山西省原发性肝癌丙型肝炎病毒、乙型肝炎病毒感染状况分析

目的　探讨山西地区原发性肝癌（ＰＨＣ） 中丙型肝炎病毒（ＨＣＶ） 和乙型肝炎病毒（ＨＢＶ） 感染状况。方法　选择以山西省肿瘤医院为主的省级４ 所医院ＰＨＣ患者９８ 例，检测抗－ＨＣＶ、ＨＢｓＡｇ、抗－ ＨＢｓ、ＨＢｅＡｇ、抗－ ＨＢｅ、抗－ ＨＢｃ、抗－ ＨＢｃＩｇＭ 等指标，均采用ＥＬＩＳＡ 法进行测定。结果　ＰＨＣ 组抗－ ＨＣＶ 阳性率８．１６ ％ ，ＨＢＶ 感染率６８ ．３７％ ，均显著高于对照组的阳性率（ Ｐ＜０ ．０５） 。两者的病因分值（ＡＲＰ） 分别为９４％ 和９１ ％ 。经１∶２ 条件ｌｏｇｉｓｔｉｃ 多元回归分析，抗－ ＨＣＶ、ＨＢｓＡｇ 和抗－ ＨＢｃ 均作为独立的危险因素进入了回归方程，其ＯＲ值分别为５５ ．０６、１０ ．１８ 和９．８５ 。叉生分析结果表明，抗－ ＨＣＶ和ＨＢｓＡｇ 双阳性的ＯＲ值为６１ ．３７，较两指标单一阳性的ＯＲ值明显为高，亦高于两者单独阳性的ＯＲ值之和。结论　ＨＣＶ 和ＨＢＶ 感染均是ＰＨＣ发生的主要病原学因素。ＨＣＶ感染在致肝癌作用中，是当地不可忽视的重要因素，ＨＢＶ 仍是肝癌发生的主要因素。ＨＢＶ和ＨＣＶ双重感染对肝癌的发生具有协同作用。

Prevalence of HCV and HBV infection in patients with primary hepatocellular carcinoma in Shanxi Province

Objective To study the prevalence of hepatitis C and B viruses (HCV and HBV) infection in the patients with primary hepatocellular carcinoma (PHC) in Shanxi Province and evaluate their etiologic roles in the pathogenecity of PHC to lay a foundation for the prevention and control of it. Methods Ninety-eight patients with PHC and 196 non-PHC controls matched in age and sex were selected from the four hospitals at provincial level in Shanxi Province. Serum antibodies against HCV (anti-HCV),HBs (anti-HBs),HBe (anti-HBe) and HBc (anti-HBc), IgM-antibody against HBc (anti-HBc-IgM), HBsAg and HBeAg were determined for all of them with enzyme-linked immunosorbent assay (ELISA). Results Positivity for anti-HCV and rate of HBV infection were 8.16 % and 68.37 %, respectively, in the PHC patients,both significantly higher than those in the controls ( P <0.05), with attributable risk proportions of (ARP) 94% and 91%, respectively. Multiple conditional logistic regression analysis showed that positive serum anti-HCV, HBsAg and anti- HBc, as risk factors for PHC, all entered the regression model, with odds ratios (ORs) of 55.06 , 10.18 and 9.85 ,respectively. Dichotomized contingency table analysis showed that OR for those positive both for anti-HCV and HBsAg was 61.37 ,significantly higher than that for single positive of either one,with an additive effect. Conclusion It suggested that both HCV and HBV infection were main etiologic factors for PHC in local. HBV also was an important factor in the pathogenecity of PHC,especially in those with both positive for HBsAg and anti-HBc.Coinfection with HBV and HCV had an additive effect on PHC pathogenecity.