肝细胞癌
内科学
医学
优势比
置信区间
胃肠病学
病例对照研究
乙型肝炎表面抗原
乙型肝炎病毒
肝癌
黄曲霉毒素
免疫学
病毒
生物
食品科学
作者
Chuanfen Zheng,Hui Zeng,Hui Lin,Jia Wang,Xiaobin Feng,Zhiqun Qiu,Jian Chen,Jiaohua Luo,Yang Luo,Yujing Huang,Lingqiao Wang,Wenyi Liu,Yao Tan,Anwei Xu,Yuan Yao,Weiqun Shu
出处
期刊:Hepatology
[Lippincott Williams & Wilkins]
日期:2017-06-09
卷期号:66 (5): 1519-1528
被引量:140
摘要
Microcystins have been reported to be carcinogenic by animal and cell experimentation, but there are no data on the linkage between serum microcystins and hepatocellular carcinoma (HCC) risk in humans. We conducted a clinical case‐control study to investigate the association between serum microcystins and HCC risk after controlling several known risk factors, such as hepatitis B virus, alcohol, and aflatoxin. From December 2013 to May 2016, 214 patients newly diagnosed with HCC along with 214 controls (frequency‐matched by age and sex) were recruited from three hospitals in Chongqing, southwest China. Basic information on lifestyle and history of disease was obtained by questionnaire. Blood samples were collected and analyzed for serum microcystin‐LR (MC‐LR) and aflatoxin‐albumin adduct by enzyme‐linked immunosorbent assay and for hepatitis B surface antigen status by chemiluminescence assay. Binary logistic regression analyses were performed to assess the independent effects of MC‐LR and its joint effects with other factors on HCC risk. The adjusted odds ratio for HCC risk by serum MC‐LR was 2.9 (95% confidence interval [CI], 1.5‐5.5) in all patients. Notably, a clear relationship between increased MC‐LR level (Q2, Q3, and Q4) and HCC risk was observed with elevated adjusted odds ratios (1.3, 2.6, and 4.0, respectively). Positive interactions with the additive model were investigated between MC‐LR and hepatitis B virus infection (synergism index = 3.0; 95% CI, 2.0‐4.5) and between MC‐LR and alcohol (synergism index = 4.0; 95% CI, 1.7‐9.5), while a negative interaction was found between MC‐LR and aflatoxin (synergism index = 0.4; 95% CI, 0.3‐0.7). Additionally, serum MC‐LR was significantly associated with tumor differentiation ( r = –0.228, P < 0.001). Conclusion : We provide evidence that serum MC‐LR was an independent risk factor for HCC in humans, with an obvious positive interaction with hepatitis B virus and alcohol but a negative interaction with aflatoxin. (H epatology 2017;66:1519–1528)
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