广西肝癌高发区原发性肝癌危险因素病因分值及其交互效应

Etiologic fraction and interaction of risk factors for primary hepatic carcinoma in Guangxi, China

目的探讨广西肝癌高发区原发性肝癌危险因素的病因分值及乙型肝炎病毒（HBV）感染与其他各危险因素问的交互效应。方法对广西500例原发性肝癌患者和500例非肿瘤患者进行以医院为基础的病例对照研究，在叉生分析和非条件logistic回归的基础上，分析了原发性肝癌危险因素的病因分值及HBV感染与其他各危险因素间的交互效应。结果HBV感染、肝癌家族史、糖尿病、食鱼生、饮酒、常用药物、经济收入差、精神压抑和B血型为广西肝癌高发区原发性肝癌的主要危险因素，病因分值分别为0．725、0．186、0．119、0．486、0．385、0．438、0．277、0．607、0．299；交互作用的病因分值分别为0．736、0．643、0．849、0．551、0．592、0．618、0．902、0．577。交互指数分别为0．743、0．651、0．853、0．560、0．600、0．626、0．907、0．586。结论HBV感染、肝癌家族史、糖尿病、食鱼生、饮酒、常用药物、经济收入差、精神压抑和B血型可能是原发性肝癌重要的危险因素；HBV感染与其他危险因素在原发性肝癌的发生中可能具有协同致病作用，能增加原发性肝癌的危险性。

Objective To explore etiologic fraetion（EF） and interaction of hepatitis B virus（HBV） infection and other risk factors for primary hepatoeellular carcinoma（PHC） in Guangxi, China. Methods A hospital-based ease-control study including 500 PHC patients and 500 nontumorous patients was carried out in Guangxi. EF and interactions of HBV infection and other risk factors for PHC were analyzed by crossover analysis and noneonditional multiple logistic regression. Results HBV infection, family history of PHC, diabetes mellitus, eating raw fish, heavy alcohol consumption, frequently used drug, low income, mental oppression and blood type B all were risk factors for PHC. With EFs of 0. 725,0. 186,0. 119,0. 486,0. 385, 0. 438,0. 277,0. 607,0. 299, respectively and with etiologic fractions attributable to interaction[ EF（ A × B） of 0. 736,0. 643,0. 849,0. 551,0. 592,0. 618,0. 902,0. 577 ; and indices of interaction of 0. 743,0. 651, 0. 853,0. 560,0. 600,0. 626,0. 907,0. 586, respectively. Conclusion Main risk factors for PHC might include HBV infection, family history of PHC, diabetes mellitus, eating raw fish, heavy alcohol consumption, frequently used drug, low income, mental oppression and blood type B. HBV infection with other risk factors might exert synergistic action on developing PHC and increase the risk of PHC.