饮酒与原发性肝癌关系的调查——附吉林省1057例原发性肝癌病因学分析

To investigate the relationship of alcohol intake and primary hepatocellular carcinoma (The etiologic factor of 1057 PHC in JILIN province)

明确饮酒与肝炎病毒感染是否有协同致原发性肝癌的作用。采用病例对照研究的方法对吉林省 10 5 7例原发性肝癌患者及 3 171例非肝病患者的饮用酒精量和HBV/HCV感染状况进行比较。结果表明饮酒可增加患原发性肝癌的危险性 ,饮酒 ( 40 - 10 0 )g/d者OR值为 1 41,>10 0g/d为 3 0 4。饮酒可增加HBV、HCV感染者患原发性肝癌的危险性 ,饮酒 ( 40 - 10 0 )g/d的HBV感染者OR值为 18 82 ,>10 0g/d为 3 1 15 ;饮酒 ( 40 - 10 0 )g/d的HCV感染者OR值为 3 2 0 2 ,>10 0g/d为 47 63 ;饮酒 ( 40 - 10 0 )g/d的HBV、HCV重叠感染OR值为 79 3 9,>10 0g/d为12 1 42。 45 2例行HBV -DNA检测的患者中 ,非嗜酒史者阳性率为 2 6 15 % ,饮酒 ( 40 - 10 0 )g/d为 49 0 7% ,饮酒 >10 0g/d为 70 5 6% ;特别是HBsAg、抗 -HBc、抗 -HBe阳性的重度嗜酒者HBV -DNA阳性率最高为 78 2 1%。嗜酒可增加HBV、HCV及重叠感染者患原发性肝癌的危险性 ,酒精对HBV。

To definite the synergism between alcohol intake and hepatitis virus infection in causing with primary hepatocellular carcinoma (PHC) in Jilin province. A case-control study were performed to investigat alcohol intake and hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in 1057 newly diagnosed PHC cases and 3171 non-hepatic diseases admitted to the 3 main hospitals in Jilin province. The odds ratio (OR) for alcohol intake of (40-100)g/d and >100g/d was 1.41 and 3.04, respectively. The OR for alcohol intake of (40-100)g/d and >100g/d was 18.82 and 31.15 when patient infected HBV, 32.02 and 47.63 when patient infected HCV, respectively. The OR for alcohol intake of (40-100)g/d and >100g/d was 79.39 and 121.42 when patient coinfect HBV and HCV, respectively. In 452 patients who examined HBV-DNA, the positive rate of HBV-DNA with non-alcohol intake was 26.15% and increased to 49.07% and 70.56% with alcohol intake of (40-100)g/d and >100g/d, respectively. The positive rate of HBV-DNA was the highest (78.21%) in HBsAg and anti-HBc and anti-HBe positive with alcohol intake of >100g/d. Alcohol intake could increased the risk of causing PHC in patients who infected HBV or HCV or coinfect with HBV and HCV. Synergism was found between HBV infection and HCV infection and alcohol intake in causing PHC.