Risk factors for hepatocellular carcinoma in a Japanese population: A nested case-control study
Risk factors for hepatocellular carcinoma in a Japanese population: A nested case-control study
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DOI：
10.1158/1055-9965.epi-07-2806
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发表时间：
2008-04-01
影响因子：
3.8
通讯作者：
Chayama, Kazuaki
中科院分区：
文献类型：
--
作者：
Ohishi, Waka;Fujiwara, Saeko;Chayama, Kazuaki
背景：流行病学研究表明，与生活方式相关的因素对肝细胞癌的风险有影响。然而，很少有队列研究严格而深入地将乙肝病毒(乙肝病毒)和丙型肝炎病毒(丙型肝炎病毒)感染结合在一起，或者研究这些因素之间的协同作用。方法：我们在原子弹幸存者的纵向队列中，使用肝细胞癌诊断前储存的血清进行嵌套病例对照研究。224例肝细胞癌患者和644例对照在性别、年龄、城市、血清保存时间和血清保存方法上匹配，在辐射剂量上相反。结果：单因素分析显示，乙肝病毒和丙型肝炎病毒感染、饮酒、吸烟、体重指数(BMI)和糖尿病与肝细胞癌风险增加有关，而喝咖啡与降低肝细胞癌风险相关。诊断前10年，单纯乙肝病毒感染、单纯丙型肝炎病毒感染、同时感染丙型肝炎病毒、每天饮酒40g、体重指数25.0 kg/m(2)的多因素相对危险度分别为45.8(15.2~138)、101(38.7~263)、70.7(8.3~601)、4.36(1.48~13.0)和4.57(1.85~11.3)。即使在调整了肝纤维化的严重程度后，乙肝病毒和丙型肝炎病毒感染以及体重指数为25.0 kg/m(2)仍然是独立的危险因素。在丙型肝炎病毒感染者中，体重指数每增加1 kg/m(2)，患肝细胞癌的相对风险为1.39(P=0.003)。结论：控制超重对慢性肝病患者，特别是慢性丙型肝炎患者来说，可能是限制患肝细胞癌风险的关键。
Background: Epidemiologic studies have shown effects of lifestyle-related factors on risk for hepatocellular carcinoma. However, few cohort studies have incorporated, in a strict and in-depth manner, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections or investigated synergism between such factors.Methods: We conducted a nested case-control study using sera stored before hepatocellular carcinoma diagnosis in the longitudinal cohort of atomic bomb survivors. The study included 224 hepatocellular carcinoma cases and 644 controls that were matched to the cases on gender, age, city, time of serum storage, and method of serum storage, and countermatched on radiation dose.Results: Univariate analysis showed that HBV and HCV infections, alcohol consumption, smoking habit, body mass index (BMI), and diabetes mellitus were associated with increased hepatocellular carcinoma risk, whereas coffee drinking was associated with decreased hepatocellular carcinoma risk. Multivariate relative risks of hepatocellular carcinoma (95% confidence interval) were 45.8 (15.2-138), 101 (38.7-263), 70.7 (8.3-601), 4.36 (1.48-13.0), and 4.57 (1.85-11.3), for HBV infection alone, HCV infection alone, both HBV and HCV infections, alcohol consumption of >= 40 g of ethanol per day, and BMI of >25.0 kg/m(2) 10 years before diagnosis, respectively. HBV and HCV infection and BMI of >25.0 kg/m(2) remained independent risk factors even after adjusting for severity of liver fibrosis. Among HCV-infected individuals, the relative risk of hepatocellular carcinoma for a 1 kg/m(2) increase in BMI was 1.39 (P = 0.003).Conclusions: To limit the risk for hepatocellular carcinoma, control of excess weight may be crucial for individuals with chronic liver disease, especially those with chronic hepatitis C.