Is Diabetesmellitus A Risk Factor for Oral Cancers?

Öz

Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia resulting from defects in insulin secretion, insülin action, or both. In DM, which can be divided into two main groups, type 1 and type 2, microvascular and macrovascular complications occur a result of prolonged hyperglycemia.DM can lead to decreased salivary flow, periodontitis, and oral mucosal changes such as oral lichen planus, leukoplakia by causing many immunological and metabolic changes in the oral mucosa. Oral cancers are carcinomas that are found in middle age and over, frequently in males with high morbidity and mortality rates. Factors such as smoking and alcohol abuse play important role in the etiology. In the reported studies, it has been determined that type 2 DM is a risk factor for several cancers such as breast, endometrium, and pancreas, and the incidence of oral precancerous lesions increases with type 2 DM. Also, DM can lay the groundwork formation of oral cancers and to cause the deterioration of cancer prognosis. It has been thought that the etiological factors of DM such as hyperinsulinemia and obesity play a role in the emergence of this condition by various mechanisms and the drugs used in the management of DM effect on cancer. Although DM has been shown as a risk factor for oral cancers, the relationship between DM and oral cancer has not been fully clarified. In this review, the relationship between DM and oral cancers and possible pathobiological mechanisms in this relationship are discussed in the light of reported articles.

Anahtar Kelimeler

• Diabetes mellitus, oral cancer, precanserous lesion; risk factor

Diyabetes Mellitus Ağız Kanserleri İçin Bir Risk Faktörü Mü?

Öz

Diyabetes Mellitus (DM) hiperglisemi ile karakterize, insülin sekresyonunda ve/veya insülin aktivitesinde bozulmayla ortaya çıkan metabolik bir hastalıktır. Tip 1 ve tip 2 olmak üzere başlıca iki gruba ayrılan DM’de uzun süren hiperglisemi sonucunda mikrovasküler ve makrovasküler komplikasyonlar ortaya çıkar. DM, oral mukozada da birçok immünolojik ve metabolik değişikliğe neden olarak, tükürük akışında azalma, periodontitis ve oral liken planus, lökoplaki gibi oral mukozal değişikliklere yol açabilir.Ağız kanserleri orta yaş ve üzerinde, yüksek morbidite ve mortalite oranına sahip sıklıkla erkeklerde saptanan karsinomlardır. Sigara, aşırı alkol tüketimi gibi etkenler ağız kanserlerinin etiyolojisinde önemli rol oynar.Yapılan çalışmalarda, tip 2 DM’nin kolon, meme, endometriyum ve pankreas dâhil olmak üzere birçok malignite için risk faktörü olduğu ve tip 2 DM’li hastalarda oral prekanseröz lezyonların görülme sıklığının arttığı belirlenmiştir. Bununla birlikte DM, ağız kanserlerinin oluşumuna zemin hazırlayabilir ve kanser prognozunun kötüleşmesine yol açabilir. Bu durumun ortaya çıkmasında hiperinsülinemi ve obezite gibi DM’nin etiyolojik faktörlerinin çeşitli mekanizmalarla rol oynadığı düşünülmekte ve DM tedavisinde kullanılan ilaçların da kanser üzerinde etkisi olduğu savunulmaktadır. Her ne kadar DM oral kanserler için risk faktörü olarak gösterilse de DM ile oral kanser arasındaki ilişki tam olarak açıklığa kavuşturulamamıştır.Bu derlemede DM ile oral kanserler arasındaki ilişki ve bu ilişkide rol oynayan olası patobiyolojik mekanizmalar makaleler ışığında tartışılmıştır.

Anahtar Kelimeler

• Diyabetes mellitus;
• oral kanser;
• prekanseröz lezyon;
• risk faktörü

Kaynakça

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