Di Bisceglie A M, Simpson L H, Lotze M T, Hoofnagle J H
Liver Diseases Section, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, Maryland 20892.
J Clin Gastroenterol. 1994 Oct;19(3):222-6. doi: 10.1097/00004836-199410000-00011.
Although chronic infection with hepatitis C (HCV) and B viruses (HBV) are important risk factors for hepatocellular carcinoma (HCC), their relative roles in causing liver cancer remain poorly defined, particularly in developed Western countries. Thirty-one patients with HCC seen at the Clinical Center of the National Institutes of Health between 1986 and 1992 were evaluated serologically for evidence of HBV and HCV infection: antibodies to HBV and HCV and hepatitis B surface antigen (HBsAg) were detected by conventional immunoassays, and HCV RNA and HBV DNA were detected by polymerase chain reaction (PCR). Serologic evidence of HBV infection was found in 18 patients (56%), 17 with antibodies, 16 with HBV DNA, and 14 with HBsAg. Evidence of HCV infection was found in 10 patients (32%), seven of whom also had HCV RNA. One patient had both anti-HCV and HBsAg. In comparison to patients with HBV-related HCC, those with HCV-related cancer were older and more likely to be white, to have been born in the United States, to have a history of parenteral exposure, and to have cirrhosis. In two patients in whom the course of hepatitis C could be traced from its onset, hepatocellular carcinoma developed after 5 years in one and after 9 years in another case. Thus chronic HCV infection is a common etiology of cirrhosis among United States patients with HCC, often as a late complication of intravenous drug abuse or blood transfusion.
尽管丙型肝炎病毒（HCV）和乙型肝炎病毒（HBV）的慢性感染是肝细胞癌（HCC）的重要危险因素，但它们在引发肝癌方面的相对作用仍不明确，尤其是在西方发达国家。对1986年至1992年间在美国国立卫生研究院临床中心就诊的31例肝细胞癌患者进行了血清学评估，以检测HBV和HCV感染的证据：通过传统免疫测定法检测HBV和HCV抗体以及乙型肝炎表面抗原（HBsAg），并通过聚合酶链反应（PCR）检测HCV RNA和HBV DNA。18例患者（56%）有HBV感染的血清学证据，其中17例有抗体，16例有HBV DNA，14例有HBsAg。10例患者（32%）有HCV感染的证据，其中7例也有HCV RNA。1例患者同时有抗-HCV和HBsAg。与HBV相关肝细胞癌患者相比，HCV相关癌症患者年龄更大，更可能是白人，出生在美国，有非肠道暴露史，并有肝硬化。在2例可以追溯丙型肝炎病程的患者中，1例在发病后5年、另1例在发病后9年发生了肝细胞癌。因此，慢性HCV感染是美国肝细胞癌患者肝硬化的常见病因，通常是静脉药物滥用或输血的晚期并发症。
