation(s)
- Tseng-Cheng Chen
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, 10002, Taiwan.,Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, 10002, Taiwan
| | - Chen-Tu Wu
- Department of Pathology, National Taiwan University Hospital, National Taiwan University Cancer Center and National Taiwan University College of Medicine, Taipei, 10002, Taiwan.,Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, 10002, Taiwan
| | - Jenq-Yuh Ko
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, 10002, Taiwan
| | - Tsung-Lin Yang
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, 10002, Taiwan
| | - Pei-Jen Lou
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, 10002, Taiwan
| | - Cheng-Ping Wang
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, 10002, Taiwan.,Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, 10002, Taiwan
| | - Yih-Leong Chang
- Department of Pathology, National Taiwan University Hospital, National Taiwan University Cancer Center and National Taiwan University College of Medicine, Taipei, 10002, Taiwan. .,Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, 10002, Taiwan.
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22
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Joo YJ, Newcombe D, Nosa V, Bullen C. Investigating Betel Nut Use, Antecedents and Consequences: A Review of Literature. Subst Use Misuse 2020; 55:1422-1442. [PMID: 31549570 DOI: 10.1080/10826084.2019.1666144] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Betel nut use is a public health issue in the Asia-Pacific region that is often neglected. To control betel nut use, understanding of the adverse effects of betel nut use and evidence-based policies and strategies is necessary. Objectives: This narrative review aims to characterize the current situation on betel nut use at a global level regarding the epidemiology, pharmacology and toxicology, health effects, treatment options, policies and strategies. Methods: We found 139 existing literature published between 1970-2019 on the Web of Science database and other technical documents to collate the most relevant information on betel nut use. Data were categorized into appropriate themes. Results: The literature demonstrates that there is a lack of up to date statistics on betel nut use. There is limited research on the effect of policies and strategies to control betel nut use. Conclusion: Betel nut-chewing countries should focus on understanding which populations chew betel nut and implement appropriate policies, educational and cessation programs to help control betel nut use.
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Affiliation(s)
- Ye Jin Joo
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - David Newcombe
- Centre for Addiction Research, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Vili Nosa
- Pacific Health Section, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Chris Bullen
- National Institute for Health Innovation (NIHI), School of Population Health, The University of Auckland, Auckland, New Zealand
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23
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Buente W, Rathnayake C, Neo R, Dalisay F, Kramer HK. Tradition Gone Mobile: An Exploration of #Betelnut on Instagram. Subst Use Misuse 2020; 55:1483-1492. [PMID: 32569541 PMCID: PMC7811411 DOI: 10.1080/10826084.2020.1744657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: As a psychoactive substance that spans borders and cultures, researchers estimate that 600 million people use the areca nut. Despite its historical and geographical significance, betel nut use has received far less research attention than other stimulants such as tobacco, coffee or tea. Scholars have observed that social media platforms have significant effects on the promotion and use of addictive substances. Objectives: Our study investigates user practices and activities on a sample of Instagram posts tagged #betelnut dating back to 2011. Methods: Using social media analytics and hashtag network analysis, we examined user practices and activities on a sample of over 7800 Instagram posts tagged #betelnut dated between July 2011 to February 2019 that were collected in early 2019. Results: Findings determined that #betelnut is a growing topical hashtag on Instagram with content that drives social engagement. Importance: Co-occurring hashtags with #betelnut reflect regional language and cultural naming conventions that center around the Indian subcontinent and Melanesia. The importance of future work in this area is highlighted.
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Affiliation(s)
- Wayne Buente
- School of Communications, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | | | - Rachel Neo
- School of Communications, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Francis Dalisay
- Communication and Fine Arts Division, University of Guam, Mangilao, Guam
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24
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Lung Y, Chang SS, Hsu CY, Wu SC, Chen CY, Chen WJ. Residential Socioeconomic Environments and Areca Nut Use in Taiwan: A Comparison with Alcohol and Tobacco Use in Multilevel Analysis. Subst Use Misuse 2020; 55:2025-2034. [PMID: 32654584 DOI: 10.1080/10826084.2020.1788089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
While the association between residential socioeconomic environments and the use of globally common substances such as alcohol and tobacco has been well documented in Western countries, it remains little known about regionally important substances, such as areca nut in Asia. Objective: This study was aimed to develop residential environmental indicators in the context of Taiwan and examine their associations with areca nut use, in comparison to alcohol and tobacco use. Methods: Data were drawn from 13,392 adults across 168 townships in the 2014 National Survey on Substance Use in Taiwan. Residential socioeconomic environment variables were derived from the census and analyzed using factor analysis. Multilevel logistic regression models were used to examine the association of individual- and residential-level factors with the use of areca nut (use/nonuse), alcohol (harmful use, low-risk use, or nonuse), and tobacco (nicotine dependence, regular active use, or nonuse). Results: A three-factor structure of socioeconomic environments derived from 16 residential-level variables consisted of Rural Disadvantage, Affluence, and Family Fragmentation. Multilevel analyses showed that areca nut use was associated with both individual-level (male sex, age group 35-44 years, being divorced/widowed/separated, low educational attainment, and the occupational group of labors) and residential-level (Rural Disadvantaged and Family Fragmented) variables; such a profile was most similar to that of nicotine dependence. Conclusions: A three-factor structure could be derived for the residential-level socioeconomic environments in the Taiwanese context. Rural Disadvantaged and Family Fragmented were associated with areca nut use, which have implications for interventions targeted at the community level.
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Affiliation(s)
- Yu Lung
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.,Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.,Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chia-Yueh Hsu
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shang-Chi Wu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chuan-Yu Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.,Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan
| | - Wei J Chen
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan.,Department of Psychiatry, College of Medicine, and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
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25
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Kuo TJ, Wu PC, Tang PL, Yin CH, Chu CH, Hung YM. Effects of continuity of care on the postradiotherapy survival of working-age patients with oral cavity cancer: A nationwide population-based cohort study in Taiwan. PLoS One 2019; 14:e0225635. [PMID: 31841525 PMCID: PMC6913929 DOI: 10.1371/journal.pone.0225635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 11/09/2019] [Indexed: 01/17/2023] Open
Abstract
Objectives Cancer of the oral cavity, a well-known global health concern, remains one of most common causes of cancer mortality. Continuity of care (COC), a measurement of the extent to which an individual patient receives care from a given provider over a specified period of time, can help cancer survivors process their experiences of dealing with the illness and recuperation; however, limited research has focused on the survival rate of working-age patients with oral cancer. Methods A total of 14,240 working-age patients (20 <age ≤65 years) with oral cavity cancer treated with radiotherapy (RT) during 2000–2013 were included in this study from a registry of patients with catastrophic illnesses maintained by the Taiwan National Health Insurance Research Database. We evaluated the effects of the Continuity of Care Index (COCI) proposed by Bice and Boxerman, sociodemographic factors, and comorbidities on the survival rate. This study categorized COC into three groups—low (COCI < 0.23), intermediate (COCI = 0.23–0.37), and high (COCI ≥ 0.38)—according to the distribution of scores in our sample. A multivariate Cox proportional hazards regression model was used to determine the demographic factors and comorbidities associated with the survival rate. Results Among all the relevant variables, low COCI, male sex, low socioeconomic status, no receipt of prior dental treatment before RT, residence outside northern Taiwan, chemotherapy receipt, and a history of diabetes increased the risk of mortality. Pre-RT dental evaluation and management was significantly associated with reduced post-RT mortality (adjusted hazard ratio [aHR] = 0.767, 95% confidence interval [CI] = 0.729–0.806, p < 0.001). Compared with patients with a high COCI, those with a low COCI exhibited an increased risk of mortality (aHR = 1.170, 95% CI = 1.093–1.252, p < 0.001). The mortality risk in the intermediate COC group was significantly higher than that in the high COC group (aHR = 1.194, 95% CI = 1.127–1.266, p < 0.001). To balance the distribution of the potential risk factors, propensity-score matching was used for the high COC (COCI > 0.38) and non-high COC (COCI ≤ 0.38) groups. After propensity-score matching, the mortality risk in the low and intermediate COC groups was also found to be significantly higher than that in the high COC group (aHR = 1.178, 95% CI = 1.074–1.292, p < 0.001 and aHR = 1.189, 95% CI = 1.107–1.277, p = 0.001, respectively). Conclusions In Taiwan, COC and prior dental treatment before RT significantly affected the survival rate of working-age patients with oral cancer. This result merits policymakers’ attention.
