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[目的]探索肝癌高发区泰兴地区饮酒习惯、HBsAg与原发性肝癌(HCC)的关系。[方法]选择208例原发性肝癌新发病例按性别、年龄和居住地进行以人群为基础1∶1配对病例对照研究,采用ELISA方法检测研究对象血清中HBsAg,相关数据单因素分析采用Epi鄄Info,多因素分析采用SAS非条件Logistic回归。[结果]原发性肝癌病例组HBsAg阳性率(72.12%)显著高于对照组(22.12%)(P<0.0001)。单因素分析结果表明,HBsAg阳性、慢性肝炎、肝硬化和血吸虫病显著增加了泰兴市居民患肝癌的危险性。多因素分析结果显示,HBsAg阳性和慢性肝炎仍然是肝癌的主要危险因素(OR值分别为7.317,6.694)。将饮酒习惯与HBsAg阳性结合分析发现,饮酒对HBsAg阳性在肝癌发生中可能有放大效应。[结论]HBsAg阳性和个人肝病史是泰兴地区HCC高发的非常重要的因素,酒精对HBV在致HCC方面有协同作用。
[Objective] To explore the relationship between drinking habits, HBsAg and hepatocellular carcinoma (HCC) in Taixing, a high incidence area of liver cancer. [Methods] A total of 208 primary hepatocellular carcinoma cases were selected according to gender, age and place of residence. Population-based 1: 1 matched case-control studies were performed. ELISA was used to detect HBsAg in sera. Correlation data were analyzed by single factor analysis Info, multivariate analysis using SAS unconditional Logistic regression. [Results] The positive rate of HBsAg in primary liver cancer cases (72.12%) was significantly higher than that in control group (22.12%) (P <0.0001). Univariate analysis showed that HBsAg-positive, chronic hepatitis, cirrhosis and schistosomiasis significantly increased the risk of liver cancer in Taixing residents. Multivariate analysis showed that HBsAg-positive and chronic hepatitis were still the major risk factors of HCC (OR = 7.317 and 6.694, respectively). The drinking habits and HBsAg positive analysis found that alcohol consumption of HBsAg positive liver cancer may have amplification effect. [Conclusion] The history of HBsAg positive and personal liver diseases is a very important factor for the high incidence of HCC in Taixing. Alcohol has a synergistic effect on the HCC induced by HBV.