乙型肝炎病毒传播与肝癌发生：对13676名肝细胞癌患者亲属的9年回顾性队列研究
Hepatitis B virus transmission and hepatocarcinogenesis: a 9 year retrospective cohort of 13676 relatives with hepatocellular carcinoma.
作者信息
Chen Chien-Hung, Chen Yang Yuan, Chen Gran-Hum, Yang Sien-Sing, Tang Huang-Shang, Lin Hsien Hong, Lin Deng-Yn, Lo Sing Kai, Du Jeng-Ming, Chang Ting-Tsung, Chen Shinn-Cherng, Liao Li-Ying, Kuo Chung-Huang, Lin Kwo-Chuan, Tai Dar-In, Changchien Chi-Sin, Chang Wen-Yu, Sheu Jin-Chuan, Chen Ding-Shinn, Liaw Yun-Fan, Sung Juei-Low
机构信息
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, ROC.
出版信息
J Hepatol. 2004 Apr;40(4):653-9. doi: 10.1016/j.jhep.2003.12.002.
BACKGROUND/AIMS: Familial clustering of hepatitis B virus (HBV) infection is related to perinatal transmission, and is the main cause of familial-type hepatocellular carcinoma (HCC). The route of HBV transmission differs between the children and siblings of patients with HCC. This study examined the differences in HBV carrier rates and HCC-related mortality between two generations in HCC families.
METHODS
From 1992 to 1997, relatives of individuals with HCC were screened prospectively with ultrasonography, alpha-fetoprotein, liver biochemistry tests and viral markers. Total HCC-related deaths during a 9-year period were compared between the generations of index patients and their children.
RESULTS
The study included a total of 13676 relatives in two generations. More HCC-related deaths occurred in the index patient generation than in the child generation. Furthermore, children of female index patients had higher rates of liver cancer related mortality than children of male index patients. The same was true when the analysis was limited to male HBV carriers. The prevalence of HBsAg in the offspring of HBsAg positive mothers was 66% in the child generation and 72% in the index patient generation. These high prevalences indicated high maternal HBV replication status.
CONCLUSIONS
Perinatal transmission and maternal viral load are important risk factors in hepatocarcinogenesis.
背景/目的：乙型肝炎病毒（HBV）感染的家族聚集性与围产期传播有关，是家族型肝细胞癌（HCC）的主要病因。HBV在HCC患者的子女和兄弟姐妹中的传播途径有所不同。本研究调查了HCC家族两代人之间HBV携带者率和HCC相关死亡率的差异。
方法
1992年至1997年，对HCC患者的亲属进行前瞻性筛查，包括超声检查、甲胎蛋白、肝脏生化检查和病毒标志物检测。比较了两代索引患者及其子女在9年期间HCC相关死亡的总数。
结果
该研究共纳入了两代人的13676名亲属。索引患者一代发生的HCC相关死亡多于子女一代。此外，女性索引患者的子女肝癌相关死亡率高于男性索引患者的子女。当分析仅限于男性HBV携带者时，情况也是如此。HBsAg阳性母亲的后代中，子女一代的HBsAg患病率为66%，索引患者一代为72%。这些高患病率表明母亲的HBV复制状态较高。
结论
围产期传播和母亲病毒载量是肝癌发生的重要危险因素。
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