Tanaka K, Hirohata T, Fukuda K, Shibata A, Tsukuma H, Hiyama T
Department of Public Health, School of Medicine, Kyushu University, Fukuoka, Japan.
Cancer Causes Control. 1995 Mar;6(2):91-8. doi: 10.1007/BF00052768.
To elucidate the risk factors for hepatocellular carcinoma (HCC) among women, we made a combined analysis of the data from three case-control studies conducted in high-risk areas of Japan. A total of 120 cases and 257 controls were included in the analysis. After adjustment for the study category, age, and other potential confounders, significantly increased risks were associated with chronic hepatitis-B virus infection (odds ratio [OR] = 42.4, 95 percent confidence interval [CI] = 11.2-160.2), a past history of blood transfusion (OR = 3.7, CI = 1.8-7.5), and a history of smoking (OR = 2.2, CI = 12-4.1). In addition, women with a history of heavy drinking experienced an elevated risk of borderline significance (OR = 4.2, CI = 0.9-20.4, P = 0.07). When these ORs were compared with the corresponding estimates among males from the same case-control studies, no significant differences were observed between the two genders. Among the factors examined in this analysis, drinking and smoking habits--which are more common among Japanese men than women--may partly account for a large male-predominance in the incidence of HCC. Further studies are needed to clarify the roles that sex-hormones and hepatitis-C virus infection might play in the large gender difference of HCC occurrence.
为阐明女性肝细胞癌(HCC)的危险因素,我们对在日本高危地区开展的三项病例对照研究的数据进行了综合分析。分析共纳入120例病例和257例对照。在对研究类别、年龄和其他潜在混杂因素进行调整后,慢性乙型肝炎病毒感染(比值比[OR]=42.4,95%置信区间[CI]=11.2 - 160.2)、既往输血史(OR = 3.7,CI = 1.8 - 7.5)和吸烟史(OR = 2.2,CI = 1.2 - 4.1)与风险显著增加相关。此外,有大量饮酒史的女性风险升高,具有临界显著性(OR = 4.2,CI = 0.9 - 20.4,P = 0.07)。当将这些OR值与同一病例对照研究中男性的相应估计值进行比较时,未观察到两性之间存在显著差异。在本分析中所研究的因素中,饮酒和吸烟习惯在日本男性中比女性更常见,这可能部分解释了HCC发病率中男性占主导的现象。需要进一步研究以阐明性激素和丙型肝炎病毒感染在HCC发生的巨大性别差异中可能发挥的作用。