饮酒习惯、HBsAg与原发性肝癌关系

[目的]探索肝癌高发区泰兴地区饮酒习惯、HBsAg与原发性肝癌(HCC)的关系.[方法]选择208例原发性肝癌新发病例按性别、年龄和居住地进行以人群为基础1:1配对病例对照研究,采用ELISA方法检测研究对象血清中HBsAg,相关数据单因素分析采用Epi-Info,多因素分析采用SAS非条件Logistic回归.[结果]原发性肝癌病例组HBsAg阳性率(72.12%)显著高于对照组(22.12%)(R<0.0001).单因素分析结果表明,HBsAg阳性、慢性肝炎、肝硬化和血吸虫病显著增加了泰兴市居民患肝癌的危险性.多因素分析结果显示,HBsAg阳性和慢性肝炎仍然是肝癌的主要危险因素(OR值分别为7.317,6.694).将饮酒习惯与HBsAg阳性结合分析发现,饮酒对HBsAg阳性在肝癌发生中可能有放大效应.[结论]HBsAg阳性和个人肝病史是泰兴地区HCC高发的非常重要的因素,酒精对HBV在致HCC方面有协同作用.

The Impact of Alcohol Drinking Habit and HBsAg on the Risk of Hepatocellular Carcinoma in Taixing City

To explore the relationship between alcohol drinking habit,hepatitis B surface antigen (HBsAg) and hepatocellular carcinoma (HCC) in Taixing City.A case-control study including 208 cases with HCC and 208 controls matched with sex, age and resident area was carried out in Taixing City of Jiangsu Province,China.Blood samples were collected and tested for serum HBsAg by ELISA.The Epi-Info Software and Statistical Analysis System Software(SAS) were used for data analysis.The positive rate of serum HBsAg in HCC group was much higher than that in controls (72.12% vs 22.12%, P<0.0001). Univariate analysis showed that HBsAg positive, chronic hepatitis, hepatocirrhosis and schistosomiasis could increase the risk of HCC.Multi-rariate analysis with unconditional Logistic regression showed that HBsAg positive and chronic hepatitis were also the significant risk factors of HCC(OR=7.317 and 6.694).Both HBsAg positive and habitual alcohol drinking were associated with a significantly higher risk of HCC.[Conclusion]HBsAg positive and the history of liver diseases are the important risk factors of HCC in Taixing City.HBV infection and alcohol intake have synergism in carcinogenesis for HCC.