Williams A O
Am J Med Sci. 1975 Jul-Aug;270(1):53-6. doi: 10.1097/00000441-197507000-00008.
The frequency distribution of HBs Ag in different parts of the world reveals a relatively high frequency among healthy members of population groups inhabiting areas of high incidence of liver cell carcinoma. Similar high frequencies of HBs Ag are also found in those areas where macronodular cirrhosis is relatively common and is usually complicated by liver cell carcinoma. In geographic areas with low incidence of liver cell carcinoma and macronodular cirrhosis, a relatively low frequency of HBs Ag is usually encountered in the population. The frequency of HBs Ag is relatively higher in patients with liver cell carcinoma with or without cirrhosis than in comparable controls. The subtypes of the antigen do not correlate with the incidence of liver cell carcinoma and there is also no correlation between alpha fetoprotein and HBs Ag in the presence of liver cell carcinoma. HBs Ag is very rarely detected in patients with micronodular cirrhosis or in liver cell carcinoma which may be its complication. It would appear that HBs Ag is necrogenic in the liver and is capable of producing hepatic necroses or hepatitis which may progress to macronodular cirrhosis. The areas of hepatic necroses may either progress to liver cell carcinoma or the resultant macronodular cirrhosis may be complicated by carcinoma. The oncogenic potential of HBs Ag requires further studies.
乙肝表面抗原（HBs Ag）在世界不同地区的频率分布显示，在居住于肝细胞癌高发地区的人群健康成员中，其频率相对较高。在大结节性肝硬化相对常见且通常并发肝细胞癌的地区，也发现了类似的高频率HBs Ag。在肝细胞癌和大结节性肝硬化发病率较低的地理区域，人群中HBs Ag的频率通常较低。患有或未患有肝硬化的肝细胞癌患者中HBs Ag的频率相对高于可比的对照组。抗原的亚型与肝细胞癌的发病率无关，在存在肝细胞癌的情况下，甲胎蛋白与HBs Ag之间也没有相关性。在小结节性肝硬化患者或可能由其引发的肝细胞癌患者中，很少检测到HBs Ag。看来HBs Ag在肝脏中具有致坏死性，能够产生肝坏死或肝炎，可能进展为大结节性肝硬化。肝坏死区域可能进展为肝细胞癌，或者由此产生的大结节性肝硬化可能并发癌症。HBs Ag的致癌潜力需要进一步研究。