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Affiliation(s)
- Tsu Jen Kuo
- Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung, Taiwan.,Department of Dental Technology, Shu-Zen junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Pei Chen Wu
- Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien, Taiwan
| | - Pei Ling Tang
- Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Nursing, Meiho University, Pingtung, Taiwan.,College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chi Hsiang Chu
- Clinical Trial Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Institute of Statistics, National University of Kaohsiung, Kaohsiung, Taiwan
| | - Yao-Min Hung
- Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan.,School of Medicine, National Yang Ming University, Taipei, Taiwan.,Yuhing Junior College of Health Care and Management, Kaohsiung, Taiwan
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26
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Tseng WT, Lee Y, Hung CF, Lin PY, Chien CY, Chuang HC, Fang FM, Li SH, Huang TL, Chong MY, Wang LJ. Validation of the Chinese Version of the Shame and Stigma Scale in Patients with Head and Neck Cancer. Cancer Manag Res 2019; 11:10297-10305. [PMID: 31849519 PMCID: PMC6910087 DOI: 10.2147/cmar.s228843] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/15/2019] [Indexed: 12/24/2022] Open
Abstract
Purpose Head and neck cancer (HNC) patients suffer from perceived shame and stigma due to the illness diagnosis, as well as disfigurement following surgery. To measure HNC patients' perception of shame and stigma, the Shame and Stigma Scale (SSS) was developed and preliminarily validated. In this study, we aimed to translate, adapt, and validate the SSS in Chinese. Methods This study consisted of a cross-sectional design with consecutive sampling and consisted of two stages: (1) translation of the SSS into Chinese by two bilingual professionals and (2) examination of the Chinese version of the SSS (C-SSS) for internal consistency, inter-rater reliability, test-retest reliability, construct validity, and concurrent validity. In total, 159 inpatients with HNC (mean age: 56.8 years, 95% males) were enrolled at a medical center in Southern Taiwan. Results The Principal Component Analysis of the C-SSS revealed a five-factor structure: 4 of the 5 factors were replicated in the original SSS, including Shame with Appearance, Regret, Social/Speech Concern, and Sense of Stigma; only factor 4, Self-discrimination, was newly identified in the current study. C-SSS showed acceptable internal validity (Cronbach's α =0.85), test-retest reliability, inter-rater reliability, and fair concurrent validity with the Taiwanese Depression Questionnaire (TDQ), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), and Explanatory Model Interview Catalogue (EMIC). Conclusion The findings of this study indicate that C-SSS is a reliable and valid instrument for evaluating HNC patients' perception of shame and stigma in the Taiwanese population.
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Affiliation(s)
- Wei-Ting Tseng
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu Lee
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chi-Fa Hung
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Yen Chien
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hui-Ching Chuang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fu-Min Fang
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shau-Hsuan Li
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tai-Lin Huang
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Mian-Yoon Chong
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Chiayi, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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27
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Chang YL, Huang BS, Hung TM, Lin CY, Chen SC. Factors influencing body image in posttreatment oral cavity cancer patients. Psychooncology 2019; 28:1127-1133. [PMID: 30889623 DOI: 10.1002/pon.5067] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 03/13/2019] [Accepted: 03/15/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The purpose of this study of posttreatment oral cavity cancer (OCC) patients was to identify factors associated with self-reported overall body image, perceived attractiveness, and dissatisfaction with body appearance. METHODS This cross-sectional study recruited patients with OCC from the outpatient radiation department of a single cancer center in Northern Taiwan. Demographic and clinical characteristics were recorded, and patients were assessed using the Hospital Anxiety and Depression Scale (HADS), the Liebowitz Social Anxiety Scale (LSAS), the University of Washington Quality of Life Scale (UW-QOL), and the Body Image Scale (BIS). RESULTS A total of 168 patients were included in this current study, 76 females and 92 males. Negative overall body image was associated with greater degree of depression, greater fear of social interactions, poorer social-emotional function, receipt of surgery, female gender, and greater avoidance of social interaction; these factors explained 49.0% of the variance in this outcome measure. Poor perceived attractiveness was associated with greater depression, greater fear of social interaction, and receipt of surgery; these factors explained 25.4% of the variance in this outcome measure. Dissatisfaction with body appearance was associated with poor social-emotional function, greater fear of social interaction, receipt of reconstruction, advanced cancer stage, and female gender; these factors explained 52.2% of the variance in this outcome measure. CONCLUSIONS This study of posttreatment OCC patients indicated that depression and fear of social interaction strongly influenced overall body image, perceived attractiveness, and dissatisfaction with body appearance.
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Affiliation(s)
- Ya-Lan Chang
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Bing-Shen Huang
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tsung-Min Hung
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Yu Lin
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shu-Ching Chen
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,School of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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Huang CC, Lin CN, Chung CH, Hwang JS, Tsai ST, Wang JD. Cost-effectiveness analysis of the oral cancer screening program in Taiwan. Oral Oncol 2018; 89:59-65. [PMID: 30732960 DOI: 10.1016/j.oraloncology.2018.12.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 11/23/2018] [Accepted: 12/11/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVES We assess the incremental cost-effectiveness ratio (ICER) of the oral cancer (OC) screening program in Taiwan. MATERIALS AND METHODS We interlinked the Cancer Registry, Mortality Registry, National Vital Statistics, reimbursement database of National Health Insurance, and the National Oral Cancer Screening database of Taiwan. A total of 40,092 pathologically verified OC patients were identified and followed during 2002-2014. After stratification by stages, lifetime survival curves were estimated by a rolling extrapolation algorithm to obtain life expectancy (LE), expected years of life lost (EYLL), and lifetime medical costs (LMC). RESULTS The LE for stages I-IV were 19.5, 14.0, 11.9, and 7.7 life-years, respectively, while those of EYLL were 7.3, 12.2, 15.4, and 18.7 life-years, respectively. The LMC for stages I-IV were US$ 65,752, 60,086, 53,675, and 47,570, respectively. We assumed no life loss for stage 0 with LMC of US$ 5380 spent for the first year after diagnosis. During 2010-2013, 967 out of the 28,018 cases detected with abnormal oral pathology by screening were found to develop OC. The ICER of the screening program was US$ 28,516 per life-year saved, which could be improved to US$ 5579 per life-year saved if all cancers transformed from abnormal oral pathology were detected before stage I. CONCLUSION The ICER of the current OC screening program in Taiwan slightly exceeds 1 GDP (gross domestic product) per capita per life-year saved. Intensive follow-up and treatment for all patients with abnormal oral pathology would improve screening efficiency and effectiveness of prevention.
