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Hepatocarcinogenetic Studies in Myanmar Thalassemiacs

缅甸地中海贫血患者的肝癌发生研究

基本信息

批准号：
08042005
负责人：
OKADA Shigeru
金额：
$ 5.82万
依托单位：
OKAYAMA UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for international Scientific Research
财政年份：
1996
资助国家：
日本
起止时间：
1996 至 1997
项目状态：
已结题

项目摘要

The aim of the present study is to make the epidemiological survey on the prevalence of iron overload and hepatocellular carcinoma (HCC)among Myanmar population, and clarify the association of iron overload with other factors such as hepatitis B and C virus (HBV and HCV) infection in the development of HCC.The survey was conducted from 24 December 1996 to 7 January 1997, and from 17 to 27 December 1997 at the Department of Medical Research ; the Section of Hepatology and Haematology, Yangon General Hospital ; and the Yangon Children's Hospital. 104 patients including 28 patients of HCC,38 thalassemiacs were surveyed. Their blood was collected with consent from the patients.The results were :l) Hepatitis virus markers : 94% of the liver patients had the past history of HBV infection. Persistent HBV infection was found in 36 patients (35%). HCV-RNA positivity that means persistent HCV infection was 79% among anti-HCV antibody positive patients. 31% of the total patients was suspected to have persistent HCV infection. 46% of HCC was related to HBV only was, 7% to both HBV and HCV,21.4% to HCV.HCV infection were more prevalent among transfuction dependent thalassemiacs. 52% were positive for anti-HCV antibody, and41% are suspected to have persistent HCV infection.2)Iron overload status : Almost all the patients survey had some kind of abnormalities concerning iron metabolism. Two thirds of the hepatology patients showed low TIBC.All the thalassemiacs showed increased transferrin iron saturation and free iron (Gutteridge method).Surprising findings among Myanmar in-patients were the epidemic of hepatitis C virus infection. It is felt imperative to combat the epidemic. Another surprising findings about HCV infection was the identified virus subtype was all lb. Survey system for hepatitis C must be constructed. lron overload found among patients with liver disease must be treated.

本研究的目的是对缅甸人群中铁超载和肝细胞癌（HCC）的患病率进行流行病学调查，并阐明铁超载与其他因素如乙型肝炎（B）和丙型肝炎病毒（HCV）的关系（HBV和HCV）感染在HCC发展中的作用。调查于1996年12月24日至1997年1月7日进行，1997年12月17日至27日，在医学研究部、仰光总医院肝病和血液科和仰光儿童医院。共调查104例患者，其中原发性肝癌28例，地中海贫血38例。结果表明：1）肝炎病毒标志物：94%的肝病患者有HBV感染史。HBV持续感染36例（35%）。抗-HCV抗体阳性患者中HCV-RNA阳性者占79%，表明HCV持续感染。31%的患者怀疑有持续性HCV感染。46%的HCC与HBV有关，7%与HBV和HCV有关，21.4%与HCV有关。抗-HCV抗体阳性率为52%，怀疑HCV持续感染率为41%。2）铁负荷：几乎所有患者都存在某种铁代谢异常。三分之二的肝病患者TIBC较低。所有地中海贫血患者的转铁蛋白铁饱和度和游离铁（Gutteridge法）均升高。人们感到必须防治这一流行病。关于HCV感染的另一个令人惊讶的发现是鉴定的病毒亚型都是lb。必须建立丙型肝炎的监测系统。在肝病患者中发现的铁过载必须治疗。