HBsAg携带及肝癌家族史与原发性肝癌发病年龄的相关性分析

Analysis of association of hepatitis B virus infection and family history of hepatocellular carcinoma with age at primary liver cancer

目的：探讨乙型肝炎病毒表面抗原（HBsAg）携带及肝癌家族史与高发区原发性肝癌发病年龄的关系。方法以1359例启东籍原发性肝癌住院病例为研究对象，分析 HBsAg 携带及肝癌家族史与发病年龄的相关性及相互间的协同作用。结果肝癌患者中男性1053例，女性306例，发病年龄20～84岁，平均（54.02±10.47）岁。HBsAg 阳性肝癌平均发病年龄比 HBsAg 阴性肝癌提前9.24岁（51.99岁：61.23岁，t =13.51，P =0.000）；有肝癌家族史肝癌比无肝癌家族史肝癌提前2.70岁（52.53岁：55.23岁，t =4.839，P =0.000），差异均有统计学意义。HBsAg 阳性肝癌中，平均发病年龄男性低于女性（51.18岁：54.89岁，t =5.353，P =0.000），有家族史患者低于无家族史患者（51.33岁：52.62岁， t =2.233，P =0.026）；HBsAg 阴性肝癌中，虽然平均发病年龄男性与女性相比（60.83岁：62.45岁）、有家族史与无家族史相比（59.58岁：61.92岁）都有所提前，但差异均无统计学意义（t =1.126，P =0.261；t =1.728，P =0.085）。结论启东地区 HBsAg 携带使原发性肝癌平均发病年龄显著提前。性别和肝癌家族史在 HBsAg 阳性肝癌中与发病年龄密切相关，在 HBsAg 阴性肝癌中对发病年龄影响不显著。

Objective To explore the relationship of hepatitis B virus surface antigen（HBsAg）infec-tion and family history of hepatocellular carcinoma（HCC）with age at primary liver cancer. Methods Totally 1 359 cases of primary liver cancer were enrolled. Their data of sex,HBsAg status and family history informa-tions of liver cancer were analyzed on the associations with diagnosis age. Results Of the 1 359 cases,1 053 were males and 306 were females,their average age at diagnosis was（54. 02 ± 10. 47）years（20-84 years）. For HBsAg positive cases,the average age at diagnosis was 51. 99,significantly younger than that of HBsAg negative cases（61. 23）,t = 13. 51,P = 0. 000. Cases with family history of HCC were diagnosed at a signifi-cantly earlier age than those without family history（52. 53 vs 55. 23,t = 4. 389,P = 0. 000）. In HBsAg posi-tive cases,the average age at diagnosis showed a significant difference not only between males and females （51. 18 vs 54. 89,t = 5. 353,P = 0. 000）,but also between cases with family history and cases without family history（51. 33 vs 52. 62,t = 2. 233,P = 0. 026）. In HBsAg negative cases,the average age at diagnosis of males and females were 60. 83 and 62. 45 respectively（t = 1. 126,P = 0. 261）. The average age at diagnosis of cases with family history and cases without family history were 59. 58 and 61. 92 respectively（t = 1. 728,P =0. 085）,both showed no significant difference. Conclusion Cases of primary liver cancer with positive-HBsAg are diagnosed averagely 9. 24 years younger than those with negative-HBsAg in Qidong. Sex and family history of HCC significantly advance hepatocarcinogenesis only in HBsAg positive individuals,not in HBsAg negative individuals.