肝癌高发地区人群黄曲霉毒素暴露水平的评估

目的：通过对我国原发性肝癌高发区居民进行较为全面的黄曲霉毒素（AFT）暴露水平的评估，为进一步研究AFT与肝癌的关系提供依据。方法：选择甲地（广西扶绥县竹琴村）、乙地（江苏启东通兴乡）丙地（启东天汾镇）作为调查地区，应用AFT生物标记物的检测，对人群AFT暴露水平进行评估。结果：食物结构调查表明，甲地居民以玉米为主食，乙地和丙地居民则以大米为主食，粮食中黄曲霉毒素B1（AFB1）的污染水平以甲地最为严重，居民膳食中AFB1的摄取量即AFT外暴露水平，血清中AFB1-白蛋白（AFB1-ALB）加合物水平，肝癌发病率均以甲地最高，丙地最低，且有显著性差异。结论：AFT外接触水平高的居民，AFB1-ALB加合物水平，尿中AFM1水平亦高，说明两者是反映AFB1外接触剂量的良好指标，在现有膳食结构条件下，AFT暴露仍是肝癌危险因素之一。

Assessment of aflatoxin exposure in residents with high incidence of liver cancer

Objective To evaluate the aflatoxin(AFT) exposure level accurately with combination of the external dose,internal dose and biologically effective dose.Methods Three sites and three groups of residents were selected in the study:Site A,Zhuqin Village,Fusui County,Guangxi Zhuang Autonomous Region.Site B,Tongxing Township,and Site C,Tianfen Township,Qidong City,Jiangsu Province,are bordering.Results Based on measured AFT biomarkers including data of aflatoxin B 1(AFB 1) in food,AFB 1?albumin adducts in serum,and urinary AFT metabolites,these study sites(A?C) were classified into high(A),middle(B),and low(C) in overall AFT exposure,which is correlated to the hepatocellular carcinoma(HCC) incidence in the residents studied.Conclusion The AFT exposure still is an important risk factor for HCC under the current dietary patterns.Participants who had higher external aflatoxin exposure in food usually had higher level of serum aflatoxin albumin adducts and aflatoxin M 1(AFM 1) in urine,the levels of serum aflatoxin albumin adducts and AFM 1 in urine are good indexes reflecting the aflatoxin exposure.