AFM1暴露量与原发性肝癌关系研究  

作　　者：吴燕[1] 陆培新[1] 王金兵[1] 孙燕[1] 张启南[1] 陈陶阳[1] 

机构地区：[1]江苏省启东肝癌防治研究所,江苏南通226200

出　　处：《中国实用内科杂志》2010年第S1期10-12,共3页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金(859140303969060107)

摘　　要：目的研究黄曲霉毒素M1(AFM1)暴露量与原发性肝癌(PHC)发生的关系。方法对HBsAg阳性的25～60岁男性(肝癌高危人群)148例进行瞻性调查研究。采用高亲和力的抗-AFM1单克隆抗体系统,以免疫浓缩和高压液相(HPLC)系列,进行尿中AFM1累积排出量测定;用酶联免疫吸附试验检测血清HBV感染5项标志;肝功能ALT检测采用赖氏法;甲胎蛋白(AFP)检测采用固相放免法。结果⑴HBsAg(+)伴AFM1(+)组PHC发生率占总发生率的70.73%,20年里PHC的平均年发生率高达1835.45/10万,该组不论是PHC发生率还是ALT阳性率均显著高于AFM1(-)组,P<0.01。(2)AFM1(+)组的HBV感染模式主要为1,4,5同时(+),显著高于AFM1(-)组,P<0.01。(3)AFM1(+)组的AFP(+)率显著高于AFM1(-)组,P<0.05。(4)本研究对象中大量饮酒者(≥50g/d)均发生PHC。结论 HBV感染是导致PHC的基本病因,黄曲霉毒素则是重要的辅助病因,AFM1暴露与HBV有明显的协同致癌效应;而长期大量饮酒对PHC的发生具有促进作用。提倡健康饮食理念和对HBV开展预防研究在肝癌防治现场具有重要意义。Objective To study the relations between exposition quantity of ADM1 and occurrence of PHC.M ethods We carry on a twenty-year prospective study in 148 males who are 25-60 years old and positive inh epatitis B surface antigen(individuals at high risk for liver cancer).Using the monoclonal antibody system of anti-AFM1 with high affinity and immunity concentration,high-pressure liquid chromatography(HPLC),wed etermine the accumulation displacement of AFM1 in urine.We detect the five symbols of hepatitis B virus infection in serum with enzyme-linked immunosorbent assay(ELISA).We use the LAI to determine alanine aminotransferase(ALT).Using solid phase radioimmunoassay to detect AFP.Result(1)Of the total rate of PHC,rate of the group is 70.73%,who are positive in hepatitis B surface antigen with AFM1-positive.In this twenty years,the rate of PHC is 1835.45/100,000 per year in average.Either the rate of PHC or the positive rate ofA LT in this group is obviously higher than those with AFM1-negative(P<0.01).(2)Rate of 1,4,5 positive simultaneously in the AFM1-positive is obviously higher than that in the AFM1-negative(P<0.01).(3)Rate of AFP-positive in the AFM1-positive is obviously higher than that in the AFM1-negative(P<0.05).(4)Thosew ho drink wine massively(≥50g/d)all have PHC.Conclusion HBV infection is the basic cause of PHC.A FM1 is an important auxiliary cause of the disease.Exposition of AFM1 and HBV infection obviously have syncarcinogenesis.And long-term massively drinking will promote PHC.So we advocate healthy diet and study on preventing HBV infection,and these have important meanings in preventing and controlling liver cancer.

关 键 词：AFM1暴露量 原发性肝癌 前瞻性研究 协同作用 

分 类 号：R735.7[医药卫生—肿瘤]