HBV感染,家族肝癌史与ABO血型在低发区原发性肝癌的关系

本文研究了高，低发区５１０例ＰＨＣＨＢＶ感染、家庭肝癌史及与ＡＢＯ血型的关系，结果表明：１肝癌低发区与高发区一样，全并ＨＢＶ感染的ＰＨＣ患者达８０．７４％，远多于元ＨＶＣ感染者；２低发区ＰＨＣ中，有家族肝癌史的Ａ型血者显著多于相应对照组。     

肝癌患者一级亲属HBV感染的调查分析

本文从ＨＢＶ感染的角度研究肝癌家族内的遗传效应。结果表明：１，原发性肝癌（ＰＨＣ）患者一级亲属２２７人。其乙型肝炎病毒感染标记（ＨＢＶＭ）阳性率为７１．８１％，ＨＢｓＡｇ阳性率为４２．７３％，显著高于当地的自然人群（Ｐ＜０．０５）；其ＨＢＶＭ最常见模式是ＨＢｓＡｇ、抗－ＨＢｅ和抗－ＨＢｃ同时阳性，与有ＨＢＶ感染的ＰＨＣ患者ＨＢＶＭ的最常见模式相一致。２．患者同胞的ＨＢＶＭ阳性率为８２，９８％，ＨＢｓＡｇ为５１．０％，均显著高于患者双亲、子代（Ｐ＜０．０５）；且男性显著多于女性（Ｐ＜０．０５）。３．患者母亲组的ＨＢＶＭ明显高于父亲组（＋３１．４３％）。提示ＰＨＣ患者一级亲属确是一组ＨＢＶ易感人群，且肝癌家族内ＨＢＶ感染、ＰＨＣ都呈明显的、以母系亲代传递为特征的家族聚集现象；ＨＢＶ经垂直感染可导致家族性ＰＨＣ，ＰＨＣ患者同胞（尤其男性）是ＨＢＶ、ＰＨＣ最易感人群。因此，对该人群需密切关注，定期复查，警惕ＰＨＣ的发生。     

家族肿瘤史在肝炎与原发性肝癌关系中的作用

研究ＰＨＣ９２４例中家族肿瘤史对肝炎与ＰＨＣ关系的影响，结果表明：①合并ＨＢＶ感染的ＰＨＣ、乙肝组中有家族肿瘤史的患者均显著多于非乙肝组和无肝炎组（Ｐ＜０．０１～０．０５）。②乙肝组发病高峰年龄为３０～４９岁，显著高于其它两组（５０～５９，Ｐ＜０．０１）；乙肝组中有家族肿瘤史者发病高峰年龄为３０～３９岁，显著高于无家族肿瘤史者（４０～４９岁，Ｐ＜０．０１）。③肝炎后至发生临床肝癌时间乙肝组以５～９年居多，较非乙肝组１０～１４年居多提前一个年龄组（Ｐ＜０．０５），且有家族肿瘤史者比例显著高（Ｐ＜０．０５）。提示ＨＢＶ感染可促使ＰＨＣ的高发、早发，而家族肿瘤史则加速了这一进程。     

ABO血型与PHC患者HBV感染标记相关性研究

研究伴ＨＢＶ感染的ＰＨＣ４４５例乙型肝炎抗原抗体与ＡＢＯ血型的关系，结果表明：１．伴ＨＢＶ感染的ＰＨＣＡ型血者显著高于对照组（Ｐ＜０．０１）。２．ＰＨＣ患者中ＨＢｓＡｇ、抗－ＨＢｃ的阳性率均以Ａ型血显著高于对照组（Ｐ＜０．０５）。３．ＰＨＣ患者中ＨＢｓＡｇ与抗－ＨＢｃ均阳性模式Ａ型血者显著多于对照组，而Ｂ型血者显著少（Ｐ＜０．０５）；抗－ＨＢｅ与抗ＨＢｃ均阳性的ＰＨＣ中，亦为Ａ型血者显著多（Ｐ＜０．０５）。提示有ＨＢＶ感染的Ａ型血者罹患ＰＨＣ的倾向性最高；而有ＨＢＶＭ、ＨＢｓＡｇ、抗－ＨＢｃ的Ａ型血者则为ＰＨＣ的易感人群，其中以ＨＢｓＡｇ和抗－ＨＢｃ同时阳性或抗－ＨＢｅ和抗－ＨＢｃ同时阳性的感染模式更易发生ＰＨＣ；也提示ＰＨＣ、ＨＢＶ、Ａ型血三者之间存在某种密切的、复杂的联系，对ＰＨＣ的发生有协同作用。对上述人群应密切关注，定期复查，以期早诊早治。     

