食生鱼与HBV感染和饮酒在原发性肝癌发生中的协同作用  

Synergistic effect of HBV infection, alcohol and raw fish consumption on oncogenisis of primary hepatic carcinoma

作　　者：仇小强[1] 谭盛葵[1] 余红平[1] 曾小云[1] 黎乐群[2] 胡浪[1] 

机构地区：[1]广西医科大学公共卫生学院流行病学教研室,南宁530021 [2]广西医科大学第一附属医院肝胆外科

出　　处：《中华肿瘤杂志》2008年第2期113-115,共3页Chinese Journal of Oncology

基　　金：国家自然基金资助项目（30660162）;广西研究生教育创新计划资助项目（2007105981004D12）

摘　　要：目的探讨食生鱼与原发性肝癌的关系及其与HBV感染和饮酒的协同致病作用。方法采用病例对照研究的方法，以500例原发性肝癌患者（病例组）及同期住院的500例非肿瘤患者（对照组）为研究对象，比较两组患者的食生鱼史，评价食生鱼发生原发性肝癌的危险性及其与HBV感染和饮酒的协同致病作用。结果病例组中，食生鱼者274例，占54．8％；对照组中食生鱼者48例，占8．4％。两组间差异有统计学意义（P〈0．001）；食生鱼者发生原发性肝癌的OR值为13．6（95％CI：9．1—19．5），食生鱼与HBV感染和食生鱼与饮酒之间呈正相加交互作用，其交互作用超额相对危险度（RERI）分别为195．3和17．8，交互作用归因比（API）分别为0．8630和0．5251，交互作用指数（S）分别为7．5和2．8。结论食生鱼可能是原发性肝癌的重要危险因素之一，食生鱼与HBV感染或饮酒在原发性肝癌的发生中可能具有协同致病作用。Objective To study the correlation of eating raw fish with primary hepatic carcinoma （PHC）, and to investigate the synergistic effect of HBV infection, alcohol consumption and eating raw fish on the oncogenesis of PHC. Methods A hospital-based case-control study was conducted among 500 PHC patients and 500 non-cancerous patients in order to compare the history of eating raw fish. The synergistic pathogenetic action of eating raw fish, HBV infection and alcohol consumption on carcinogenesis of PHC was analyzed by crossover analysis and multiple logistic regression. Results The rates of eating raw fish in the past between the case （54.8 % ） and the control group （ 8.4% ） were significantly different （ P 〈 0.001 ）. OR value of suffering PHC in the patients who ate raw fish in the past was 13.6（95% CI： 9.1-19.5） when compared with the non-cancerous patient. HBV infection, alcohol consumption and eating raw fish showed an interactive effect on the development of PHC, with a relative excessive risk of interaction （RERI） of 195.3 and 17.8;attributable proportion of interaction（APl） of 0. 8630 and 0. 5251 ;and synergy index（S） of 7.5 and 2.8, respectively. Conclusion A history of eating raw fish may be an important risk factor for suffering primary hepatic carcinoma. HBV infection, alcohol consumption and eating raw fish may have a synergistic effect on the developing of primary hepatic carcinoma.

关 键 词：食生鱼 肝肿瘤 HBV感染 饮酒 协同病作用 

分 类 号：R735.7[医药卫生—肿瘤]