Chung Nak So, Kwon Oh Sang, Park Cheul Hee, Kim Young Nam, Cho Gwon Hyun, Lee Jong Jun, Kim Gil Hyun, Kim Hyun Ok, Ko Kwang Il, Yu Sang Kyun, Kwon Kwang An, Kim Yun Soo, Choi Duck Ju, Kim Ju Hyun
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
Korean J Gastroenterol. 2007 Jun;49(6):369-75.
BACKGROUND/AIMS: Alcohol may be a cocarcinogen in patients with chronic viral hepatitis. We investigated the effect of alcohol on the development of hepatocellular carcinoma (HCC) in liver cirrhosis (LC) caused by hepatitis B virus (HBV).
All patients with LC or HCC associated with HBV or alcohol, admitted between March 2001 and June 2005, were included. Patients were divided into three groups according to the etiology of LC: Alcohol (AL), HBV, or HBV alcohol (HBV AL). Age and laboratory data at the enrollment of study were analyzed. The logistic regression coefficiency for the prevalence of HCC was calculated by using variables such as age, gender, serologic markers, and etiology of LC.
In LC patients (n=342), the proportions of AL, HBV, and HBV AL groups were 44%, 39%, and 17%, respectively. The proportions of HCC in AL, HBV and HBV AL groups were 17%, 55%, and 76%, respectively. Age at the diagnosis of HCC was younger in HBV AL than in AL group (p=0.036). In logistic regression analysis for the risk factor of HCC, odds ratio of age was 1.056 (p0.001). Odds ratios of HBV and HBV AL group comparing AL were 8.449 (p0.001) and 17.609 (p0.001), respectively. Therefore, old age and chronic alcohol intake in patients with HBsAg were the risk factors of HCC.
Chronic alcohol intake may be an additive factor for the development of HCC in patient with LC caused by HBV. However, a prospective cohort study is needed to confirm these findings.
背景/目的:酒精可能是慢性病毒性肝炎患者的一种协同致癌物。我们研究了酒精对乙型肝炎病毒(HBV)所致肝硬化(LC)患者肝细胞癌(HCC)发生发展的影响。
纳入2001年3月至2005年6月期间收治的所有与HBV或酒精相关的LC或HCC患者。根据LC的病因将患者分为三组:酒精性(AL)、HBV感染性、HBV合并酒精性(HBV AL)。分析研究入组时的年龄和实验室数据。使用年龄、性别、血清学标志物和LC病因等变量计算HCC患病率的逻辑回归系数。
在LC患者(n = 342)中,AL组、HBV组和HBV AL组的比例分别为44%、39%和17%。AL组、HBV组和HBV AL组的HCC比例分别为17%、55%和76%。HBV AL组HCC诊断时的年龄比AL组年轻(p = 0.036)。在HCC危险因素的逻辑回归分析中,年龄的优势比为1.056(p < 0.001)。与AL组相比,HBV组和HBV AL组的优势比分别为8.449(p < 0.001)和17.609(p < 0.001)。因此,HBsAg阳性患者的老年和长期饮酒是HCC的危险因素。
长期饮酒可能是HBV所致LC患者发生HCC的一个附加因素。然而,需要进行前瞻性队列研究来证实这些发现。