吸菸与口、咽、喉癌.doc

吸菸與口、咽、喉癌 吸菸與咽、喉癌相關之流行病學研究 吸菸與口、咽、喉癌相關基因病變及其他致癌機轉 第一節 菸導致口、咽、喉癌基因病變、 之研究 第、 二節 菸致癌物與口、咽、喉癌個体易感受性、 基因學研究 第四章 結論與建議 吸菸與口、咽、喉癌 摘要 口、咽、喉癌的發生率，在台灣最近幾年一直在增加中，由於菸草煙霧含有,800多種化學物質，其中種致癌成分，吸菸公認是口、咽、喉癌重要的誘因，喉癌，吸菸，，，，，菸草口，，，，，，。，、，，，，，，，，，，，，，，。，，，，，，。，，。，，，，，，，。，，，，。口咽喉癌、吸菸、、 Smoking and Oro-Pharyngo-Laryngeal Cancers Abstract The incidence of oro-pharyngo-laryngeal cancers in Taiwan is increasing in the recent years. Among 4,800 chemical substances found in the cigarette smoke, there are 69 compounds carcinogenic to humans. Cigarette smoke is thought to be one of the important risk factors for oro-pharyngo-laryngeal cancers, especially for laryngeal cancers. Most epidemiological studies show that cigarette smoking may increase the risk for oro-pharyngo-laryngeal cancers. The more packs-years of black cigarettes are consumed, the more relative risks for oro-pharyngo-laryngeal cancers are found. Smoke inhalation without a filter may increase the risk for oro-pharyngo-laryngeal cancers also. The longer the quitting of smoking is, the lower risk for oro-pharyngo-laryngeal cancers will be. The nicotine in the cigarette can induce hyperplasia of oral mucosa. After nitrosating, the nicotine becomes the tobacco-specific nitrosamine: NNK or NNN. They will induce DNA methylation and produce nucleotide transition or transversion during replication. Besides, the polycyclic aromatic hydrocarbon, such as benzo(a)pyrene produced during smoking will damage the p53 gene via point mutation. The cigarette smoke contains many compounds, including mutagens, carcinogens and free radicals. They may inhibit DNA replicatio