Taborelli Martina, Polesel Jerry, Montella Maurizio, Libra Massimo, Tedeschi Rosamaria, Battiston Monica, Spina Michele, Di Raimondo Francesco, Pinto Antonio, Crispo Anna, Grimaldi Maria, Franceschi Silvia, Dal Maso Luigino, Serraino Diego
Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano, Italy.
Unit of Epidemiology, National Cancer Institute "G. Pascale Foundation", Cappella dei Cangiani, 80131 Naples, Italy.
Infect Agent Cancer. 2016 Jun 23;11:27. doi: 10.1186/s13027-016-0073-x. eCollection 2016.
Hepatitis C virus (HCV) has been consistently associated to non-Hodgkin lymphoma (NHL); conversely, few studies have evaluated a comprehensive serological panel of hepatitis B virus (HBV) in NHL etiology.
We conducted a case-control study in Italy in 1999-2014, enrolling 571 incident, histologically confirmed NHLs and 1004 cancer-free matched controls. Study subjects provided serum for HCV and HBV testing and for HCV RNA. Odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) were estimated by logistic regression, adjusting for potential confounders.
Circulating HCV RNA was detected in 63 (11.1 %) NHL cases and 35 (3.5 %) controls (OR = 3.51, 95 % CI: 2.25-5.47). Chronic HBV infection (i.e., positive to HBV surface antigen - HBsAg(+)) was found in 3.7 % of cases and 1.7 % of controls (OR = 1.95, 95 % CI: 1.00-3.81); a significantly elevated OR was observed for B-cell NHL (2.11, 95 % CI: 1.07-4.15). People with serological evidence of past HCV or HBV infection, vaccination against HBV, or detectable antibodies against HBV core antigen (anti-HBc(+)) alone were not at increased NHL risk.
Our results support a role of chronic HCV infection in NHL in Italy and suggest an involvement of HBV infection. Associations were clearest for B-cell NHL and diffuse large B-cell lymphoma. Prevention and treatment of HCV and HBV infection may diminish NHL incidence, notably in areas with high prevalence of hepatitis viruses infection.
丙型肝炎病毒（HCV）一直与非霍奇金淋巴瘤（NHL）相关；相反，很少有研究评估乙型肝炎病毒（HBV）的全面血清学指标在NHL病因中的作用。
我们于1999年至2014年在意大利进行了一项病例对照研究，纳入571例新发病例、经组织学确诊的NHL患者以及1004名无癌匹配对照。研究对象提供血清用于HCV和HBV检测以及HCV RNA检测。通过逻辑回归估计比值比（OR）和相应的95%置信区间（CI），并对潜在混杂因素进行调整。
63例（11.1%）NHL病例和35例（3.5%）对照检测到循环HCV RNA（OR = 3.51，95%CI：2.25 - 5.47）。3.7%的病例和1.7%的对照发现慢性HBV感染（即乙肝表面抗原阳性 - HBsAg(+)）（OR = 1.95，95%CI：1.00 - 3.81）；B细胞NHL的OR显著升高（2.11，95%CI：1.07 - 4.15）。仅有既往HCV或HBV感染血清学证据、HBV疫苗接种或仅检测到抗乙肝核心抗原抗体（抗-HBc(+)）的人群患NHL风险未增加。
我们的结果支持慢性HCV感染在意大利NHL发病中的作用，并提示HBV感染也有参与。B细胞NHL和弥漫性大B细胞淋巴瘤的关联最为明显。预防和治疗HCV和HBV感染可能会降低NHL发病率，特别是在肝炎病毒感染高发地区。