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Affiliation(s)
- Cheng-Chih Huang
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Head and Neck Collaborative Oncology Group, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Ni Lin
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Hua Chung
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | | | - Sen-Tien Tsai
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Head and Neck Collaborative Oncology Group, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jung-Der Wang
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Departments of Internal Medicine and Environmental and Occupational Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
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Ghani WMN, Razak IA, Doss JG, Yang YH, Rahman ZAA, Ismail SM, Abraham MT, Wan Mustafa WM, Tay KK, Zain RB. Multi-ethnic variations in the practice of oral cancer risk habits in a developing country. Oral Dis 2018; 25:447-455. [DOI: 10.1111/odi.12995] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 10/02/2018] [Accepted: 10/11/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Wan Maria Nabillah Ghani
- Oral Cancer Research and Coordinating Centre (OCRCC), Faculty of Dentistry; University of Malaya; Kuala Lumpur Malaysia
| | - Ishak Abdul Razak
- Oral Cancer Research and Coordinating Centre (OCRCC), Faculty of Dentistry; University of Malaya; Kuala Lumpur Malaysia
- Faculty of Dentistry; MAHSA University; Selangor Malaysia
| | - Jennifer Geraldine Doss
- Oral Cancer Research and Coordinating Centre (OCRCC), Faculty of Dentistry; University of Malaya; Kuala Lumpur Malaysia
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry; University of Malaya; Kuala Lumpur Malaysia
| | - Yi-Hsin Yang
- School of Pharmacy; Kaohsiung Medical University; Kaohsiung City Taiwan
| | - Zainal Ariff Abdul Rahman
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry; University of Malaya; Kuala Lumpur Malaysia
| | - Siti Mazlipah Ismail
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry; University of Malaya; Kuala Lumpur Malaysia
| | - Mannil Thomas Abraham
- Oral Health Division, Ministry of Health; Federal Government Administrative Centre; Putrajaya Malaysia
| | | | - Keng Kiong Tay
- Oral Health Division, Ministry of Health; Federal Government Administrative Centre; Putrajaya Malaysia
| | - Rosnah Binti Zain
- Oral Cancer Research and Coordinating Centre (OCRCC), Faculty of Dentistry; University of Malaya; Kuala Lumpur Malaysia
- Faculty of Dentistry; MAHSA University; Selangor Malaysia
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Chen SC, Huang BS, Hung TM, Chang YL, Lin CY, Chung CY, Wu SC. Swallowing ability and its impact on dysphagia-specific health-related QOL in oral cavity cancer patients post-treatment. Eur J Oncol Nurs 2018; 36:89-94. [DOI: 10.1016/j.ejon.2018.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/01/2018] [Accepted: 07/04/2018] [Indexed: 10/28/2022]
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Lai YC, Tang PL, Chu CH, Kuo TJ. Effects of income and residential area on survival of patients with head and neck cancers following radiotherapy: working age individuals in Taiwan. PeerJ 2018; 6:e5591. [PMID: 30245932 PMCID: PMC6147123 DOI: 10.7717/peerj.5591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 08/16/2018] [Indexed: 01/29/2023] Open
Abstract
Objectives The five-year survival rate of head and neck cancer (HNC) after radiotherapy (RT) varies widely from 35% to 89%. Many studies have addressed the effect of socioeconomic status and urban dwelling on the survival of HNC, but a limited number of studies have focused on the survival rate of HNC patients after RT. Materials and methods During the period of 2000–2013, 40,985 working age individuals (20 < age < 65 years) with HNC patients treated with RT were included in this study from a registry of patients with catastrophic illnesses maintained by the Taiwan National Health Insurance Research Database (NHIRD). Results The cumulative survival rate of HNC following RT in Taiwan was 53.2% (mean follow-up period, 3.75 ± 3.31 years). The combined effects of income and geographic effect on cumulative survival rates were as follows: high income group > medium income group > low income group and northern > central > southern > eastern Taiwan. Patients with moderate income levels had a 36.9% higher risk of mortality as compared with patients with high income levels (hazard ratio (HR) = 1.369; p < 0.001). Patients with low income levels had a 51.4% greater risk of mortality than patients with high income levels (HR = 1.514, p < 0.001). Conclusion In Taiwan, income and residential area significantly affected the survival rate of HNC patients receiving RT. The highest income level group had the best survival rate, regardless of the geographic area. The difference in survival between the low and high income groups was still pronounced in more deprived areas.
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Affiliation(s)
- Yu Cheng Lai
- Department of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Marine Biotechnology and Resources, National Sun Yat-Sen University, Kaohsiung, Taiwan.,Department of Occupational Therapy, Shu Zen junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Pei Ling Tang
- Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Nursing, Meiho University, Pingtung, Taiwan.,College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi Hsiang Chu
- Department of Clinical Trial Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Tsu Jen Kuo
- Department of Marine Biotechnology and Resources, National Sun Yat-Sen University, Kaohsiung, Taiwan.,Department of Dental Technology, Shu-Zen junior College of Medicine and Management, Kaohsiung, Taiwan.,Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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Tsai KZ, Lin JW, Lin F, Su FY, Li YH, Lin YP, Lin YK, Han CL, Hsieh CB, Lin GM. Association of betel nut chewing with exercise performance in a military male cohort: the CHIEF study. J ROY ARMY MED CORPS 2018; 164:399-404. [PMID: 30012664 DOI: 10.1136/jramc-2017-000899] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 05/20/2018] [Accepted: 06/24/2018] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Betel nut chewing may cause obesity, neurohormonal activation and inflammation, possibly impairing exercise performances. METHODS We examined the cross-sectional association in 4388 military male adults aged 18-50 years from the cardiorespiratory fitness in armed forces study in Taiwan between 2013 and 2014. The status of betel nut chewing was classified as current and former/never based on each participant's response to a questionnaire. Physical fitness was evaluated by three basic exercise tests including 3000 m running, 2 min sit-ups and 2 min push-ups. Multiple logistic regression for the best 10% and the worst 10% performers in each exercise, and linear regression were used to determine the relationship. RESULTS There were 564 current chewers and 3824 non-current chewers for the analysis. The linear regression shows that current betel nut chewing was positively correlated with 3000 m running duration (r=0.37, p=0.042) after adjusting for age, service specialty, body mass index, exercise frequency and alcohol intake. In addition, the logistic regression shows that as compared with non-current chewers, current chewers had lower odds of being the top 10% performers in 2 min push-ups and higher odds of being the bottom 10% performers in 2 min sit-ups (ORs and 95% CIs: 0.71 (0.50 to 0.99) and 1.32 (1.00 to 1.75), respectively). However, the associations between betel nut chewing and physical fitness were all insignificant after further adjusting for current smoking. CONCLUSIONS Our findings suggest that the impairment of physical fitness associated with betel nut chewing of military young men might be mainly mediated or moderated by the coexisted cigarette smoking.
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Affiliation(s)
- Kun-Zhe Tsai
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan
| | - J-W Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.,Department of Dentistry, National Yang-Ming Univeristy, Taipei, Taiwan
| | - F Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan
| | - F-Y Su
- Department of Public Health, Tzu-Chi University, Taipei, Taiwan
| | - Y-H Li
- Department of Public Health, Tzu-Chi University, Taipei, Taiwan
| | - Y-P Lin
- Department of Critical Care Medicine, Yonghe Cardinal Tien Hospital , Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Y-K Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.,Department of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - C-L Han
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - C-B Hsieh
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.,Department of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - G-M Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.,Department of Medicine, National Defense Medical Center, Taipei, Taiwan
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Analysis of oral microorganism diversity in healthy individuals before and after chewing areca nuts using PCR-denatured gradient gel electrophoresis. ACTA ACUST UNITED AC 2018; 4:294-299. [PMID: 30182066 PMCID: PMC6117735 DOI: 10.1016/j.aninu.2018.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/03/2018] [Accepted: 07/07/2018] [Indexed: 11/30/2022]
Abstract
To analyze oral microbial diversity in the saliva of 8 healthy individuals before and after chewing areca nuts. Saliva samples were collected before chewing areca nuts, after chewing areca nuts for 5 min and after chewing areca nuts for 30 min. DNA was extracted, and microbial diversity was examined using PCR-denaturing gradient gel electrophoresis (PCR-DGGE). When examining DGGE profiles collectively, the bands associated with Streptococcus and Veillonella were the most intense, making them the most prevalent bacteria. Furthermore, the band intensities did not decrease after chewing areca nuts for 5 or 30 min; thus, these bacteria were unaffected. However, when examining some individuals, the band intensities for Streptococcus and Veillonella became more intense after 5 min of chewing and then returned to the pre-chewing level. This difference may be attributed to the mechanical movements of the oral cavity or individual differences. Other bacteria, such as Neisseria, Actinomycetes, and Rothia dentocariosa, were also found to have an increased or decreased prevalence following areca nut-chewing. Since the predominant species that are present following areca nut-chewing include Streptococcus and Veillonella, it would seem likely that these bacteria play an important role in the periodontal diseases associated with areca chewing.
