Bosch F X, Muñoz N
International Agency for Research on Cancer, Lyon, France.
IARC Sci Publ. 1988(89):427-38.
Chronic infection with hepatitis B virus (HBV) accounts for 1-10% of hepatocellular carcinoma (HCC) in low-risk countries and for 56-94% in high-risk populations. However, although HBV is perhaps the second most important human carcinogen so far identified, chronic HBV infection is neither a sufficient nor a necessary cause of HCC. Other factors must be causally related to HCC, and some of them have been identified: aflatoxins, tobacco smoking, and use of alcohol and oral contraceptives. The evidence for an association between these factors and HCC is reviewed, as well as their joint effects. Finally, prospects for epidemiological research on HCC, and specifically the assessment of viral and chemical interactions, are discussed.
在低风险国家，慢性乙型肝炎病毒（HBV）感染导致的肝细胞癌（HCC）占1%-10%，而在高风险人群中这一比例为56%-94%。然而，尽管HBV可能是迄今已确定的第二重要的人类致癌物，但慢性HBV感染既不是HCC的充分病因，也不是必要病因。其他因素必定与HCC存在因果关系，其中一些因素已被确定：黄曲霉毒素、吸烟、饮酒和使用口服避孕药。本文综述了这些因素与HCC之间关联的证据以及它们的联合作用。最后，讨论了HCC流行病学研究的前景，特别是病毒与化学物质相互作用的评估。
