乙型肝炎肝硬化并发原发性肝癌的危险因素评估

目的评估以乙型肝炎肝硬化并发原发性肝癌的危险因素,为预防肝癌提供参考依据。方法采用3∶1病例对照研究,回顾性分析肝癌相关性危险因素。观察组为我科住院的乙型肝炎肝硬化并发原发性肝癌患者330例,对照组为同期住院的乙肝肝硬化病程≥10年的患者110例。结果通过单因素、多因素非条件Logistic回归分析,最终有5个因素进入多因素非条件Logistic回归模型,包括长期吸烟史,糖尿病,未抗病毒治疗,HBV DNA阳性,HBsAg、抗-HBe、抗-HBc伴HBV DNA同时阳性,OR值及95%CI分别为2.495(1.293～4.816)、18.167(2.261～145.950)、0.185(0.100～0.343)、1.184(1.072～1.308)、2.916(2.041～4.165)。结论乙肝肝硬化患者如伴随HBV DNA阳性,尤HBsAg、抗-HBe、抗-HBc伴HBV DNA同时阳性,长期吸烟史,糖尿病者是原发性肝癌高危人群,抗病毒治疗在一定程度上可减少此危险性。

Risk factors for hepatocellular carcinoma in patients with liver cirrhosis

Objective To evaluate the risk factors hepatocellular carcinoma(HCC) due to LC,in order to provid prevention references.Methods 3 ∶ 1 case-control study was analysed the related-risks for HCC retrospectiverly.330 HCC patients in observation group and 110 patients with course of the LC disease for over 10 years in the control group were both admitted to the first affiliated hospital of Anhui medical university in the same period.Results By univariate analysis and muiltiple logistic regression analysis,five factors were involved in the mode of muiltiple logistic regression analysis,including long-term smoking history,diabetes mellitus(DM),anti-HBV therapy,hepatitis B virus(HBV) replication,HBeAg-negative accompanied by HBV replication,which had close relations with hepatocarcinogenesis.The odds ratio(OR) values were 2.495(1.293～4.816),18.167(2.261～145.95),0.185(0.100～0.343),1.184(1.072～1.308),2.916(2.041～4.165),respectively.Conclusion Patients with LC accompanied with HBV DNA positive,especially HBsAg,anti-HBe,anti-HBc accompanying with HBV DNA positive,long-term smoking history as well as diabetes are populations of primary hepatic carcinoma at higher risk,while the risk can be reduced by antiviral therapy.