Sharp Gerald B, Mizuno Terumi, Fukuhara Toshiyuki, Tokuoka Shoji
Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan.
Int J Radiat Biol. 2006 Apr;82(4):231-40. doi: 10.1080/09553000600649224.
Although previous studies have shown significantly increased risks of liver cirrhosis and chronic liver disease for acute radiation exposure among survivors of the atomic bombings of Hiroshima and Nagasaki, Japan, these studies have not taken into account hepatitis B virus (HBV) infections. Because HBV is associated with both A-bomb radiation and liver cirrhosis, our goal was to investigate the relationship of acute ionizing radiation to liver cirrhosis adjusting for HBV, co-occurring primary liver cancer (PLC), and other potential confounders.
Using a cross-sectional design and pathology review of a cohort of Japanese atomic-bomb survivors, we found that 213 of 335 (63.6%) subjects with PLC and 55 of 776 (7.1%) subjects without PLC had cirrhosis.
We found no association between acute exposure to A-bomb radiation and liver cirrhosis. The adjusted odds ratio of cirrhosis per Sv liver irradiation was 0.59 (95% confidence interval: 0.27 - 1.27). Cirrhosis risks for the highest tertile of radiation exposure (mean exposure 0.7 Sv) were also not elevated (0.8, 0.26 - 2.12 and 0.2, 0.03 - 0.98 among subjects with and without PLC.
Acute exposure to liver irradiation does not increase risks of liver cirrhosis, regardless of PLC status.
尽管先前的研究表明，日本广岛和长崎原子弹爆炸幸存者中，急性辐射暴露会显著增加患肝硬化和慢性肝病的风险，但这些研究并未考虑乙型肝炎病毒（HBV）感染情况。由于HBV与原子弹辐射及肝硬化均有关联，我们的目标是在对HBV、同时发生的原发性肝癌（PLC）及其他潜在混杂因素进行校正的情况下，研究急性电离辐射与肝硬化之间的关系。
采用横断面设计并对一组日本原子弹爆炸幸存者进行病理检查，我们发现，335例患有PLC的受试者中有213例（63.6%）以及776例未患PLC的受试者中有55例（7.1%）患有肝硬化。
我们发现急性原子弹辐射暴露与肝硬化之间无关联。每西弗肝脏照射量导致肝硬化的校正比值比为0.59（95%置信区间：0.27 - 1.27）。辐射暴露最高三分位数（平均暴露量0.7西弗）的肝硬化风险也未升高（患有和未患PLC的受试者中分别为0.8，0.26 - 2.12和0.2，0.03 - 0.98）。
无论PLC状态如何，肝脏的急性照射均不会增加肝硬化风险。
