Arya S C, Ashraf S J, Parande C M, Tobeiqi M S, Ageel A R
Department of Medicine, King Fahad Central Hospital, Gizan, Saudi Arabia.
APMIS Suppl. 1988;3:30-4.
Hepatitis B virus (HBV) has been hyperendemic in the Gizan area of Saudi Arabia, located 17 degrees N 43 degrees E, with 20% male and 9% female HBsAg carriers among the native population. Among HBsAg carriers, 8% have been positive for anti-delta antibody while intravenous drug abuse and alcohol have been unknown. Monthly hospitalisation of primary hepatocellular carcinoma (PHC) patients from a catchment population of 500,000 approximates 2-3. HBV markers were tested in 30 PHC cases and compared with 326 otherwise healthy natives. Both HBsAg and total HBV exposure were higher among PHC (p less than 0.001), with no difference between sexes. Anti-delta antibody was demonstrable in 5 of 30 HBsAg-positive PHC with similar distribution among PHC, healthy carriers and those with chronic hepatic disorders. Serum aliquots from 3 hitherto HBV-negative PHC cases are to be tested for HBV-DNA along with immunohistochemical staining on biopsy material. Pending reduction in PHC incidence decades later, subsequent to initiation of HBV immunization, regular examination of HBsAg carriers and established cirrhotics for alphafetoprotein level and ultrasonic hepatic lesions would constitute important interim measures both towards early detection of, and an effective chemotherapy/surgery for, hepatic malignancy.
乙型肝炎病毒（HBV）在沙特阿拉伯吉赞地区（北纬17度，东经43度）呈高度地方性流行，当地原住民中HBsAg携带者男性占20%，女性占9%。在HBsAg携带者中，8%的抗δ抗体呈阳性，而静脉吸毒和酗酒情况不明。在一个50万人口的集水区，原发性肝细胞癌（PHC）患者的月住院人数约为2至3人。对30例PHC病例进行了HBV标志物检测，并与326名其他方面健康的当地人进行了比较。PHC患者中HBsAg和总的HBV暴露水平均较高（p<0.001），男女之间无差异。在30例HBsAg阳性的PHC患者中，有5例可检测到抗δ抗体，在PHC患者、健康携带者和慢性肝病患者中的分布相似。将对3例迄今HBV阴性的PHC病例的血清样本进行HBV-DNA检测，并对活检材料进行免疫组织化学染色。在开始HBV免疫接种几十年后，在PHC发病率降低之前，定期检查HBsAg携带者和已确诊的肝硬化患者的甲胎蛋白水平及肝脏超声病变，将是早期发现肝恶性肿瘤并对其进行有效化疗/手术的重要临时措施。
