Hepatitis B virus infection and the risk of cancer among the Chinese population
Hepatitis B virus infection and the risk of cancer among the Chinese population
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中国人群乙型肝炎病毒感染与癌症风险
DOI：
10.1002/ijc.33130
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发表时间：
2020-07-16
影响因子：
6.4
通讯作者：
Li, Jun
中科院分区：
文献类型：
--
作者：
Tian, Ting;Song, Ci;Li, Jun
B型肝炎病毒（HBV）和非肝细胞癌之间的关系仍然没有定论。这项大型病例对照研究旨在评估HBV感染状态与多种癌症之间的关系。病例组（n = 50 392）和对照组（n = 11 361）于2008年至2016年在南京医科大学第一附属医院连续招募。通过调整年龄和性别，使用logistic回归估计多变量调整的比值比（aOR）和95%置信区间（95%CI）。还进行了基于已发表研究的荟萃分析，以验证相关性。其中，12.1%的病例和5.5%的对照组为B型肝炎表面抗原（HBsAg）血清阳性。我们观察到HBsAg血清阳性与食管癌之间存在显著相关性（aOR [95% CI] = 1.32 [1.13-1.54]），胃癌（1.46 [1.30-1.65]），肝细胞癌（HCC; 39.11 [35.08-43.59]），肝内和肝外胆管癌（ICC和ECC; 3.83 [2.58-5.67]和1.72 [1.28-2.31]）、胰腺癌（PaC; 1.37 [1.13-1.65]）、非霍奇金淋巴瘤（NHL; 1.88 [1.61-2.20]）和白血病（11.48 [4.05-32.56]）。此外，与HBsAg-/抗-HBs-/抗-HBc-受试者相比，HBsAg-/抗-HBs-/抗-HBc+受试者（表明既往HBV感染）患食管癌的风险增加（aOR [95% CI] = 1.46 [1.24-1.73]），胃癌（1.20 [1.04-1.39]），肝癌（4.80 [3.95-5.84]）和白血病（15.62 [2.05-119.17]）。总体荟萃分析也证实HBsAg阳性与胃癌显著相关（OR [95% CI] = 1.23 [1.14-1.33]），ICC（4.05 [2.78-5.90]）、ECC（1.73 [1.30-2.30]）、PaC（1.26 [1.09-1.46]）、NHL（1.95 [1.55-2.44]）和白血病（1.54 [1.26-1.88]）。总之，我们的病例对照研究和荟萃分析均证实了HBsAg血清阳性与胃癌、ICC、ECC、PaC、NHL和白血病的显著相关性。值得注意的是，我们的研究结果还表明，暴露于HBV的人患胃癌的风险增加。
The relationship between hepatitis B virus (HBV) and nonhepatocellular cancers remains inconclusive. This large case-control study aimed to assess the associations between HBV infection status and multiple cancers. Cases (n = 50 392) and controls (n = 11 361) were consecutively recruited from 2008 to 2016 at the First Affiliated Hospital of Nanjing Medical University. Multivariable adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were estimated using logistic regression by adjusting age and gender. A meta-analysis based on published studies was also performed to verify the associations. Of these, 12.1% of cases and 5.5% of controls were hepatitis B surface antigen (HBsAg) seropositive. We observed significant associations between HBsAg seropositivity and esophagus cancer (aOR [95% CI] = 1.32 [1.13-1.54]), stomach cancer (1.46 [1.30-1.65]), hepatocellular carcinoma (HCC; 39.11 [35.08-43.59]), intrahepatic and extrahepatic bile duct carcinoma (ICC and ECC; 3.83 [2.58-5.67] and 1.72 [1.28-2.31]), pancreatic cancer (PaC; 1.37 [1.13-1.65]), non-Hodgkin lymphoma (NHL; 1.88 [1.61-2.20]) and leukemia (11.48 [4.05-32.56]). Additionally, compared to participants with HBsAg-/anti-HBs-/anti-HBc-, participants with HBsAg-/anti-HBs-/anti-HBc+, indicating past HBV-infected, had an increased risk of esophagus cancer (aOR [95% CI] = 1.46 [1.24-1.73]), stomach cancer (1.20 [1.04-1.39]), HCC (4.80 [3.95-5.84]) and leukemia (15.62 [2.05-119.17]). Then the overall meta-analysis also verified that HBsAg seropositivity was significantly associated with stomach cancer (OR [95% CI] = 1.23 [1.14-1.33]), ICC (4.05 [2.78-5.90]), ECC (1.73 [1.30-2.30]), PaC (1.26 [1.09-1.46]), NHL (1.95 [1.55-2.44]) and leukemia (1.54 [1.26-1.88]). In conclusion, both our case-control study and meta-analysis confirmed the significant association of HBsAg seropositivity with stomach cancer, ICC, ECC, PaC, NHL and leukemia. Of note, our findings also suggested that the risk of stomach cancer elevated for people whoever exposed to HBV.