Hepatitis C Virus Infection as a Risk Factor for Hepatocellular Carcinoma in Patients with Cirrhosis
Hepatitis C Virus Infection as a Risk Factor for Hepatocellular Carcinoma in Patients with Cirrhosis
复制标题
丙型肝炎病毒感染是肝硬化患者发生肝细胞癌的危险因素
DOI：
--
复制
发表时间：
1992
影响因子：
39.2
通讯作者：
L. Pagliaro
中科院分区：
文献类型：
--
作者：
R. Simonetti;C. Cammà;F. Fiorello;M. Cottone;M. Rapicetta;L. Marino;G. Fiorentino;A. Craxì;A. Ciccaglione;R. Giuseppetti;T. Stroffolini;L. Pagliaro
目标
确定慢性丙型肝炎病毒（HCV）感染是否是肝细胞癌的独立危险因素，以及是否会增加肝硬化相关的肝细胞癌风险。
设计
两项配对病例对照研究。
设置
转诊医院。
患者
在研究 I 中，将 212 名肝细胞癌患者（其中 197 名已知患有潜在肝硬化）与患有慢性非肝病的对照患者进行了比较。在研究 II 中，将 197 名患有肝细胞癌和肝硬化的患者与 197 名患有肝硬化但未患有肝细胞癌的配对对照进行了比较。
测量值
检测丙型肝炎病毒抗体（抗-HCV）、乙型肝炎表面抗原（HBsAg）和乙型肝炎核心抗原抗体（抗-HBc）水平，并根据病史评估酗酒情况。
主要结果
在研究 I 中，151 名肝细胞癌患者 (71%) 呈抗 HCV 阳性，而 11 名对照者 (5%) 患有慢性非肝脏疾病（比值比，42；95% CI，22 至 95）。多变量分析显示，抗-HCV 是肝细胞癌的独立危险因素（比值比，69；CI，15 至 308）。分析还显示，HBsAg（比值比，8.7；CI，1.5至50）和抗-HBc（比值比，4.2（CI，1.7至11））是肝细胞癌的危险因素。抗-HCV与HBV感染标志物之间没有发现统计学上显着的相互作用。在研究II中，146名患有肝细胞癌和肝硬化的患者（74%）被检测为肝细胞癌的危险因素。与 122 名单纯肝硬化患者 (62%) 相比，抗 HCV 呈阳性（优势比为 1.8；CI，1.1 至 2.8）。多变量分析证实，抗 HCV（优势比为 2.0；CI，1.3 至 32）和 HBsAg（优势比为 2.0；CI，1.0 至 4.2）是肝细胞癌的独立危险因素。癌。
结论
丙型肝炎病毒感染是肝细胞癌的危险因素，显然会诱发肝硬化，并在较小程度上增加肝硬化患者的风险。丙型肝炎病毒感染的作用与乙型肝炎病毒感染（另一个危险因素）以及酗酒、年龄或性别无关。
OBJECTIVE
To determine whether chronic hepatitis C virus (HCV) infection is an independent risk factor for hepatocellular carcinoma and whether it increases the cirrhosis-related risk for hepatocellular carcinoma.
DESIGN
Two pair-matched case-control studies.
SETTING
A referral-based hospital.
PATIENTS
In study I, 212 patients with hepatocellular carcinoma (197 of whom had known underlying cirrhosis) were compared with controls who had chronic nonhepatic diseases. In study II, the 197 patients with hepatocellular carcinoma and cirrhosis were compared with 197 pair-matched controls who had cirrhosis but not hepatocellular carcinoma.
MEASUREMENTS
Levels of antibody to HCV (anti-HCV), hepatitis B surface antigen (HBsAg), and antibody to hepatitis B core antigen (anti-HBc) were assayed, and alcohol abuse was assessed by history.
MAIN RESULTS
In study I, 151 patients (71%) with hepatocellular carcinoma were anti-HCV positive compared with 11 controls (5%) with chronic nonhepatic diseases (odds ratio, 42; 95% CI, 22 to 95). Multivariate analysis showed that anti-HCV was an independent risk factor for hepatocellular carcinoma (odds ratio, 69; CI, 15 to 308). The analysis also showed that HBsAg (odds ratio, 8.7; CI, 1.5 to 50) and anti-HBc (odds ratio, 4.2 (CI, 1.7 to 11) were risk factors for hepatocellular carcinoma. No statistically significant interaction was found between anti-HCV and the markers of HBV infection. In study II, 146 patients (74%) with hepatocellular carcinoma and cirrhosis were anti-HCV positive compared with 122 patients (62%) with cirrhosis alone (odds ratio, 1.8; CI, 1.1 to 2.8). Multivariate analysis confirmed that anti-HCV (odds ratio, 2.0; CI, 1.3 to 32) and HBsAg (odds ratio, 2.0; CI, 1.0 to 4.2) were independent risk factors for hepatocellular carcinoma.
CONCLUSIONS
Hepatitis C virus infection is a risk factor for hepatocellular carcinoma, apparently by inducing cirrhosis and, to a lesser extent, by enhancing the risk in patients with cirrhosis. Hepatitis C virus infection acts independently of HBV infection (another risk factor) and of alcohol abuse, age, or gender.
原发性肝细胞癌——病因、发病机制和预防。
影响因子：
3.3
作者：
London,WT
通讯作者：
London,WT
DOI：
--
发表时间：
1990
期刊：
JAMA : the journal of the American Medical Association
影响因子：
--
作者：
Stevens,CE;Taylor,PE;Pindyck,J;Choo,QL;Bradley,DW;Kuo,G;Houghton,M
通讯作者：
Houghton,M