酒精合并病毒性肝损伤与肝癌的关系

Relationship of alcohol intake plus viral infection with the development of liver cancer

病毒性肝炎和酒精均是肝细胞癌(肝癌)致病的主要病因,慢性乙型肝炎病毒(hepatitis Bvirus,HBV)和丙型肝炎病毒(hepatitis C virus,HCV)感染引起肝癌的危险性为正常人10倍以上,饮酒引起肝癌危险性近2倍,病毒性肝炎伴饮酒危险性进一步增大.病毒和酒精协同作用的机制尚未完全清楚,在多数患者,两种因素均先通过肝硬化再进展为肝癌.预防肝炎病毒感染和控制饮酒是预防肝癌的最好手段,普及乙型肝炎疫苗接种已取得非常好的成绩.对慢性HBV和HCV感染者应抗病毒治疗,早期戒酒对预防肝癌的肯定有益,但尚没有足够证据支持戒酒可减低肝硬化向肝癌发展的风险.

Both viral hepatitis and alcohol have been proved to be the main causes of hepatocellular carcinoma （HCC）.Chronic hepatitis B virus/hepatitis C virus （HBV/HCV） infection increases the risk of HCC by more than 10 times and alcohol by about 2 times.A combination of viral infection and alcohol intake will further increase the risk of HCC.At present, the mechanism underlying such synergistic effect is not yet well understood.In the majority of patients, both factors cause HCC by inducing hepatic cirrhosis first.Control of HBV/HCV infection and withdrawal of alcohol are good approaches for HCC prevention.Vaccination against hepatitis B has achieved great success.Antiviral therapy should be recommended to patients with chronic HBV/HCV infection.Alcohol withdrawal should be started at early stage.There is no suff icient evidence to suggest that alcohol withdrawal could decrease the evolution of cirrhosis to HCC.