Yuan Jian-Min, Govindarajan Sugantha, Arakawa Kazuko, Yu Mimi C
Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles 90089-9176, USA.
Cancer. 2004 Sep 1;101(5):1009-17. doi: 10.1002/cncr.20427.
Heavy alcohol consumption, viral hepatitis, and diabetes are risk factors for hepatocellular carcinoma (HCC). However, to the authors' knowledge, the information concerning their interaction effect in patients with risk of HCC is sparse.
A population-based, case-control study of HCC was conducted during 1984-2002. The study involved 295 HCC cases and 435 age-, gender-, and race-matched control subjects among Hispanic and non-Hispanic whites and blacks in Los Angeles County, California. Lifestyle risk factors were ascertained through in-person interviews. Infections with the hepatitis B and C (HCV) viruses were determined using their serologic markers.
Fourteen HCC cases but no control subjects tested positive for the hepatitis B surface antigen. Seropositivity for antibodies to HCV was associated with an odds ratio (OR) of 125 (95% confidence interval [95% CI], 17-909) for HCC, whereas seropositivity for antibodies to the hepatitis B core antigen was related to an OR of 2.9 (95% CI, 1.7-5.0). Heavy alcohol consumption and cigarette smoking were found to be independently associated with a statistically significant two to threefold increase in risk of HCC after adjustment for hepatitis B and C serology. Subjects with a history of diabetes had an OR of 2.7 (95% CI, 1.6-4.3) for HCC compared with nondiabetic subjects. A synergistic interaction on HCC risk was observed between heavy alcohol consumption and diabetes (OR = 4.2; 95% CI, 2.6-5.8), heavy alcohol consumption and viral hepatitis (OR = 5.5; 95% CI, 3.9-7.0), or between diabetes and viral hepatitis (OR = 4.8; 95% CI, 2.7-6.9).
Heavy alcohol consumption, diabetes, and viral hepatitis were found to exert independent and synergistic effects on risk of HCC in U.S. blacks and whites.
大量饮酒、病毒性肝炎和糖尿病是肝细胞癌（HCC）的危险因素。然而，据作者所知，关于它们在有HCC风险的患者中的相互作用效应的信息很少。
在1984年至2002年期间进行了一项基于人群的HCC病例对照研究。该研究涉及加利福尼亚州洛杉矶县西班牙裔和非西班牙裔白人和黑人中的295例HCC病例以及435例年龄、性别和种族匹配的对照对象。通过面对面访谈确定生活方式危险因素。使用血清学标志物确定乙型和丙型肝炎病毒（HCV）感染情况。
14例HCC病例乙型肝炎表面抗原检测呈阳性，而对照对象均为阴性。抗HCV抗体血清阳性与HCC的比值比（OR）为125（95%置信区间[95%CI]，17 - 909），而抗乙型肝炎核心抗原抗体血清阳性与OR为2.9（95%CI，1.7 - 5.0）相关。在对乙型和丙型肝炎血清学进行调整后，发现大量饮酒和吸烟与HCC风险在统计学上有显著的两到三倍增加独立相关。有糖尿病史的受试者与无糖尿病受试者相比，HCC的OR为2.7（95%CI，1.6 - 4.3）。在大量饮酒与糖尿病（OR = 4.2；95%CI，2.6 - 5.8）、大量饮酒与病毒性肝炎（OR = 5.5；95%CI，3.9 - 7.0）或糖尿病与病毒性肝炎之间（OR = 4.8；95%CI，2.7 - 6.9）观察到对HCC风险的协同相互作用。
发现大量饮酒、糖尿病和病毒性肝炎对美国黑人和白人的HCC风险有独立和协同作用。