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Tsai WC, Kung PT, Wang YH, Kuo WY, Li YH. Influence of the time interval from diagnosis to treatment on survival for early-stage liver cancer. PLoS One 2018; 13:e0199532. [PMID: 29933395 PMCID: PMC6014663 DOI: 10.1371/journal.pone.0199532] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 06/08/2018] [Indexed: 01/02/2023] Open
Abstract
Objectives Liver cancer is the fifth most common cancer in men and the ninth most common cancer in women, and the WHO expects that there will be 1,341,344 cases in 2034 worldwide. Liver cancer also has the second-highest cancer death rate, accounting for 7% of all cancers. The study is going to explore the relationship between time interval from diagnosis to treatment and survival status of early-stage liver cancer patients. Materials and methods This is a retrospective cohort study using the national database from Taiwan. The datasets include the Taiwan Cancer Registry Database (TCR), the National Health Insurance Research Database (NHIRD), and the National Registry of Deaths. The target population for the study was patients newly diagnosed with stage I and stage II liver cancer between the years 2004 and 2010. Total of 26,038 cases were included in the study. Except descriptive analysis, the relationship between patient characteristics and the time interval from diagnosis to treatment was examined by chi-square tests. In addition, modified Cox proportional hazard models were used to analyze the hazard ratio of patient death with various treatment delay durations. Results There were 20,430 patients (78.46%) who received treatment less than 30 days after diagnosis, while 2,674 patients (10.27%) received treatment between 31 and 60 days after diagnosis, and 2,068 patients (7.94%) received treatment between 61 and 180 days after diagnosis, and 866 patients (3.33%) who received treatment 181 days after diagnosis. Those treated more than 181 days and 61–180 days after diagnosis had a 1.68-fold increased risk of death (95% confidence interval: 1.50–1.88) and a 1.39-fold increased risk of death (95% confidence interval: 1.31–1.17), respectively. Being male, being elderly, having a higher CCI level, and being treated in a hospital with a low service volume were factors associated with a poorer prognosis. Conclusion Overall, this study utilized a national cohort to conclude that for early-stage liver cancer patients, a longer the time interval from diagnosis to treatment results in a lower survival rate.
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Affiliation(s)
- Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Yueh-Hsin Wang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Wei-Yin Kuo
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Ya-Hsin Li
- Department of Health Policy and Management, Chung Shan Medical University, Chung Shan Medical University Hospital, Taichung, Taiwan
- * E-mail:
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Weng JC, Chou YS, Huang GJ, Tyan YS, Ho MC. Mapping brain functional alterations in betel-quid chewers using resting-state fMRI and network analysis. Psychopharmacology (Berl) 2018; 235:1257-1271. [PMID: 29441422 DOI: 10.1007/s00213-018-4841-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/21/2018] [Indexed: 02/08/2023]
Abstract
RATIONALE The World Health Organization regards betel quid (BQ) as a human carcinogen, and DSM-IV and ICD-10 dependence symptoms may develop with its heavy use. BQ's possible effects of an enhanced reward system and disrupted inhibitory control may increase the likelihood of habitual substance use. OBJECTIVES The current study aimed to employ resting-state fMRI to examine the hypothesized enhanced reward system (e.g., the basal forebrain system) and disrupted inhibitory control (e.g., the prefrontal system) in BQ chewers. METHODS The current study recruited three groups of 48 male participants: 16 BQ chewers, 15 tobacco- and alcohol-user controls, and 17 healthy controls. We used functional connectivity (FC), mean fractional amplitude of low-frequency fluctuations (mfALFF), and mean regional homogeneity (mReHo) to evaluate functional alternations in BQ chewers. Graph theoretical analysis (GTA) and network-based statistical (NBS) analysis were also performed to identify the functional network differences among the three groups. RESULTS Our hypothesis was partially supported: the enhanced reward system for the BQ chewers (e.g., habitual drug-seeking behavior) was supported; however, their inhibitory control was relatively preserved. In addition, we reported that the BQ chewers may have enhanced visuospatial processing and decreased local segregation. CONCLUSIONS The current results (showing an enhanced reward system in the chewers) provided the clinicians with important insight for the future development of an effective abstinence treatment.
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Affiliation(s)
- Jun-Cheng Weng
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yu-Syuan Chou
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Guo-Joe Huang
- Department of Psychology, Chung Shan Medical University, No. 110, Sec. 1, Chien-Kuo N. Road, Taichung, 402, Taiwan
| | - Yeu-Sheng Tyan
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ming-Chou Ho
- Department of Psychology, Chung Shan Medical University, No. 110, Sec. 1, Chien-Kuo N. Road, Taichung, 402, Taiwan.
- Clinical Psychological Room, Chung Shan Medical University Hospital, Taichung, Taiwan.
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Chu YH, Wang L, Ko PC, Lan SJ, Liaw YP. The risk of cirrhosis in non-alcohol drinkers is greater in female than male betel nut chewers. Oncotarget 2018; 9:8731-8737. [PMID: 29492232 PMCID: PMC5823571 DOI: 10.18632/oncotarget.23885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 11/09/2017] [Indexed: 12/17/2022] Open
Abstract
Background and Aim The association of betel nut with liver cirrhosis among alcohol drinkers has been clearly shown. However, very few studies have shown such an association among non-alcohol drinkers. The aim of this study was to assess the relationship between betel nut chewing and cirrhosis among non-alcohol drinkers. Materials and Methods This study retrospectively analyzed data retrieved from the 2012 Adult Preventive Medical Services and the National Health Insurance Research Datasets in Taiwan. Participants’ information included physical examination and lifestyle, alongside laboratory tests. Betel nut chewers were grouped into three categories: never, occasional and frequent. Diseases were diagnosed using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Initially, 1573024 adults aged 40 years and above who engaged in the free adult preventive medical services in 2012 were recruited. However, only 1065246 of them were included in the analysis. Chi-square test and logistic regression were used for the analyses. Results After multivariable adjustments, there were significant relationships between cirrhosis and betel nut chewing in both sexes (P-trend < 0.0001). The risk of cirrhosis was greater in females than males. The odds ratios of cirrhosis in occasional and frequent female chewers were respectively 2.91; 95% C.I: 1.75–4.83 and 3.06; 95% C.I: 1.69–5. However, they were respectively 1.76; 95% C.I: 1.47–2.10 and 2.32; 95% C.I: 1.90–2.85 in occasional and frequent male chewers. Conclusions This study demonstrated significant relationships between betel nut chewing and cirrhosis in both male and female non-alcohol drinkers. The risk of cirrhosis was greater in female than male chewers.
