Kew M C, Rossouw E, Hodkinson J, Paterson A, Dusheiko G M, Whitcutt J M
Hepatology. 1983 Jan-Feb;3(1):65-8. doi: 10.1002/hep.1840030110.
Hepatocellular carcinoma (HCC) is less common and occurs at a much older age in urban than in rural southern African Blacks. These differences may reflect differences in the etiology of the tumor in the two populations. The purpose of this study was to compare the hepatitis B virus (HBV) status of 150 HCC patients who were born and had lived all their lives in a rural environment with 158 patients who were born and brought up in a rural setting but then became urbanized. HBsAg and all markers of present or past HBV infection [HBsAg(+) or anti-HBc(+) or anti-HBs] were significantly less common in the urban patients when the two groups were considered as a whole (p less than 0.001 and p less than 0.05, respectively). However, because the rural patients were considerably younger (mean age 34.7 years; 66% less than 40 years of age) than in urban patients [mean age 50.9 years (p less than 0.0005), 19.0% less than 40 years of age (p less than 0.001)], an age-related analysis was performed. No significant difference in any HBV marker was found between rural and urban patients. The association between active HBV infection and HCC was similar in young patients, both rural and urban, and the prevalence of HBs antigenemia decreased in both groups with increasing age. We conclude that the differences in incidence and age of onset of HCC in rural and urban southern African Blacks cannot be attributable to differences in HBV status.
肝细胞癌（HCC）在城市地区比在非洲南部农村黑人中更不常见，且发病年龄要大得多。这些差异可能反映了这两个人群中肿瘤病因的不同。本研究的目的是比较150名出生并一生都生活在农村环境中的HCC患者与158名出生并在农村长大但后来城市化的患者的乙肝病毒（HBV）感染状况。当将两组患者作为一个整体考虑时，城市患者中HBsAg以及所有现症或既往HBV感染的标志物[HBsAg(+)或抗-HBc(+)或抗-HBs]明显较少见（分别为p<0.001和p<0.05）。然而，由于农村患者比城市患者年轻得多（平均年龄34.7岁；66%年龄小于40岁）[城市患者平均年龄50.9岁（p<0.0005），19.0%年龄小于40岁（p<0.001）]，因此进行了年龄相关性分析。农村和城市患者在任何HBV标志物方面均未发现显著差异。农村和城市的年轻患者中，现症HBV感染与HCC之间的关联相似，且两组中HBs抗原血症的患病率均随年龄增长而下降。我们得出结论，非洲南部农村和城市黑人中HCC发病率和发病年龄的差异不能归因于HBV感染状况的差异。
