慢性丙型肝炎病毒感染是否是乳腺癌的一个危险因素？
Is chronic hepatitis C virus infection a risk factor for breast cancer?
机构信息
Liver Unit and INSERM Unit 632, Saint-Eloi Hospital, Montpellier University, 80 rue Augustin Fliche, Montpellier Cedex 5, France.
出版信息
World J Gastroenterol. 2010 Aug 7;16(29):3687-91. doi: 10.3748/wjg.v16.i29.3687.
AIM
To evaluate the prevalence of breast tumors in adult females with chronic hepatitis C virus (HCV) infection.
METHODS
Prospective, single-center study, based on female outpatients consulting in a liver unit, for 1 year. The study group included females with present and/or past history of chronic infection by HCV. Patients with spontaneous recovery were excluded. Chronic hepatitis had been proved by liver biopsy in the majority of cases and/or biological markers of inflammation and fibrosis. The control group included female patients with other well documented chronic liver diseases: chronic hepatitis B, alcoholic liver disease, autoimmune hepatitis, hemochromatosis, non alcoholic liver disease, chronic cholangitis. Participating patients were prospectively questioned during consultation about past breast history and follow-up by mammography.
RESULTS
Breast carcinoma was recorded in 17/294 patients with HCV infection (5.8%, 95% CI: 3.1-8.4) vs 5/107 control patients (4.7%, 95% CI: 0.67-8.67). Benign tumors of the breast (mastosis, nodules, cysts) were recorded in 75/294 patients with HCV infection (25.5%, 95% CI: 20.5-30.5) vs 21/107 (19.6%, 95% CI: 12.1-27.1) in the control group. No lesion was noted in 202 patients with HCV (68.7%, 95% CI: 63.4-74) vs 81 control patients (75.7%, 95% CI: 67.6-83.8). Despite a trend to an increased prevalence in the group with HCV infection, the difference was not significant compared to the control group (P = NS). In patients over 40 years, the results were, respectively, as follows: breast cancer associated with HCV: 17/266 patients (6.3%, 95% CI: 3.4-9.3) vs 5/95 patients (5.2%, 95% CI: 0.7-9.7) in the control group; benign breast tumors: 72/266 patients with HCV infection (27%, 95% CI: 21.7-32.4) vs 18/95 patients (18.9%, 95% CI: 11-26.8) in the control group; no breast lesion 177/266 (66.5%, 95% CI: 60.9-72.2) in patients with HCV infection vs 72/95 (75.7%, 95% CI: 67.1-84.4) in the control group. The differences were not significant (P = NS).
CONCLUSION
These results suggest that chronic HCV infection is not a strong promoter of breast carcinoma in adult females of any age.
目的
评估成年慢性丙型肝炎病毒（HCV）感染女性中乳腺肿瘤的患病率。
方法
前瞻性、单中心研究，基于在肝脏科就诊的女性门诊患者，为期 1 年。研究组包括患有目前和/或既往慢性 HCV 感染的女性。排除自发性恢复的患者。大多数情况下，通过肝活检和/或炎症和纤维化的生物学标志物证实慢性肝炎。对照组包括患有其他明确慢性肝病的女性患者：慢性乙型肝炎、酒精性肝病、自身免疫性肝炎、血色病、非酒精性肝病、慢性胆管炎。参与研究的患者在就诊期间被前瞻性询问乳腺病史和乳腺 X 线检查随访情况。
结果
在 294 例 HCV 感染患者中（5.8%，95%CI：3.1-8.4）记录到乳腺癌，而在 107 例对照组患者中（4.7%，95%CI：0.67-8.67）记录到 5 例。在 294 例 HCV 感染患者中（25.5%，95%CI：20.5-30.5）记录到乳腺良性肿瘤（乳腺增生、结节、囊肿），而在对照组中（19.6%，95%CI：12.1-27.1）记录到 21 例。在 202 例 HCV 感染患者中（68.7%，95%CI：63.4-74）未发现病变，而在对照组中（75.7%，95%CI：67.6-83.8）记录到 81 例。尽管 HCV 感染组的患病率呈上升趋势，但与对照组相比差异无统计学意义（P = NS）。在 40 岁以上的患者中，结果分别为：与 HCV 相关的乳腺癌：266 例患者中（6.3%，95%CI：3.4-9.3）记录到 17 例，对照组中（5.2%，95%CI：0.7-9.7）记录到 5 例；乳腺良性肿瘤：266 例 HCV 感染患者中（27%，95%CI：21.7-32.4）记录到 72 例，对照组中（18.9%，95%CI：11-26.8）记录到 18 例；266 例 HCV 感染患者中（66.5%，95%CI：60.9-72.2）无乳腺病变，对照组中（75.7%，95%CI：67.1-84.4）记录到 72 例。差异无统计学意义（P = NS）。
结论
这些结果表明，慢性 HCV 感染不是成年女性任何年龄段乳腺癌的强烈促进因素。
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