HBV与HCV在HCC高危人群中的病因学作用

本文对在在启东、泰兴原发性肝细胞癌（ＨＣＣ）高发区随机抽取的１４０份ＨＣＣ病例和２４７份对照资料，进行了乙型肝炎病毒（ＨＢＶ）、丙型肝炎病毒（ＨＣＶ）感染与ＨＣＣ关系的病因学研究。结果显示：病例ＨＢＶ总感染指标和抗－ＨＣＶ的ＯＲ值为４．６７，多元非条件Ｌｏｇｉｓｔｉｃ回归分析显示：在ＨＢＶ感染指标中，以ＨＢｓＡｇ，抗－ＨＢｃ和前Ｓ２蛋白３指标的意义较大，均入选多元模型，抗－ＨＣＶ也作为ＨＣＶ感染的唯一指标入选多元模型Ａ，且两模型的拟合较满意，说明两者的感染均对ＨＣＣ的发生有一定的病因学作用，ＨＢＶ和ＨＣＶ混合感染的ＯＲ值为７．８４２，约等于两者分别感染的ＯＲ值之积，说明两者之间有一定的协同作用。ＰＡＲ指标的分析表明，ＨＢＶ和ＨＣＶ的综合ＰＡＲ值在７３．６４％～７５．１１％之间，抗－ＨＣＶ的ＰＡＲ值为１１．４６％，即如能有效控制人群ＨＢＶ和ＨＣＶ的感染率，将使该地ＨＣＣ的发病数减少７５％左右，其中由ＨＣＶ感染引起的ＨＣＣ病例约占１１．４６％，说明该地ＨＢＶ的感染仍为ＨＣＣ的主要病因因素，ＨＣＶ感染的病因作用次之。

Etiologic Value Of HBV and HCV Infection in HCCHigher Risk Population-A Result of Case-control multiple Logistic Regression Analyses

HCC patients and 247 controls who were randomly sampled in Qidong and Taixin-HCC higher incidence areas of China were analysed about the etiologic relation between HBV. HCV infectio' and the oecurance of HCC. The results showed that the epidemic rate of HBV and the positive rate of anti-HCV were all significantly higher than that in controls.The OR value of HBV infection were from 2. 63 to 9. 63,OR of anti-HCV was 4. 67. Multiple non-conditional logisticregression model showed that HBsAg, anti-HBC and Pre-S2which had more important etiologic value were elected in the model. Anti-HCV as the only index of HCV infection was alsobeen enrolled in model A. It means that both HBV and HCVinfection were important agents of HCC in these areas. The coinfection OR value of HBV and HCV 7. 842, which was about the same as two on value in HBV and HCV infection times each other. PAR analysis showed that the total PAR value was between 73. 64%and 75.11%,while the PAR of anti-HCV was only 11. 46%. It suggested that if we would control the prevalence of HBV and HCV infection at the same time, the occurance of HCC in these areas would decreaseabout 75%. It is a very effective treasure.