Unoura M, Adachi K, Kawai H, Inagaki Y, Kaneko S, Kobayashi K
Dept. of Internal Medicine, School of Medicine, Kanazawa University.
Gan To Kagaku Ryoho. 1990 Apr;17(4 Pt 1):608-14.
It is reported that the number of hepatocellular carcinoma (HCC) in Japan is increasing and this is mainly due to the increase of HBsAg negative HCC patients with history of blood transfusion. However 80% of HCC patients are positive for HBV related serum markers. HBV DNA is detected by PCR method in 15% of HBsAg negative HCC patients with other HBV marker. These findings indicated that at least 40% of HCC patients in Japan are closely related to HBV infection. Several hypotheses on the mechanism of carcinogenesis by HBV have been proposed, however none of these has yet to be established. The type C hepatitis virus (HCV) reported by Chiron Co. is thought to be the majority of viruses which cause chronic non A non B hepatitis in Europe, United States and also Japan. The rate of anti-HCV in HBsAg negative HCC patients is about 70% in Japan. As strategies for HCC, the following 3 steps should be established; 1) prophylaxis against infection, 2) prevention of progression of liver cirrhosis, and 3) early detection of HCC. Though the role of hepatitis virus in hepatocarcinogenesis has not yet been established, it is thought that HBV and HCV are responsible for about 85% of HCC patients in terms of the development of liver cirrhosis which frequently associates with HCC. A marked decrease of HCC in Japan is forthcoming through the establishment of prophylaxis against HBV and HCV infection.
据报道，日本肝细胞癌（HCC）的数量正在增加，这主要是由于有输血史的HBsAg阴性HCC患者数量增加。然而，80%的HCC患者HBV相关血清标志物呈阳性。在15%的有其他HBV标志物的HBsAg阴性HCC患者中，通过PCR方法检测到HBV DNA。这些发现表明，日本至少40%的HCC患者与HBV感染密切相关。关于HBV致癌机制已经提出了几种假说，但这些假说都尚未得到证实。Chiron公司报道的丙型肝炎病毒（HCV）被认为是在欧洲、美国以及日本导致慢性非甲非乙型肝炎的主要病毒。在日本，HBsAg阴性HCC患者中抗-HCV的比例约为70%。作为HCC的防治策略，应确立以下三个步骤：1）预防感染；2）防止肝硬化进展；3）早期发现HCC。虽然肝炎病毒在肝癌发生中的作用尚未得到证实，但就经常与HCC相关的肝硬化发展而言，HBV和HCV被认为与约85%的HCC患者有关。通过建立针对HBV和HCV感染的预防措施，日本的HCC将显著减少。
