HEPATITIS-B VIRUS, CIGARETTE-SMOKING AND ALCOHOL-CONSUMPTION IN THE DEVELOPMENT OF HEPATOCELLULAR-CARCINOMA - A CASE-CONTROL STUDY IN FUKUOKA, JAPAN
HEPATITIS-B VIRUS, CIGARETTE-SMOKING AND ALCOHOL-CONSUMPTION IN THE DEVELOPMENT OF HEPATOCELLULAR-CARCINOMA - A CASE-CONTROL STUDY IN FUKUOKA, JAPAN
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DOI：
10.1002/ijc.2910510402
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发表时间：
1992-06-19
影响因子：
6.4
通讯作者：
ISHIBASHI, H
中科院分区：
文献类型：
--
作者：
TANAKA, K;HIROHATA, T;ISHIBASHI, H
B型肝炎病毒（HBV）、吸烟和饮酒在肝细胞癌（HCC）病因学中的作用在一项病例对照研究中进行了研究，该研究涉及福冈县的204例HCC患者和410例对照受试者，福冈县HCC风险在日本是最高的。通过详细的访谈调查获得吸烟和饮酒习惯的信息，并在调整性别、年龄和其他可能的混杂因素后，结合血清B表面抗原（HBsAg）状态对结果进行分析。血清HBsAg阳性个体发生HCC的相对危险度（RR）为13.8（95%置信区间，CI 5.9至32.5），而重度饮酒者的风险比不饮酒者增加约2倍。然而，轻度或中度饮酒者的RR接近统一。与非吸烟者相比，在戒烟者（RR = 1.5，95% CI 0.8至2.8）和当前吸烟者（RR = 1.5，0.8至2.7）中观察到一些风险超额，但没有证据表明在包年方面存在剂量-反应关系。对HBsAg阴性受试者的分析显示，与吸烟无显著相关性，饮酒和吸烟对HCC风险无明显相互作用。其他重要的危险因素包括输血阳性史（RR = 3.7，2.2至6.3）和家族性肝病（RR = 2.6，1.6至4.2）。归因风险计算表明，慢性HBV感染和大量饮酒可能分别占肝癌发生率的17%和13%，在这个高风险地区。在我们的研究中，吸烟与肝癌的关系并不明显。
The roles of the hepatitis B virus (HBV), cigarette smoking and alcohol consumption in the etiology of hepatocellular carcinoma (HCC) were examined in a case-control study involving 204 patients with HCC and 410 control subjects in Fukuoka prefecture, where HCC risk is among the highest in Japan. Information on smoking and drinking habits was obtained by a detailed interview survey, and the results were analyzed in conjunction with serum hepatitis B surface antigen (HBsAg) status after adjustment for sex, age and other possible confounding factors. Individuals positive for serum HBsAg showed a relative risk (RR) for HCC of 13.8 (95% confidence interval, CI 5.9 to 32.5), whereas heavy drinkers experienced about a 2-fold risk increase compared with non-drinkers. Light or moderate drinkers, however, demonstrated RRs near the unity. Some risk excess was observed among ex-smokers (RR = 1.5, 95% CI 0.8 to 2.8) and current smokers (RR = 1.5, 0.8 to 2.7) compared with non-smokers, but without evidence for a dose-response relationship in terms of pack-years. Analysis among HBsAg-negative subjects revealed similar non-significant association with smoking, and there was no clear interaction between alcohol and cigarette consumption on HCC risk. Other significant risk factors included positive histories of blood transfusion (RR = 3.7, 2.2 to 6.3) and familial liver disease (RR = 2.6, 1.6 to 4.2). Attributable risk calculations suggest that chronic HBV infection and heavy drinking may account for 17% and 13% of HCC occurrence, respectively, in this high risk area. The association of cigarette smoking with HCC was not evident in our study.