家庭肿瘤史在肝炎与原发性肝癌关系中的作用

研究ＰＨＣ９２４例中家族肿瘤史对肝炎与ＰＨＣ关系的影响。结果表明：①合并ＨＢＶ感染的ＰＨＣ，乙型肝有家族肿瘤史的患者均显著多于非乙肝组和无肝炎组。②乙肝组发病高峰年龄为３０－４９岁，显著高于其它两组；乙肝组中有家族肿瘤史者发病高峰年龄为３０－３９岁，显著高于无家族肿瘤史者。③肝炎后至发生临床肝癌时间乙肝组以５－９年居多，较非乙肝组１０－１４年居多提前一个年龄组，且有家族肿瘤史者比例显著高。提示ＨＢ     

肝癌患者一级亲属HBV感染的调查分析

本文从ＨＢＶ感染的角度研究肝癌家族内的遗传效应。提示ＰＨＣ患者一级亲属确是一组ＨＢＶ易感人群，且肝癌家族内ＨＢＶ感染、ＰＨＣ都呈明显的、以母系亲代传递为特征的家族聚集现象；ＨＢＶ经垂直感染可导致家族性ＰＨＣ，ＰＨＣ患者同胞是ＨＢＶ、ＰＨＣ最易感人群。因此，对该人群需密切关注，定期复查，警惕ＰＨＣ的发生。     

肝癌患者同胞罹患原发性肝癌的因素及特征

本文对１５２例具有同胞患肝癌家族史的原发性肝癌先证者进行分析，结果表明：该组人群ＨＢＶ感染率为８１．５８％，感染标记类型有１２种，其中６８％为抗一ＨＢｃ阳性伴ＨＢｓＡｇ和（或）抗－ＨＢｅ阳性；发病高峰年龄为３０～４９岁（占７２％）；兄弟同患肝癌（６７．１１％）显著多于兄妹、姐弟同患，更显著多于姐妹同患（Ｐ＜０．００１），但伴有母患肝癌家族史的患者女性同胞也易患肝癌（Ｐ＜０．０２５）。提示具有同胞患肝癌史、年龄３０～４９岁、尤其是抗－ＨＢｃ阳性伴ＨＢｓＡｇ和（或）抗－ＨＢｅ阳性的男性乙肝患者为肝癌患者一级亲属中原发性肝癌最易感人群，应密切关注，警惕肝癌发生。     

HBV,HCV在原发性肝癌发生中的相互作用研究

为了解河南省原发性肝癌（ＰＨＣ）发生中ＨＢＶ、ＨＣＶ的相互作用，我们应用ＥＬＩＳＡ法和ＰＣＲ法对ＰＨＣ患者及其１：１对照进行了ＨＢＶ标志物（ＨＢＶＭ）和ＨＣＶ标志物（ＨＣＶＭ）检测。结果：ＰＨＣ患者ＨＢＶＭ阳性率为８１．２５％，对照组ＨＢＶＭ阳性率为９．６０％，Ｐ〈０．０１，ＯＲ＝７０（２５．３６，１９３．２３）；ＰＨＣ患者ＨＣＶＭ阳性率为１９．７９％，对照组ＨＣＶＭ阳性率为８．３３％，Ｐ〈０．０     

原发性肝癌与乙型肝炎病毒感染血清学标记的关系

为了探讨原发性肝癌（ＰＨＣ）患者血清乙型肝炎病毒（ＨＢＶ）感染标志在各年龄组间的差异，采用酶联免疫法（ＥＬＩＳＡ）检测了２２１例住院病人的血清ＨＢＶ五项标志，结果发现ＨＢＶ感染率在各年龄组均呈高值，证实了ＨＢＶ感染是ＰＨＣ的一个重要致病因素，尤其是ｅ抗原系统，ＰＨＣ患者ＨＢｅＡｇ阳性率其年龄分布，３０岁以后随年龄增长而下降，６０岁以后明显下降，差异均有显著性（Ｐ〈０．０５），３０岁～４０岁组年龄组     