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Affiliation(s)
- Yu-Hua Chu
- Department of Healthcare Administration, Asia University, Wufeng District, Taichung City, Taiwan
| | - Lee Wang
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Pei-Chieh Ko
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Shou-Jen Lan
- Department of Healthcare Administration, Asia University, Wufeng District, Taichung City, Taiwan.,Department of Medical Research, China Medical Hospital, China Medical University, Taichung, Taiwan
| | - Yung-Po Liaw
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan.,Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
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Huang BS, Wu SC, Lin CY, Fan KH, Chang JTC, Chen SC. The effectiveness of a saline mouth rinse regimen and education programme on radiation-induced oral mucositis and quality of life in oral cavity cancer patients: A randomised controlled trial. Eur J Cancer Care (Engl) 2018; 27:e12819. [PMID: 29315944 DOI: 10.1111/ecc.12819] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2017] [Indexed: 11/28/2022]
Abstract
Radiation therapy (RT) and concurrent chemotherapy RT (CCRT) generate radiation-induced oral mucositis (OM) and lower quality of life (QOL). This study assessed the impact of a saline mouth rinse regimen and education programme on radiation-induced OM symptoms, and QOL in oral cavity cancer (OCC) patients receiving RT or CCRT. Ninety-one OCC patients were randomly divided into a group that received saline mouth rinses and an education programme and a control group that received standard care. OM symptoms and QOL were assessed with the WHO Oral Toxicity Scale, MSS-moo and UW-QOL. Data were collected at the first postoperative visit to the radiation department (T0) and at 4 weeks and 8 weeks after beginning RT or CCRT. Patients in both groups had significantly higher levels of physical and social-emotional QOL at 8 weeks after beginning RT or CCRT compared to the first visit. Patients in the saline rinse group had significantly better physical and social-emotional QOL as compared to the standard care group at 8 weeks. Radiation-induced OM symptoms and overall QOL were not different between the groups. We thus conclude the saline rinse and education programme promote better physical and social-emotional QOL in OCC patients receiving RT/CCRT.
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Affiliation(s)
- B-S Huang
- Department of Radiation Oncology, Chang Gung Medical Foundation, Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - S-C Wu
- Department of Radiation Oncology, Chang Gung Medical Foundation, Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - C-Y Lin
- Department of Radiation Oncology, Chang Gung Medical Foundation, Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - K-H Fan
- Department of Radiation Oncology, Chang Gung Medical Foundation, Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - J T-C Chang
- Department of Radiation Oncology, Chang Gung Medical Foundation, Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - S-C Chen
- Department of Radiation Oncology, Chang Gung Medical Foundation, Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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Chang SL, Lo CH, Peng HL, Chen CR, Wu SC, Chen SC. Factors associated with continued smoking after treatment of oral cavity cancer: An age and survival time-matched study. J Adv Nurs 2017; 74:926-934. [PMID: 29148210 DOI: 10.1111/jan.13506] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 11/28/2022]
Abstract
AIMS The aims of this study of people with oral cavity cancer were to compare the social support, depression, nicotine dependence, physical function and social-emotional function of those who continued smoking with those who quit smoking, by matching age and survival time and to identify the predictors of continued smoking during the survival period. BACKGROUND People who continue to smoke after cancer treatment may have an impact on treatment response and survival. DESIGN A cross-sectional survey was conducted. METHODS This study compared 92 people with oral cavity cancer who continued smoking with 92 people who quit smoking, with matching for age and survival time between January 2015 - November 2015. Conditional logistic regression analysis was used to compare the two groups. RESULTS The quit smoking group had significantly more social support, less depression and greater social-emotional function than the continued smoking group. People who were unmarried, received surgery without reconstruction, had poor social support and had poor social-emotional function were more likely to continue smoking. CONCLUSIONS People with oral cavity cancer were more likely to continue smoking after the treatment if they had low social support, depression, greater nicotine dependence and poor social-emotional function. Healthcare professionals should pay more attention to social support, psychological status and nicotine dependence of people who were treated for oral cavity cancer.
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Affiliation(s)
- Su-Ling Chang
- Department of Nursing, St. Martin De Porres Hospital, Chiayi, Taiwan
| | - Cheng-Hsing Lo
- Department of Oral and Maxillofacial Surgery, St. Martin De Porres Hospital, Chiayi, Taiwan
| | - Hsi-Ling Peng
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Taipei, Taiwan
| | - Chien-Rong Chen
- Department of Nursing, St. Martin De Porres Hospital, Chiayi, Taiwan
| | - Shu-Chen Wu
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shu-Ching Chen
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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Adverse Health Effects of Betel Quid and the Risk of Oral and Pharyngeal Cancers. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3904098. [PMID: 29376073 PMCID: PMC5742426 DOI: 10.1155/2017/3904098] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 05/01/2017] [Accepted: 05/18/2017] [Indexed: 02/06/2023]
Abstract
Global reports estimate 600 million betel quid (BQ) chewers. BQ chewing has been demonstrated not only to be a risk factor for cancers of the oral cavity and pharynx and oral potentially malignant disorders (OPMD) but also to cause other cancers and adverse health effects. Herein, we summarized the international comparison data to aid in the understanding of the close relationship between the prevalence of BQ chewing, the occurrence of oral and pharyngeal cancers, and adverse health effects. Potential biomarkers of BQ carcinogens, such as areca nut, alkaloids, and 3-methylnitrosaminopropionitrile (MNPN), are closely associated with human health toxicology. Molecular mechanisms or pathways involving autophagy, hypoxia, COX-2, NF-κB activity, and stemness are known to be induced by BQ ingredients and are very closely related to the carcinogenesis of cancers of oral and pharynx. BQ abuse-related monoamine oxidase (MAO) gene was associated with the occurrence and progress of oral and pharyngeal cancers. In summary, our review article provides important insights into the potential roles of environmental BQ (specific alkaloid biomarkers and nitrosamine products MNPN) and genetic factors (MAO) and offers a basis for studies aiming to reduce or eliminate BQ-related OPMD and oral/pharyngeal cancer incidences in the future.
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Betel nut chewing associated with increased risk of arterial stiffness. Drug Alcohol Depend 2017; 180:1-6. [PMID: 28850901 DOI: 10.1016/j.drugalcdep.2017.07.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 07/25/2017] [Accepted: 07/29/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Betel nut chewing is associated with certain cardiovascular outcomes. Subclinical atherosclerosis may be one link between betel nut chewing and cardiovascular risk. Few studies have examined the association between chewing betel nut and arterial stiffness. The aim of this study was thus to determine the relationship between betel nut chewing and arterial stiffness in a Taiwanese population. METHODS We enrolled 7540 eligible subjects in National Cheng Kung University Hospital from October 2006 to August 2009. The exclusion criteria included history of cerebrovascular events, coronary artery disease, and taking lipid-lowering drugs, antihypertensives, and hypoglycemic agents. Increased arterial stiffness was defined as brachial-ankle pulse wave velocity (baPWV) ≥1400cm/s. According to their habit of betel nut use, the subjects were categorized into non-, ex-, and current chewers. RESULTS The prevalence of increased arterial stiffness was 32.7, 43.3, and 43.2% in non-, ex- and current chewers, respectively (p=0.011). Multiple logistic regression analysis revealed that ex-chewers (odds ratio [OR] 1.69, 95% confidence interval (CI)=1.08-2.65) and current chewers (OR 2.29, 95% CI=1.05-4.99) had elevated risks of increased arterial stiffness after adjustment for co-variables. CONCLUSIONS Both ex- and current betel nut chewing were associated with a higher risk of increased arterial stiffness. Stopping betel nut chewing may thus potentially be beneficial to reduce cardiovascular risk, based on the principals of preventive medicine.
