原发性肝癌与HBV\HCV感染关系(1)
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[摘要] 目的：了解乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)在原发性肝细胞癌(HCC)发生中的作用以及两种病毒的相互关系。方法：168例HCC组和182例正常组的配对对照研究。结果：HCC组中HBV-DNA和HCV-RNA阳性率分别为74.4%及11.9%，显著高于对照组的10.4%和3.3%，HBV-DNA或HCV-RNA阳性以及两者均阳性时发生HCC的相对危险度分别为52.7、30.2和84.0。此外，原发性肝癌还与既往肝硬化史、家族肝癌史有关，且以男性高发。结论：原发性肝癌的发生受多种因素影响，尤其HBV和(或)HCV慢性感染是主要危险因素之一。 HBV感染除可能有直接致癌作用外，还可与HCV有协同致癌作用。
[关键词] 原发性肝癌；乙型肝炎病毒；丙型肝炎病毒；危险因素
[中图分类号] R735.7 [文献标识码] B[文章编号] 1673-7210(2010)11(c)-042-02
Relationship between primary hepatocellular carcinoma and HBV, HCV infection
KUANG Jiaxi, GAN Hongwen, LI Rongjiao, HU Jimei, HUANG Chuoyu
(Clinical Laboratory, the Centre Hospital of Conghua City, Guangdong Province, Conghua510900, China)
[Abstract] Objective: To know effect of chronic hepatitis B virus (HBV) and chronic hepatitis C virus (HCV) infection on hepatocellular carcinoma(HCC) and their relation. Methods: HBV-DNA and HCV-RNA values were obtained from 168 patients with HCC (HCC group) and 182 healthy individuals (control group). Results: Positive rate of HBV-DNA and HCV-RNA was 74.4% and 11.9% in HCC group remarkably higher 10.4% and 3.3% in control group, HCV-RNA carriage was present in of HCC patients and 3.3% of healthy individuals. Increased HCC risk was strong associated with chronic HBV (52.7), HCV (30.2), and dual infection (84.0). The same difference existed in HCV infection. Moreover, the history of hepatitis B and cirrhosis were also found relating to HCC. Conclusion: There are several factors relative to HCC, and the main risk factors are HBV and HCV infection. In addition to nature of risk with coinfection as representative of HBV and HCV acting primarily through share steps in the multistage process of hepatocarcinogenesis.
[Key words] Hepatocellular carcinoma; Hepatitis B virus; Hepatitis C virus; Risk factor
原发性肝细胞癌(HCC)是许多国家常见的恶性肿瘤之一，原发性肝细胞癌(HCC)病因十分复杂，迄今尚未完全阐明。近年来，肝细胞性肝癌的流行病学研究显示，除了乙型肝炎病毒(HBV)感染、黄曲霉素污染等以外，肝癌的发生还与丙型肝炎病毒(HCV)的感染有关。研究结果表明，肝癌的发生与环境因素有密切关系，其中乙型肝炎病毒(HBV)感染、丙型肝炎病毒(HCV)感染、不良生活方式(如吸烟饮酒)及环境致癌因素暴露(如黄曲霉毒素)等是导致肝癌的重要原因[1-2]。为了解本地区城乡原发性肝癌发生的危险因素，尤其是HBV、HCV感染与原发性肝癌的关系，笔者对168例肝细胞癌患者进行了乙型肝炎病毒感染检查，现报道如下：
1 对象与方法
1.1 研究对象
1.1.1 HCC组明确诊断为原发性肝细胞癌患者168例，诊断根据病理组织学或细胞学检查证实为肝细胞性肝癌和(或)血清AFP>400 ng/ml，B超和(或)CT示肝脏占位性病灶。168例患者中，男111例，女57例；年龄24～78岁，平均61.4岁；其中120例为病理诊断，48例为临床确诊。
1.1.2 对照组随机选择同期常规体检自然人群，男142例，女40例；年龄23～82岁，平均61.0岁。
1.2 HBV和HCV感染指标检测
标本采集与保存空腹抽取新鲜血标本 ......
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