支气管动脉灌注治疗肺癌对患者肺功能和酸碱血气的影响

对２５例支气管肺癌患者共３０例次，经支气管动脉ＤＳＡ，加抗癌药物灌注治疗前后的肺功能和酸碱、血气观察。结果表明，经化疗药物灌注治疗后，肺通气功能指标ＦＶＣ、ＦＥＶ１、ＭＭＦ、ＰＥＦＲ、Ｖ７５、Ｖ５０、Ｖ２５无显著改变，Ｐ＞０．０５；酸碱、血气指标ＨＢ、ＰＨ、ＰａＣＯ２、ＰａＯ２、ＨＣＯ３、ＴＣＯ２、ＡＢＥ、ＳＢＥ、ＳＢＣ、ＳＡＴ、Ｋ和Ｃ－Ｏ２也无显著改变，Ｐ＞０．０５。但Ａ－ａＤＯ２改变显著，Ｐ＜０．０５。     

HBV感染与原发性肝细胞癌的关系及临床意义

目的 探讨乙型肝炎病毒(HBV)感染与原发性肝细胞癌(PHC)的关系及临床意义.方法 选取240例PHC患者作为PHC组,480例健康体检者作为对照组,检测并分析两组研究对象的HBV感染情况,并采用多因素分析法探讨HBV感染与原发性肝细胞癌的关系.结果 PHC组患者的HBV感染阳性率、HBsAg阳性率、HBeAg阳性率、抗HBe阳性率、抗HBc阳性率均明显高于对照组(P﹤0.01),抗HBs阳性率明显低于对照组,差异均有统计学意义(P﹤0.01);经非条件Logistic回归分析结果显示:有PHC家族史、有饮酒史、合并HBV感染是发生PHC的独立危险因素(P﹤0.05).结论 PHC的发病风险由多种因素导致,其中,HBV感染是其重要的发病原因之一.     

食生鱼与HBV感染和饮酒在原发性肝癌发生中的协同作用

目的 探讨食生鱼与原发性肝癌的关系及其与HBV感染和饮酒的协同致病作用.方法 采用病例对照研究的方法,以500例原发性肝癌患者(病例组)及同期住院的500例非肿瘤患者(对照组)为研究对象,比较两组患者的食生鱼史,评价食生鱼发生原发性肝癌的危险性及其与HBV感染和饮酒的协同致病作用.结果 病例组中,食生鱼者274例,占54.8%;对照组中食生鱼者48例,占8.4%.两组间差异有统计学意义(P＜0.001);食生鱼者发生原发性肝癌的OR值为13.6(95%CI:9.1～19.5),食生鱼与HBV感染和食生鱼与饮酒之间呈正相加交互作用,其交互作用超额相对危险度(RERI)分别为195.3和17.8,交互作用归因比(API)分别为0.8630和0.5251,交互作用指数(S)分别为7.5和2.8.结论 食生鱼可能是原发性肝癌的重要危险因素之一,食生鱼与HBV感染或饮酒在原发性肝癌的发生中可能具有协同致病作用.     

青少年原发性肝癌与乙型和丙型肝炎病毒感染的相关性分析

目的探讨青少年原发性肝癌(PHC)患者中乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)及HBV和HCV混合感染率及其相互关系。方法将50例青少年PHC患者纳入观察组,将同期住院的50例其他肝病患者纳入对照组,检测两组患者血清中HBV、HCV、HBV/HCV标志物阳性率等情况。结果观察组患者血清中HBsAg、抗Hbe和HBV-DNA阳性率均显著高于对照组患者,差异有统计学意义(P<0.05)。两组患者血清中HBeAg阳性率比较,差异无统计学意义(P>0.05)。观察组和对照组患者血清中抗HCV和HCV-RNA阳性率比较,差异无统计学意义(P>0.05);HBV(+)HCV(+)和HBV(+)HCV(-)与青少年PHC发病呈正相关性(P<0.05),HBV(-)HCV(+)与青少年PHC发病无相关性(P>0.05),HBV(-)HCV(-)与青少年PHC发病呈负相关性(P<0.05)。结论 HBV感染与青少年PHC发病有着较强的相关性,属高度危险因素。     

Primary hepatocellular carcinoma in intertropical Africa: relationship between age and hepatitis B virus etiology

