黄曲霉毒素与乙型肝炎病毒对肝癌发生协同作用的前瞻性研究  

INTERACTION BETWEEN AFLATOXIN AND HEPATITIS (?) VIRUS ON LIVER CANCER RISK FROM A PROSPECTIVE STUDY IN SHANGHAI

作　　者：袁剑敏[1] R.K.Ross 钱耕荪[1] M.C.Yu 屠基陶[1] G.N.Wogan 王学励[1] 张玉兰[1] J.D.Groopman B.E.Henderson 高玉堂[1] 

机构地区：[1]上海市肿瘤研究所 [2]美国南加州大学 [3]美国麻省理工学院 [4]美国约翰斯.霍普金斯大学

出　　处：《肿瘤》1992年第5期193-196,共4页Tumor

摘　　要：我们利用最近建立的检测尿液黄曲霉毒素(AF)B_1及其代谢产物(AFP_1、AFM_1)和DNA加成物(AFB_1-N^7-Guanine)的方法,分别检测上海市区队列研究中发现的22例肝癌及其140名对照尿液AFB_1、AFP_1、AFM_1和DNA加成物,同时测定血清乙型肝炎病毒表面抗原(HBsAg)。肝癌病例尿液AF检出率(59％)比对照高(38％)。DNA加成物阳性者肝癌相对危险度估计值(OR)为4.9。尽管AFP_1(OR=6.1)、AFM_1(OR=3.0)和AFB_1(OR=2.3)均与OR显著或接近显著增高有关,但伴随DNA加成物阴性时,AFP_1、AFM_1或AFB_1阳性并不显著增高OR。本文还发现HBsAg阴性者尿AF阳性OR仅增高1倍,而HBsAg阳性者伴尿AF阳性使OR增高11.5倍。以条件Logistic回归模型调整HBsAg、受教育程度、吸烟和重度饮酒等因素后,尿液检出AF的OR为3.8(95％CI:1.2～12.2)。To assess the relationship between aflatoxin (AF) exposure and development ofliver cancer in human beings, we used recently developed assays to test urinary AFB_1and its metabolites--AFP_1 AFM_1 as well as DNA-adducts (AFB_1-N～7-Guanine) for22 liver cancer cases and 140 their matched controls. Serum hepatitis B surface antigen(HBsAg) was also tested. Liver cancer cases (59%) were more likely than controls(38%) to have had detectable levels of any of the 4 urinary aflatoxins measured. Theodds ratio (OR) was 4.9 for DNA-adducts. Although ORs were significantly elevated ornearly so for AFP_1(OR=6.2), AFM_1 (OR=3.0) and AFB_1(OR=2.3), in the absenceof DNA-adducts, the ORs associated with the presence of AFP_1, AFM_1 or AFB_1 werenot statistically significant. There appeared a strong interaction between AF exposureand RBsAg positivity on liver cancer risk. Among individuals who were RBsAg nega-tive, there was only a 1.9-fold increase in risk associated with urinary AF positivity,whereas for those who were HBsAg positive, detection of AF in urine was associatedwith a 12.5-fold elevation in risk. In a multivariate analysis including HBsAg positi-vity, level of education, smoking and heavy alcohol consumption, the OR for the pre-sence of urinary AFB_1 or its metabolites/DNA-adducts was 3.8 (95% CI:1.2-12.2).

关 键 词：黄曲霉毒素 乙型肝炎病毒 肝肿瘤 

分 类 号：R735.702[医药卫生—肿瘤]