Lawrence Philip, Chabane Mawlouda, Abrouk Lucie, Thiesson Adrien, Berthé Diakaridia, Diarra Amadou B, Bengaly Karim, Traoré Brehima, Kassogué Djibril, Durand Geoffroy, Voegele Catherine, Le Calvez-Kelm Florence, Steenkeste Nicolas, Hainaut Pierre, Kouriba Bourema, Gormally Emmanuelle
CONFLUENCE: Sciences et Humanités Confluence (EA 1598), Université Catholique de Lyon (UCLy), 69002 Lyon, France.
Centre d'Infectiologie Charles Mérieux, Bamako BPE2283, Mali.
Diagnostics (Basel). 2023 Jan 19;13(3):375. doi: 10.3390/diagnostics13030375.
In Mali, hepatocellular carcinoma (HCC) is the third and sixth most common cancer in men and women, respectively. Mali comprises several distinct climato-ecological zones. Most studies to date have been conducted in the sub-Sahelian zone of southern Mali, including the capital city Bamako. In this part of the country, the main risk factors for HCC are chronic hepatitis B virus (HBV) carriage and dietary exposure to aflatoxins, a well-known hepatocarcinogen. Data are scarce for other ecological zones, but our preliminary data from 721 blood donors in the area of Timbuktu, presented in this study, suggest that chronic HBV carriage is also endemic in the northern Saharan zone of Mali. For further study, 29 healthy HBV chronic carrier volunteers were recruited from the blood transfusion center in Timbuktu. Successful viral genotyping in 20 volunteers revealed HBV genotype E in 13 cases and D in 7 cases, suggesting that this geographical and anthropological transition zone may also represent a transition zone between HBV genotypes that dominate sub-Saharan and northern Africa, respectively. Sequencing of circulating cell-free plasma DNA (cfDNA) from donors did not reveal the presence of the mutation in these donors, a marker of dietary exposure to aflatoxins in sub-Saharan Africa. These results suggest that the geo-epidemiological distribution of the risk factors for HCC is not uniform across Mali, but is dependent upon climatic, socioeconomic and anthropological factors that might have an impact on patterns of chronic liver disease and cancer.
在马里，肝细胞癌（HCC）分别是男性和女性中第三和第六常见的癌症。马里由几个不同的气候生态区组成。迄今为止，大多数研究是在马里南部的萨赫勒地区进行的，包括首都巴马科。在该国的这一地区，HCC的主要危险因素是慢性乙型肝炎病毒（HBV）携带以及饮食中接触黄曲霉毒素，黄曲霉毒素是一种众所周知的肝癌致癌物。其他生态区的数据很少，但我们在本研究中展示的来自廷巴克图地区721名献血者的初步数据表明，慢性HBV携带在马里的撒哈拉北部地区也是地方病。为了进一步研究，从廷巴克图的输血中心招募了29名健康的HBV慢性携带者志愿者。对20名志愿者成功进行病毒基因分型后发现，13例为HBV E基因型，7例为D基因型，这表明这个地理和人类学过渡区也可能分别代表了在撒哈拉以南非洲和北非占主导地位的HBV基因型之间的过渡区。对献血者循环游离血浆DNA（cfDNA）的测序未发现这些献血者中存在该突变，该突变是撒哈拉以南非洲饮食中接触黄曲霉毒素的标志物。这些结果表明，HCC危险因素的地理流行病学分布在马里并不均匀，而是取决于可能对慢性肝病和癌症模式产生影响的气候、社会经济和人类学因素。