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Osborne PG, Ko YC, Wu MT, Lee CH. Intoxication and substance use disorder to Areca catechu nut containing betel quid: A review of epidemiological evidence, pharmacological basis and social factors influencing quitting strategies. Drug Alcohol Depend 2017; 179:187-197. [PMID: 28787696 DOI: 10.1016/j.drugalcdep.2017.06.039] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 06/12/2017] [Accepted: 06/12/2017] [Indexed: 11/21/2022]
Abstract
AIM We present a systematic review of substance use disorder (SUD) to Areca catechu nut (AN) and AN containing betel quid (ANcBQ) with emphasis on dependence resulting from chewing of tobacco-free ANcBQ. We examined pharmacology of intoxication and addiction, and factors influencing quitting strategies. METHODS Epidemiological publications of SUD were included according to PRISMA criteria. Pharmacological publications were retrieved from the PUBMED database and websites of the WHO, United Nations, and Sigma-Aldrich. RESULTS Nine epidemiological studies show clear evidence of abuse and dependence in tobacco-free ANcBQ and/or ANcBQ+Tobacco chewers. Dependency is greater if ANcBQ contains tobacco. In both groups higher dependency scores were positively correlated with higher frequency of chewing. Dependency on AN+Lime is associated with altered brain morphology, resting state brain activity, neurochemistry and deterioration of working spatial memory. ANcBQ contains a complex mixture of neuroactive compounds that have the potential to act directly upon all major cerebral neurotransmitter systems. Of these compounds, only arecoline (muscarinic agonist) has been the focus of limited pharmacological investigation. In animal studies, arecoline increases dopamine transmission in the mesocorticolimbic circuit and this action may be one factor contributing to ANcBQ dependency in humans. Societal and familial acceptance of ANcBQ consumption is paramount for commencement and persistence of chewing. CONCLUSIONS ANcBQ SUD remains an orphan disease. The limited understanding of pharmacological basis of intoxication and SUD determines there are no pharmacological replacement therapies for ANcBQ SUD. The addictive properties of ANcBQ coupled with social acceptance of ANcBQ chewing limits the effectiveness of counseling-based quitting programs.
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Affiliation(s)
- Peter G Osborne
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia; Graduate Institute of Clinical Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Ying-Chin Ko
- Environment-Omics-Diseases Research Centre, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Ming-Tsang Wu
- Graduate Institute of Clinical Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chien-Hung Lee
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Yang PY, Chen YT, Wang YH, Su NY, Yu HC, Chang YC. Malignant transformation of oral submucous fibrosis in Taiwan: A nationwide population-based retrospective cohort study. J Oral Pathol Med 2017; 46:1040-1045. [DOI: 10.1111/jop.12570] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Po-Yu Yang
- School of Dentistry; Chung Shan Medical University; Taichung Taiwan
- Department of Dentistry; Chung Shan Medical University Hospital; Taichung Taiwan
| | - Yi-Tzu Chen
- Department of Dentistry; Chung Shan Medical University Hospital; Taichung Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research; Chung Shan Medical University Hospital; Taichung Taiwan
| | - Ni-Yu Su
- School of Dentistry; Chung Shan Medical University; Taichung Taiwan
| | - Hui-Chieh Yu
- School of Dentistry; Chung Shan Medical University; Taichung Taiwan
| | - Yu-Chao Chang
- School of Dentistry; Chung Shan Medical University; Taichung Taiwan
- Department of Dentistry; Chung Shan Medical University Hospital; Taichung Taiwan
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Yang SF, Wang YH, Su NY, Yu HC, Wei CY, Yu CH, Chang YC. Changes in prevalence of precancerous oral submucous fibrosis from 1996 to 2013 in Taiwan: A nationwide population-based retrospective study. J Formos Med Assoc 2017; 117:147-152. [PMID: 28390753 DOI: 10.1016/j.jfma.2017.01.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 01/17/2017] [Accepted: 01/26/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND/PURPOSE Oral submucous fibrosis (OSF) has been regarded as a precancerous condition. Research examining the prevalence of OSF could be the first step in preventing or reducing malignant transformation. In this study, we probed a nationwide registered database to assess the prevalence, gender distribution, age, income, and urbanization status of OSF patients in Taiwan. METHODS A retrospective study was conducted to analyze the registered database compiled by the National Health Insurance provided by the Ministry of Health and Welfare, Taiwan. We identified dental visit patients diagnosed with OSF during the period between January 1, 1996 and December 31, 2013. In addition, demographic characteristics were analyzed by multivariate Poisson regression. RESULTS The prevalence of OSF increased significantly from 8.3 (per 105) in 1996 to 16.2 (per 105) in 2013 (p < 0.0001). Men had a significantly higher OSF prevalence than women (p < 0.001). The mean age of patients with OSF increased from 1996 to 2013. Individuals living in rural areas had a higher risk of OSF compared with those living in urban areas [relative risk (RR), 1.10; 95% confidence interval (CI), 1.07-1.13]. The higher income group had a lower risk of OSF compared with the lower income group (RR, 0.76; 95% CI, 0.73-0.80). CONCLUSION This large-scale government-centered survey demonstrates that the prevalence of OSF in Taiwan significantly increased from 1996 to 2013. The prevalence was higher among men than among women.
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Affiliation(s)
- Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ni-Yu Su
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hui-Chieh Yu
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| | - Chia-Yi Wei
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| | - Chuan-Hang Yu
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Chao Chang
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Dentistry, Chung Shan Medical University, Taichung, Taiwan.
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Chang PMH, Lu HJ, Wang LW, Tai SK, Chen MH, Chu PY, Yang MH. Effectiveness of incorporating cetuximab into docetaxel/cisplatin/fluorouracil induction chemotherapy and chemoradiotherapy for inoperable squamous cell carcinoma of the oral cavity: A phase II study. Head Neck 2017; 39:1333-1342. [DOI: 10.1002/hed.24766] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 01/23/2017] [Accepted: 02/08/2017] [Indexed: 12/25/2022] Open
Affiliation(s)
- Peter Mu-Hsin Chang
- Division of Medical Oncology; Department of Oncology, Taipei Veterans General Hospital; Taipei Taiwan
- Faculty of Medicine; National Yang Ming University; Taipei Taiwan
| | - Hsueh-Ju Lu
- Division of Medical Oncology; Department of Internal Medicine, Chung Shan Medical University Hospital; Taichung Taiwan
- School of Medicine; Chung Shan Medical University; Taichung Taiwan
| | - Ling-Wei Wang
- Division of Radiation Therapy; Department of Oncology, Taipei Veterans General Hospital; Taipei Taiwan
- Faculty of Medicine; National Yang Ming University; Taipei Taiwan
| | - Shyh-Kuan Tai
- Department of Otolaryngology; Taipei Veterans General Hospital; Taipei Taiwan
- Faculty of Medicine; National Yang Ming University; Taipei Taiwan
| | - Ming-Huang Chen
- Division of Medical Oncology; Department of Oncology, Taipei Veterans General Hospital; Taipei Taiwan
- Faculty of Medicine; National Yang Ming University; Taipei Taiwan
| | - Pen-Yuan Chu
- Department of Otolaryngology; Taipei Veterans General Hospital; Taipei Taiwan
- Faculty of Medicine; National Yang Ming University; Taipei Taiwan
| | - Muh-Hwa Yang
- Division of Medical Oncology; Department of Oncology, Taipei Veterans General Hospital; Taipei Taiwan
- Institute of Clinical Medicine; National Yang Ming University; Taipei Taiwan
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Chen CH, Lu HI, Wang YM, Chen YH, Lo CM, Huang WT, Li SH. Areca nut is associated with younger age of diagnosis, poor chemoradiotherapy response, and shorter overall survival in esophageal squamous cell carcinoma. PLoS One 2017; 12:e0172752. [PMID: 28245263 PMCID: PMC5330470 DOI: 10.1371/journal.pone.0172752] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 02/02/2017] [Indexed: 01/05/2023] Open
Abstract
Objective Areca nut chewing is carcinogenic to humans. However, little is known about the impact of areca nut chewing on esophageal squamous cell carcinoma (ESCC). Methods We retrospectively reviewed 286 ESCC patients who received surgery or preoperative chemoradiotherapy followed by surgery at our institution. Background characteristics including areca nut chewing history were analyzed. The 4-nitroquinoline 1-oxide (4-NQO)-induced murine ESCC model was used to test the impact of arecoline, a main constituent of areca nut, on ESCC. Results Compared to patients without areca nut chewing history, patients with areca nut chewing history had overall a younger age of onset (Mean age: 56.75 versus 52.68 yrs, P<0.001) and significantly worse overall survival than those without areca nut chewing history (P = 0.026). Among patients who received surgery, the overall survival rates were not significantly different between those with or without areca nut chewing history. Among patients who received preoperative chemoradiotherapy followed by surgery, those with areca nut chewing history had a significantly lower pathologic complete response rate (P = 0.002) and lower overall survival rate (P = 0.002) than those without. In the murine ESCC model, the incidence of esophageal invasive squamous cell carcinoma was 40% in mice exposed to concomitant 4-NQO and arecoline treatment for 8 weeks and 6% in mice exposed to 4-NQO only for 8 weeks (P = 0.037). Conclusions Our results indicate that areca nut chewing history is significantly associated with younger age of onset, poor response to chemoradiotherapy, and shorter overall survival in ESCC patients. Arecoline, a main constituent of areca nut, accelerates esophageal tumorigenesis in the 4-NQO-induced murine ESCC model.