Clinical observations of patients with primary hepatocellular carcinoma (PHC) at Le Dantec Hospital, Dakar, Senegal, were studied to determine a correlation with hepatitis B virus (HBV) infection. Of the 103 patients with PHC, 80 had an active HBV infection (HBsAg and/or anti-HBc); 23 showed signs of previous HBV infection (anti-HBs and anti-HBc). The two groups were similar in the detection of alpha-fetoprotein (approximately 60%) and in the major clinical findings: hepatomegaly, 76.25% and 86.96%, respectively; and ascites, 57.50% and 47.83%, respectively. Jaundice, however, was three times more frequent (P < 0.01) in the group of patients with signs of active HBV replication. Distribution of HBV markers as a function of age at onset of PHC revealed that the presence of HBsAg was primarily confined to the sera of the younger patients (< 50 yr old). When compared with leprosy patients and blood donors, the younger PHC patients differed in the frequency of detection of HBsAg and anti-HBs. The older people (> 50 yr old) in the three groups (PHC patients, leprosy patients, and blood donors) had identical HBV markers.     

Primary hepatocellular carcinoma in alaskan natives, 1969–1979

The records of 20 Alaskan Native patients with primary hepatocellular carcinoma (PHC) diagnosed in the II-year period 1969–1979 were reviewed. The annual incidence of PHC was found to be high among Alaskan Native males and especially high among Alaskan Eskimo males (7.6 and 11.2 per 100,000, respectively) in comparison to Greenland and Canadian Eskimos and US white males. Familial and geographic clustering of PHC patients was noted in areas known to be hyperendemic for hepatitis B virus (HBV) infection. A bimodal age distribution among PHC patients occurred with peaks at 15–25 years and 40–65 years. A high prevalence of hepatitis B surface antigen (HBsAg) in serum of patients in the younger age group suggests that HBV infection might be a factor associated with the development of PHC in young Eskimos. PHC in Alaskan Natives is apparently not closely associated with alcoholic cirrhosis.     

A case-control study of primary hepatocellular carcinoma in Taiwan

A case-control study was carried out to explore possible risk factors of primary hepatocellular carcinoma (PHC) in Taiwan. One hundred thirty-one PHC patients and 207 hospital control patients were interviewed and blood samples were collected for blood type and hepatitis B virus (HBV) infection marker tests. Eighty-three percent of the PHC patients were found to be hepatitis B surface antigen (HBsAg) positive as compared with 21.0% of the control patients with an odds ratio (OR) of 21.5. Hepatitis B e antigen (HBeAg) positive status increased the risk of PHC. No significant association was observed between erythrocyte genetic markers and PHC, except c of the Rh system, which was significantly lower in the PHC cases. As compared with the control patients, the PHC patients had a higher proportion with a history of liver diseases and more siblings affected with liver diseases. However, the variables such as cigarette smoking, alcohol drinking, peanut consumption, frequent intake of raw fish, heart diseases, peptic ulcer, malaria, hypertension, diabetes, color blindness, G-6-PD deficiency, surgical operation, blood transfusion, and liver diseases of parents and children were not found to be associated with PHC.     

原发性肝癌外周血ＣＤ１３３检测的临床意义

目的：比较临床病理特征不同的肝癌患者外周静脉血ＣＤ４５^－ＣＤ１３３^＋细胞百分数,探讨ＣＤ１３３阳性表达与肿瘤进展的关系。方法：采用流式细胞术检测６５例原发性肝癌患者外周血ＣＤ４５^－ＣＤ１３３^＋细胞百分数,另采集２０例健康体检者血样作为对照。结果：肝癌组ＣＤ１３３值较对照组显著升高（P＜０.０１）;ＣＤ１３３含量与肿瘤包膜完整性、门静脉癌栓、ＴＮＭ分期显著相关（P＜０.０１）,与肿瘤直径、ＡＦＰ值无相关性（P＞０.０５）;Ｓｐｅａｒｍａｎ相关性分析显示,随病理组织分级增高,ＣＤ１３３的表达增多（P＜０.０５）。结论：肝癌患者外周血ＣＤ４５^－ＣＤ１３３^＋细胞百分数与肿瘤进展密切相关,检测肝癌患者外周血ＣＤ１３３表达对估计有无血行播散和远处转移有临床价值。