Ryder R W, Whittle H C, Sanneh A B, Ajdukiewicz A B, Tulloch S, Yvonnet B
Department of Community Medicine, Mount Sinai Medical Center, New York, NY.
Am J Epidemiol. 1992 Nov 1;136(9):1122-31. doi: 10.1093/oxfordjournals.aje.a116578.
To determine the incidence of persistent hepatitis B virus infection and its etiologic role as a cause of hepatoma, the authors carried out a case-control investigation of 70 persons with hepatoma, 70 controls, and their families in 1981-1982 in The Gambia, West Africa. The risk of developing hepatoma after the age of 39 years was 1.4% in men and 0.3% in women. Hepatoma occurred more than twice as frequently among persons who had four or more older siblings as among persons who had less than two older siblings. The attributable risk between persistent infection with hepatitis B virus and hepatoma was 78% for individuals aged less than 50 years and 37% for persons aged 50 years or more, with an overall risk of 53%. The high prevalence of hepatitis B surface antigen and hepatitis B e antigen antigenemia in children under 15 years of age (14% of 341 children) and the positive correlation between late birth order and risk of developing hepatoma suggest that postnatal early childhood exposure to hepatitis B virus is an important risk factor. The use of a hepatitis B virus vaccine which provides durable immunity in very young children will probably prevent most cases of hepatoma.
为了确定持续性乙型肝炎病毒感染的发生率及其作为肝癌病因的作用，作者于1981年至1982年在西非冈比亚对70例肝癌患者、70例对照者及其家属进行了病例对照研究。39岁以后患肝癌的风险在男性中为1.4%，在女性中为0.3%。有四个或更多哥哥姐姐的人患肝癌的频率是哥哥姐姐少于两个的人的两倍多。对于年龄小于50岁的个体，持续性乙型肝炎病毒感染与肝癌之间的归因风险为78%，对于50岁及以上的人则为37%，总体风险为53%。15岁以下儿童中乙肝表面抗原和乙肝e抗原血症的高流行率（341名儿童中的14%）以及出生顺序较晚与患肝癌风险之间的正相关表明，出生后幼儿期接触乙型肝炎病毒是一个重要的风险因素。使用能在幼儿中提供持久免疫力的乙型肝炎病毒疫苗可能会预防大多数肝癌病例。
