Hepatitis viruses, alcohol, and tobacco in the etiology of hepatocellular carcinoma in Italy
Hepatitis viruses, alcohol, and tobacco in the etiology of hepatocellular carcinoma in Italy
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DOI：
10.1158/1055-9965.epi-05-0702
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发表时间：
2006-04-01
影响因子：
3.8
通讯作者：
Talamini, R
中科院分区：
文献类型：
--
作者：
Franceschi, S;Montella, M;Talamini, R
与其他西方国家相比，意大利的肝细胞癌（HCC）死亡率较高。为了进一步阐明乙型肝炎病毒 (HBV)、丙型肝炎病毒 (HCV)、饮酒和吸烟在 HCC 病因中的作用，我们在意大利东北部的波代诺内省和南部那不勒斯镇这两个地区开展了一项以医院为基础的病例对照研究。 1999 年至 2002 年间，共有 229 名 HCC 病例（中位年龄 66 岁）和 431 名对照者（中位年龄 65 岁）回答了问卷并提供了血液样本。使用无条件多元逻辑回归计算优势比 (OR)、可归因风险百分比和相应的 95% 置信区间。乙型肝炎表面抗原 (HBsAg) 阳性与 HBsAg 阴性以及抗 HCV 抗体阳性与抗 HCV 抗体阴性的 OR 分别为 20.2 和 15.6。两种标记物的阳性与 OR 为 51.6 相关。对一部分 HCC 病例的血清应用灵敏的分子技术，发现极少数隐匿性肝炎。一生最大酒精摄入量 >= 35 杯与每周 < 7 杯相比，HBV/HCV 调整后的 OR 为 5.9。总体而言，吸烟与肝癌风险无关，但似乎会增加病毒携带者的肝癌风险。总体而言，61% 的 HCC 归因于 HCV，13% 归因于 HBV，18% 归因于酗酒。总之，我们的研究证实了 HCV 在意大利 HCC 病因学中的重要性，该病毒的广泛传播可以追溯到四五年前。
Mortality rates of hepatocellular carcinoma (HCC) are high in Italy compared with other Western countries. To elucidate further the role of hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol drinking, and tobacco smoking in the etiology of HCC, we carried out a hospital-based case-control study in two areas of Italy: the province of Pordenone in the Northeast and the town of Naples in the South. A total of 229 HCC cases (median age, 66 years) and 431 controls (median age, 65 years) answered a questionnaire and provided blood samples between 1999 and 2002. Odds ratios (OR), percent attributable risks, and corresponding 95% confidence intervals were computed using unconditional multiple logistic regression. ORs for hepatitis B surface antigen (HBsAg) positive versus HBsAg negative and for anti-HCV antibody positive versus anti-HCV antibody negative were 20.2 and 15.6, respectively. Positivity for both markers was associated with an OR of 51.6. Sensitive molecular techniques applied to sera in a subset of HCC cases disclosed a very small number of occult hepatites. Maximal lifetime alcohol intake of >= 35 versus < 7 drinks/wk was associated with an HBV/ HCV adjusted OR of 5.9. Tobacco smoking was unrelated to HCC risk overall but seemed to enhance HCC risk among virus carriers. Overall, 61% of HCC were attributable to HCV, 13% to HBV, and 18% to heavy alcohol drinking. In conclusion, our study confirms the importance of HCV in HCC etiology in Italy where the widespread dissemination of the virus dates back four or five decades.