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Affiliation(s)
- Chang-Han Chen
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital and Department of Applied Chemistry, and Graduate Institute of Biomedicine and Biomedical Technology, National Chi-Nan University, Taiwan
| | - Hung-I Lu
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Ming Wang
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yen-Hao Chen
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chien-Ming Lo
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wan-Ting Huang
- Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shau-Hsuan Li
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- * E-mail:
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46
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Chen WY, Lee CY, Lin PY, Hsieh CE, Ko CJ, Lin KH, Lin CC, Ming YZ, Chen YL. Betel Nut Chewing Is Associated With Reduced Tacrolimus Concentration in Taiwanese Liver Transplant Recipients. Transplant Proc 2017; 49:326-329. [PMID: 28219593 DOI: 10.1016/j.transproceed.2016.11.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 10/20/2016] [Accepted: 11/16/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE Studies have shown that arecoline, the major alkaloid component of betel nuts, alters the activity of enzymes in the cytochrome P450 (CYP-450) family. Tacrolimus, an immunosuppressant that protects against organ rejection in transplant recipients, not only is mainly metabolized by CYP3A enzymes but also has a narrow therapeutic range. We aimed to investigate whether dose-adjusted blood trough levels of tacrolimus differed over time between betel nut-chewing and non-betel nut-chewing liver transplant recipients. METHODS In this retrospective case-control study, 14 active betel nut-using liver recipients were matched at a 1:2 ratio to 28 non-betel nut-using liver recipients by sex, age, graft source, duration of follow-up after liver transplantation, and estimated glomerular filtration rate. Differences in liver function index, renal function index, and dose-adjusted blood trough levels of tacrolimus over an 18-month period were compared between the 2 groups by using the Generalized Estimating Equation approach. RESULTS Dose-adjusted blood trough levels of tacrolimus tended to be significantly (P = .04) lower in betel nut chewers (mean = 0.81, medium = 0.7, 95% confidence interval [CI] = 0.73 to 0.90) than in nonchewers (mean = 1.12, medium = 0.88, 95% CI = 1.03 to 1.22) during the 18-month study period. However, there was no significant difference in renal and liver function index between the 2 groups. CONCLUSION Liver transplant recipients receiving tacrolimus tend to have lower blood trough levels of the drug over time if they chew betel nuts.
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Affiliation(s)
- W-Y Chen
- Department of Pharmacy, Changhua Christian Hospital, Changhua, Taiwan
| | - C-Y Lee
- Department of Pharmacy, Changhua Christian Hospital, Changhua, Taiwan
| | - P-Y Lin
- Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan
| | - C-E Hsieh
- Department of General Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - C-J Ko
- Department of General Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - K-H Lin
- Department of General Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - C-C Lin
- Department of General Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Y-Z Ming
- Transplantation Center, Third Xiangya Hospital of Central South University, Changsha, China
| | - Y-L Chen
- Department of General Surgery, Changhua Christian Hospital, Changhua, Taiwan; Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan; Transplantation Center, Third Xiangya Hospital of Central South University, Changsha, China; School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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47
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Tai SF, Chien HT, Young CK, Tsao CK, de Pablo A, Fan KH, Liao CT, Wang HM, Kang CJ, Chang JTC, Huang SF. Roles of preoperative C-reactive protein are more relevant in buccal cancer than other subsites. World J Surg Oncol 2017; 15:47. [PMID: 28209200 PMCID: PMC5314474 DOI: 10.1186/s12957-017-1116-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 02/01/2017] [Indexed: 02/06/2023] Open
Abstract
Background C-reactive protein (CRP) is an early marker for inflammation, and a relationship between serum CRP levels and survival in oral cancer has been demonstrated previously. In this study, we investigated the roles of CRP in different oral cancer subsites. Methods Three hundred and forty-three oral squamous cell carcinoma patients between June 1999 and March 2015 were retrospectively reviewed. Serum CRP levels were measured preoperatively. Results The elevation of CRP levels (≥5.0 mg/L) was significantly correlated with pathologic tumor status, pathologic nodal status, nodal extracapsular spread, tumor stage, skin invasion, tumor depth (≥10 mm), and bone invasion. The correlation between elevation of CRP and clinicopathologic factors was more evident in the buccal cancer compared to other tumor subsites. The disease-free survival and overall survival correlation was significant in buccal cancer (p = 0.003 and p < 0.001) but not in tongue cancer (p = 0.119 and p = 0.341) or other oral cancer subsites (p = 0.246 and p = 0.696). Conclusions Preoperative serum CRP level was a prognosticator in oral squamous cell carcinoma, and its effect was more prominent in buccal cancer that occurs more frequently in areca-quid (AQ) endemic regions. Electronic supplementary material The online version of this article (doi:10.1186/s12957-017-1116-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shiao Fwu Tai
- Department of Otolaryngology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Huei-Tzu Chien
- Department of Public Health, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Chi-Kuang Young
- Department of Otolaryngology, Chang Gung Memorial Hospital, Keelung, Taiwan, Republic of China
| | - Chung-Kang Tsao
- Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
| | - Alba de Pablo
- Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
| | - Kang-Hsing Fan
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Chun-Ta Liao
- Department of Otolaryngology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Hung-Ming Wang
- Department of Medical Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Chung-Jan Kang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Joseph Tung-Chieh Chang
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Shiang-Fu Huang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Linkou, Taiwan. .,Department of Public Health, Chang Gung University, Taoyuan, Taiwan, Republic of China.
