Incidence of extrahepatic cancers among individuals with chronic hepatitis B or C virus infection: A nationwide cohort study
Incidence of extrahepatic cancers among individuals with chronic hepatitis B or C virus infection: A nationwide cohort study
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DOI：
10.1111/jvh.13304
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发表时间：
2020-05-18
影响因子：
2.5
通讯作者：
Gwak, Geum-Youn
中科院分区：
文献类型：
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作者：
Hong, Chai Yeong;Sinn, Dong Hyun;Gwak, Geum-Youn
这项研究探讨了慢性 HBV 或 HCV 感染与肝外癌症风险之间的关联。 2003 年至 2013 年间，韩国国民健康保险公团国家样本队列中共有 537 103 名 20 岁以上无癌症病史的成年人。比较了有和没有慢性 HBV 或 HCV 感染者之间的癌症发病率差异。在 3 854 130 人年的随访期间（中位随访时间：8.0 年），19 089 名参与者患上了癌症。调整性别、体重指数、吸烟、饮酒、收入百分位数、居住区域和合并症后，慢性 HBV 感染（HR：1.27，95% 置信区间 [CI]：1.20-1.35）、HCV 感染（HR：1.31，95% CI：1.16-1.48）或 HBV/HCV 双重感染的参与者发生肝外癌症的风险比（HR）显着更高与未感染 HBV 或 HCV 的参与者相比，感染率较高（HR：1.41，95% CI：1.31-1.72）。在慢性乙型肝炎病毒感染中，血液系统恶性肿瘤[HR (95% CI) = 2.46 (1.92-3.15)]、胆囊[1.55 (1.05-2.29)]、胰腺[1.52 (1.07-2.15)]、胃[1.39 (1.22-1.58)]、肺癌[1.27]的癌症风险较高。 (1.04-1.55)]、结直肠癌[1.21 (1.03-1.42)]和甲状腺癌[1.20 (1.05-1.36)]。在慢性HCV感染中，睾丸癌[10.34（1.35-79.78）]、胆囊癌[2.90（1.62-5.18）]、前列腺癌[2.51（1.65-3.82）]和甲状腺癌[1.46（1.10-1.93）]的癌症风险较高。总之，慢性 HBV 或 HCV 感染不仅与肝癌风险增加相关，而且与多种肝外癌症风险增加相关。
This study examined the association between chronic HBV or HCV infection and the risk of extrahepatic cancers. A total of 537 103 adults aged >= 20 years without history of cancer were identified from the Korean National Health Insurance Service-National Sample Cohort between 2003 and 2013. The difference in cancer incidence was compared between those with and without chronic HBV or HCV infection. During 3 854 130 person-years of follow-up (median follow-up: 8.0 years), 19 089 participants developed cancer. After adjusting for sex, body mass index, smoking, drinking, income percentile, residential area and comorbidities, hazard ratios (HRs) for incident extrahepatic cancer were significantly higher in participants with chronic HBV infection (HR: 1.27, 95% confidence interval [CI]: 1.20-1.35), HCV infection (HR: 1.31, 95% CI: 1.16-1.48) or HBV/HCV dual infection (HR: 1.41, 95% CI: 1.31-1.72) compared to participants without HBV or HCV infection. In chronic HBV infection, the cancer risk was higher for haematologic malignancy [HR (95% CI) = 2.46 (1.92-3.15)], gallbladder [1.55 (1.05-2.29)], pancreas [1.52 (1.07-2.15)], stomach [1.39 (1.22-1.58)], lung [1.27 (1.04-1.55)], colorectum [1.21 (1.03-1.42)] and thyroid cancer [1.20 (1.05-1.36)]. In chronic HCV infection, the cancer risk was higher for testis [10.34 (1.35-79.78)], gallbladder [2.90 (1.62-5.18)], prostate [2.51 (1.65-3.82)] and thyroid cancer [1.46 (1.10-1.93)]. In conclusion, chronic HBV or HCV infection was not only associated with an increased risk of liver cancer, but also associated with an increased risk of multiple extrahepatic cancers.