Iida F, Iida R, Kamijo H, Takaso K, Miyazaki Y, Funabashi W, Tsuchiya K, Matsumoto Y
Yamanashi Kosei Hospital, Kofu City, Japan.
Bull World Health Organ. 1999;77(7):573-81.
In a preliminary study carried out in the study area we found that 19.1% (173/907) of patients with chronic liver disease and 51% (35/68) of hepatocellular carcinoma cases were infected with Japanese schistosomiasis. Analysis of data from 571 autopsies revealed a similarly high incidence of schistosomiasis among cases of hepatoma and other liver diseases. A prospective case-control study conducted over 10 years showed that hepatoma developed in 5.4% (26/484) of chronic schistosomiasis cases and in 7.5% (23/307) of patients with chronic liver disease (hepatitis, cirrhosis, etc). The difference was not statistically significant (P = 0.228). A high incidence of hepatitis C virus (HCV) antibody (HCVAb) was found in the schistosomiasis group (36.5%; 95% CI = 44.9-28.1%) and in the chronic liver disease group (56.0%), 39% of whom had chronic hepatitis (P = 0.028). Various factors that might have contributed to the development of hepatoma and schistosomiasis were investigated, but no evidence of a significant correlation between schistosomiasis and hepatoma was found. The high incidence of HCVAb was considered to have been responsible for the development of hepatocellular carcinoma in chronic schistosomiasis patients. The role of HBV infection in the development of hepatoma in schistosomiasis patients was not confirmed after an assay for HCVAb was included in the study.
在研究区域开展的一项初步研究中，我们发现，19.1%（173/907）的慢性肝病患者和51%（35/68）的肝细胞癌病例感染了日本血吸虫病。对571例尸检数据的分析显示，肝癌和其他肝病病例中血吸虫病的发病率同样很高。一项为期10年的前瞻性病例对照研究表明，慢性血吸虫病病例中有5.4%（26/484）发生肝癌，慢性肝病（肝炎、肝硬化等）患者中有7.5%（23/307）发生肝癌。差异无统计学意义（P = 0.228）。血吸虫病组丙型肝炎病毒（HCV）抗体（HCVAb）的高发病率为36.5%（95%CI = 44.9 - 28.1%），慢性肝病组为56.0%，其中39%患有慢性肝炎（P = 0.028）。对可能导致肝癌和血吸虫病发生的各种因素进行了调查，但未发现血吸虫病与肝癌之间存在显著相关性的证据。HCVAb的高发病率被认为是慢性血吸虫病患者肝细胞癌发生的原因。在研究中纳入HCVAb检测后，未证实乙肝病毒感染在血吸虫病患者肝癌发生中的作用。
