乙型肝炎病毒和丙型肝炎与原发性肝癌的研究

目的 研究原发性肝癌（PHC）病人乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）血清学标志的分布状况.方法 选择全市40家医院收治住院确诊PHC患者100例,用ELISA法进行HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc和抗-HCV检测.结果 PHC组HBV和抗-HCV的感染率分别为89.0％和8.0％,与对照组相比,均有非常显著性意义（p＜0.001）,两者的病因（ARP）分值分别为93.0％和88.0％.HBV血清学标志在PHC的分布较高的是HBsAg、抗-HBc和HBsAg、HBeAg、抗-HBc及HBsAg、HBeAg这三个组合.协同作用分析结果显示HBsAg、抗-HCV同时阳性者的OR值为46.28,较两指标单一阳性的OR值明显为高,也高于两者单独阳性的OR值之和.结论 HBV和HCV感染均是PHC发生的主要病原学因素.HBV是肝癌发生的主要因素.HCV感染是导致肝癌又一重要因素不可忽视.HBV和HCV双重感染对肝癌发生具有催化作用.

Objective To study the deposition state of HCV and HBV in the patients with Primary Hepatocellular Carcinoma（PHC）. Methods Onehundred patients were selected from the forty hospitals in whole county.Serum antinodies against HCV（anti-HCV）, HBs（anti- HBs）, HBe（anti- HBe）and HBc（anti- HBc）, HBsAg were determined for all if them with enzyme linked immunosorbent assay（ELISA）. Results Posrtivity for anti-HCV and rate of HBV infection were 89.0%and8.0%, respectively,in the PHC patients, both significantly higher thabn those in the controls（P〈0.05）,with attributable risk proportions of （ARP）93.0% and 88.0%. The three higher combination of serological markers deposited in PHC are HBsAg and anti-HBc, HBsAg HBeAg and anti- HBc, HBsAg HBeAg.Dichotomized contingency table analysis showed that OR for those positive both for anti-HCV and HBsAg was 13.8,significantly higher than that for single positive of either one,with an additive effect.Conclusion It suggested that both HCV and HBV infection were main etiologic factors for PHC.HBV slso was an important factor in the pathogenecity of PHC, especially in thosewith both positive for HBsAg and anti- HBc. Coinfection with HBV and HCV had an additive effect in PHC pathogenecity.The three more dangerous combination are HBsAg and anti- HBc, HBsAg.HBeAg anti- HBc, HBsAg.HBeAg.