槟榔致口腔癌发病机制及流行病学研究综述

Review on the pathogenesis and epidemiology of oral cancer induced by Areca catechu L.

摘要:

槟榔是一种传统嗜好品，因其致癌性已被世界卫生组织列为1类致癌物。本文系统梳理了槟榔成分及其代谢产物在口腔癌变进程中的作用机制，重点剖析了槟榔碱介导的细胞信号通路异常、亚硝胺类化合物的DNA烷基化效应、氧化应激引发的基因组不稳定性，以及促癌微环境构建等关键病理环节。结合全球流行病学数据与区域暴露特征差异，揭示了长期咀嚼槟榔与口腔黏膜下纤维化 （OSMF） 等癌前病变及口腔鳞状细胞癌 （OSCC） 的发生之间存在剂量-效应关系。未来需加强跨学科技术整合以解析槟榔导致口腔癌变的动态过程，并基于不同地域特征制定防控策略，为降低相关疾病负担提供科学依据。

Abstract:

Areca catechu L., a traditional masticatory widely consumed in Asia, has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC) of the World Health Organization due to its confirmed association with oral and oropharyngeal cancers. This study systematically elucidates the mechanistic roles of areca nut components and their metabolites in oral carcinogenesis, with a focus on four pivotal pathological processes: arecoline-induced aberrant cell signaling pathways, DNA alkylation by nitrosamine derivatives, oxidative stress-induced genomic instability, and pro-tumorigenic microenvironment remodeling. By integrating global epidemiological data with regional exposure differences, a dose-response relationship was revealed between long-term betel quid chewing and the development of oral squamous cell carcinoma (OSCC) and precancerous lesions such as oral submucous fibrosis (OSMF). Strengthening interdisciplinary integration is needed to elucidate the dynamic process of Areca catechu L.-induced oral carcinogenesis and to develop region-specific prevention and control strategies, providing a scientific basis for reducing the burden of related diseases.