多发性骨髓瘤与HBV、HCV及EBV病毒感染的关系

The correlation between multiple myeloma and HBV,HCV and EBV infection

目的:探讨多发性骨髓瘤(multiple myeloma,MM)发病与乙肝病毒(HBV)、丙肝病毒(HCV)和EB病毒(EBV)感染之间的相关性。方法:采用多中心、以医院为基础的1∶1配对病例对照研究。265例MM病例来自西安市五家三级甲等医院血液科在2011年10月至2014年9月期间住院患者。对照来自同期、同院住院的非肿瘤患者,与病例在性别和年龄(±5岁)上匹配。ELISA方法检测研究对象血清中的HBs Ag、抗-HBc、抗-HCV和抗-EBV。应用Logistic回归分析不同病毒感染与MM发病的关联性。结果:MM组HBs Ag阳性率与对照组相比差异无显著性意义(7.55%vs 4.49%,P>0.05)。MM组抗-HBc阳性率明显高于对照组(45.82%vs 33.64%,P<0.01),OR值为1.66(95%CI:1.17~2.36)。将HBs Ag和抗-HBc合并分析发现两组差异有统计学意义(P<0.01),OR值1.82(1.28~2.58)。HCV和EBV病毒阳性率在两组之间的差异无统计学意义(P>0.05)。结论:HBV感染增加MM的发病风险,而HCV和EBV感染与MM发病风险无明显关联。

Objective: To explore the relationship between multiple myeloma( MM) and hepatitis B virus( HBV),hepatitis C virus( HCV) and Epstein- Barr virus( EBV) infection. Methods: A multicenter,hospital-based,1∶ 1 matched case- control study was adopted. A total of 2 6 5 MM cases were selected from 5 hospitals in Xi’an,China from October 2011 to September 2014. Patients without tumor were included in the control group from the same hospitals,matched with cases in gender and age( ± 5 years of age). Seral HBs Ag,anti- HBc,anti- HCV and anti- EBV were detected by ELISA. Logistic regression was used to analyze the correlation of different virus infection to MM. Results: HBs Ag positive rate( 7. 55%) in the MM group had no significant difference compared with the control group( 7. 55% vs 4. 49%,P > 0. 05). Anti- HBc positive rate was significantly higher compared with the control group( 45. 82% vs 33. 64%,P < 0. 01) with an OR 1. 66( 95% CI: 1. 17 ~ 2. 36). Combined analysis of HBs Ag and anti- HBc showed that the difference between the two groups had statistical significance( P < 0. 01) OR 1. 82( 1. 28~ 2. 58). HCV and EBV infection between the two groups were not different significantly( P > 0. 05). Conclusion:HBV infection increases the risk of MM incidence,whereas HCV and EBV infection have no correlation to MM.