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Yuan F, Kong L, Zhu X, Jiang C, Fang C, Liao W. Altered Gray-Matter Volumes Associated With Betel Quid Dependence. Front Psychiatry 2017; 8:139. [PMID: 28824470 PMCID: PMC5540953 DOI: 10.3389/fpsyt.2017.00139] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 07/17/2017] [Indexed: 02/06/2023] Open
Abstract
Betel quid (BQ) is one of the most commonly consumed psychoactive substances. It has been suggested to be associated with various health issues, especially oral cancer. Evidence also points to possible decreased cognitive functions after long-term BQ chewing, such as attention and inhibition control. The present study aims to investigate the brain structure basis of BQ chewing in Hunan province of China. Twenty-five BQ chewers and 25 controls were recruited to participate in this study. Voxel-based morphormetry analysis revealed that there were three key regions showing structural differences between BQ chewers and controls, including bilateral dorsolateral prefrontal cortex (DLPFC)/insula, ventral medial prefrontal cortex, and left orbitofrontal cortex. Moreover, the GMV in the DLPFC could potentially predict BQ dependence scores, level of daily BQ chewing, and history of BQ chewing. These results suggested that participants who showed BQ chewing dependence may have deficit in inhibition control and affective decision-making, and the level of deficit was dependent on the level of daily BQ chewing, and history of BQ chewing. Understanding the neurobiology features of BQ chewing would help us develop novel ways to diagnose and prevent BQ dependence.
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Affiliation(s)
- Fulai Yuan
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Lingyu Kong
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Xueling Zhu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.,School of Humanities and Social Sciences, National University of Defense Technology, Changsha, China
| | - Canhua Jiang
- Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Changyun Fang
- Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Weihua Liao
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
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Yuan F, Zhu X, Kong L, Shen H, Liao W, Jiang C. White Matter Integrity Deficit Associated with Betel Quid Dependence. Front Psychiatry 2017; 8:201. [PMID: 29075207 PMCID: PMC5643420 DOI: 10.3389/fpsyt.2017.00201] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 09/25/2017] [Indexed: 01/16/2023] Open
Abstract
Betel quid (BQ) is a commonly consumed psychoactive substance, which has been regarded as a human carcinogen. Long-term BQ chewing may cause Diagnostic and Statistical Manual of Mental Disorders-IV dependence symptoms, which can lead to decreased cognitive functions, such as attention and inhibition control. Although betel quid dependence (BQD) individuals have been reported with altered brain structure and function, there is little evidence showing white matter microstructure alternation in BQD individuals. The present study aimed to investigate altered white matter microstructure in BQD individuals using diffusion tensor imaging. Tract-based spatial statistics was used to analyze the data. Compared with healthy controls, BQD individuals exhibited higher mean diffusivity (MD) in anterior thalamic radiation (ATR). Further analysis revealed that the ATR in BQD individuals showed less fractional anisotropy (FA) than that in healthy controls. Correlation analysis showed that both the increase of MD and reduction of FA in BQD individuals were associated with severity of BQ dependence. These results suggested that BQD would disrupt the balance between prefrontal cortex and subcortical areas, causing declined inhibition control.
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Affiliation(s)
- Fulai Yuan
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Xueling Zhu
- School of Humanities and Social Sciences, National University of Defense Technology, Changsha, China.,Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Lingyu Kong
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Huaizhen Shen
- School of Humanities and Social Sciences, National University of Defense Technology, Changsha, China
| | - Weihua Liao
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Canhua Jiang
- Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, China
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Hu S, Chen WC, Hwang GS, Chen ST, Kuo SB, Chen Y, Idova G, Wang SW. Changes in plasma steroids and cytokines levels in betel chewing patients in Taiwan. Steroids 2016; 111:134-138. [PMID: 27016129 DOI: 10.1016/j.steroids.2016.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 03/01/2016] [Accepted: 03/11/2016] [Indexed: 10/22/2022]
Abstract
Betel nut is the second largest economic food product in Taiwan. In Southeast Asia, the habit of chewing betel nut seems to be highly correlated with oral submucous fibrosis and oral squamous cell carcinoma. Oral submucous fibrosis is characterized by abnormal accumulation of oral submucous collagen fibers and limitation of mouth opening. Although the mechanism responsible for tissue damage is still unknown, prolonged irritation caused by betel nut and tobacco is considered to be a major factor contributing to the pathogenesis of oral submucous fibrosis. The effect of betel nut chewing on immune system remains unknown. Present study aims to investigate the change of plasma hormones including cortisol, testosterone, and inflammatory cytokine concentrations in male chewing betel nut compared with normal subjects. Heparinized blood was obtained from control group (normal young+mid-aged individuals), betel nut-chewing, and oral cancer male subjects. The study was approved by the Ethics Committee of the Chang-Gung Memorial Hospital. Written informed consent was granted by the patients. Plasma cortisol and testosterone concentrations were detected by commercial enzyme-linked immunosorbent assay (ELISA). The inflammatory cytokines, including interleukin-1β (IL-1β), IL-15, tumor necrosis factor-α (TNF-α), were analyzed by ELISA with commercial monoclonal capture antibodies and polyclonal detection antibodies. The median concentrations of plasma IL-1β, IL-15, and TNF-α were 3.14pg/ml, 3.14pg/ml, and 6.85pg/ml, respectively, in patients with oral cancer, compared with median plasma IL-1β, IL-15, and TNF-α concentration of 2.64pg/ml, 5.86pg/ml, and 5.38pg/ml, respectively, in patients with betel nut-chewing habit. In contrast, the median concentrations of plasma IL-1β, IL-15, and TNF-α in mid-aged males (aged 30-50) were 7.00pg/ml, 10.64pg/ml, and 31.73pg/ml, respectively, compared with median plasma concentration of IL-1β, IL-15, and TNF-α of 4.48pg/ml, 33.36pg/ml, and 97.77pg/ml in young males (aged 20-22), respectively. Also, significantly elevated plasma cortisol concentration was noted in betel nut-chewing (median 727.2ng/ml) and oral cancer patients (561.9ng/ml) compared to the mid-aged (176.8ng/ml) and young males (173.4ng/ml), respectively. In addition, lower plasma testosterone concentrations were found in betel nut-chewing subjects compared with young males (2.6±3.3ng/ml vs 6.2±2.9ng/ml). To summarize, the inflammatory cytokines and steroid hormones may reflect the degree of inflammation in betel nut-chewing males and the oral cancer subjects. The above findings suggest that betel nut-chewing or oral cancer inhibits plasma cytokines and regulates steroid hormones concentrations compared to mid-aged or young normal subjects. It is also indicated that betel nut-chewing causes decreased inflammatory cytokines as the same levels as in oral cancer subjects.
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Affiliation(s)
- Sindy Hu
- Department of Dermatology, Chang Gung Memorial Hospital, Kweisan, Taoyuan, Taiwan, ROC; College of Medicine, Chang Gung University, Kweisan, Taoyuan, Taiwan, ROC
| | - Wen-Chyuan Chen
- Center for General Education,Chang Gung University of Science and Technology, Kweisan, Taoyuan, Taiwan, ROC
| | - Guey-Shyang Hwang
- Department of Dermatology, Chang Gung Memorial Hospital, Kweisan, Taoyuan, Taiwan, ROC; Department of Nursing, Chang Gung University of Science and Technology, Kweisan, Taoyuan, Taiwan, ROC; Department of Nutrition and Health Sciences, Chang Gung University of Science and Technology, Kweisan, Taoyuan, Taiwan, ROC
| | - Szu-Tah Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kweisan, Taoyuan, Taiwan, ROC
| | - Song-Bor Kuo
- Department of Dentistry, Kweisan, Taoyuan, Taiwan, ROC
| | - Yifen Chen
- Department of Dentistry, Kweisan, Taoyuan, Taiwan, ROC
| | - Galina Idova
- State Scientific Research Institute of Physiology and Basic Medicine, Timakova Street, 4, Novosibirsk 630117, Russia
| | - Shyi-Wu Wang
- Department of Dermatology, Chang Gung Memorial Hospital, Kweisan, Taoyuan, Taiwan, ROC; Department of Physiology and Pharmacology, Medical College, Chang-Gung University, Kweisan, Taoyuan, Taiwan, ROC.
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