Rinaldi G, Saccardo F, Petrozzino M R, Bossi E, Manna M R, Monti G
1st Division of Medicine, Saronno Hospital, Italy.
Clin Exp Rheumatol. 1995 Nov-Dec;13 Suppl 13:S161-3.
To assess: (1) the role of hepatitis C virus (HCV), hepatitis B virus (HBV) and alcoholism as risk factors for hepatocarcinoma (HCC) in patients with liver cirrhosis, and (2) the presence of cryoglobulins in HCV + patients with and without HCC.
82 cirrhotic patients, 41 with and 41 without HCC, who were admitted consecutively to our General Medicine Division from January 1992 to June 1994, were studied.
The prevalence of HBV markers, anti-HCV and alcoholism in patients with liver cirrhosis and HCC was 39%, 63.4% and 24%, and in cirrhotics without HCC it was 31.7%, 51.2% and 63.4%, respectively. Cryoglobulins were present in 87.5% of the patients with HCC (78.5% anti-HCV +) and in 57.8% of the patients without HCC (81.8% anti-HCV +). The cryoglobulins, as characterized in 11 cases, were type III in nine cases and type II in two.
Patients with cirrhosis, especially when associated with HCV and HBV infection, are at high risk for HCC and therefore require careful follow-up. Moreover, a strong association between HCV and the cryoglobulins in cirrhotics with and without HCC was evident, thus supporting the possible role of this virus in stimulating lymphocytes to produce cryoglobulins.
评估：（1）丙型肝炎病毒（HCV）、乙型肝炎病毒（HBV）和酗酒作为肝硬化患者肝细胞癌（HCC）危险因素的作用；（2）HCV阳性且伴有和不伴有HCC的患者中冷球蛋白的存在情况。
对1992年1月至1994年6月连续入住我院普通内科的82例肝硬化患者进行了研究，其中41例患有HCC，41例未患HCC。
肝硬化合并HCC患者中HBV标志物、抗HCV和酗酒的患病率分别为39%、63.4%和24%，无HCC的肝硬化患者中分别为31.7%、51.2%和63.4%。HCC患者中87.5%存在冷球蛋白（抗HCV阳性者占78.5%），无HCC患者中57.8%存在冷球蛋白（抗HCV阳性者占81.8%）。在11例患者中进行特征分析的冷球蛋白，9例为III型，2例为II型。
肝硬化患者，尤其是合并HCV和HBV感染时，发生HCC的风险很高，因此需要密切随访。此外，无论有无HCC，肝硬化患者中HCV与冷球蛋白之间存在明显关联，这支持了该病毒在刺激淋巴细胞产生冷球蛋白方面可能发挥的作用。
