社会心理行为及环境因素与原发性肝癌关系的调查研究
|
摘要
第一部分
社会心理行为及环境因素与原发性肝癌的关系研究
目的:探讨社会心理行为及环境因素与原发性肝癌的关系,阐明原发性肝癌的主要危险因素,探索其病因模型,为采取有效的综合防治措施提供科学依据。
方法:采用病例对照研究的方法进行回顾性调查。病例选择参照2001年中国肝癌协会专业委员会修订的临床诊断标准。从2005年11月到2006年11月,对来自于广西医科大学一附院、肿瘤医院等住院的所有参与调查的、经临床表现、血清肝癌标志物、手术、病理及影像学检查等确诊的新发病例,组成病例组;对照的选择首先根据对照选择标准选取来自于同期住院的脊柱、创伤外科经诊断为非肿瘤患者作为对照人群,组成对照组。制定专门的《调查员手册》,经过专门、严格、统一培训调查员,用统一制定的调查表,采用面访的调查方式对病例和对照按调查表内容逐一询问,填写调查表格,收集相关资料。将单因素分析结果中,显著性水平小于0.10的因素,通过逐步回归方法(STEPWISE)拟合肝癌的非条件Logistic回归模型,并计算标准回归系数(β)以判断模型中各因素作用的大小。
结果:社会心理行为因素及环境因素与原发性肝癌的发生密切相关。单因素分析发现,经济收入低,强体力劳动、适应能力差、O血型、B血型、A性格、B性格、情绪差、精神创伤、精神压抑、吸烟、饮酒、饮水(江河水或沟塘水)、食鱼生、喝生水、食物霉变、腌晒食品、烟薰食品、盐渍食品、油炸食品、喜食玉米、喜食花生油、喜食猪油、农药接触史、灭蚊药、常用药物、住房装修、厨房油烟、职业接触、乙型肝炎感染、肝炎家族史、肝癌家族史、肝吸虫病、糖尿病等34个因子为原发性肝癌的危险因素;而喜食新鲜蔬菜类、新鲜水果类、口味清淡、饮茶、纯净水、深井水等6个因子为保护性因素。进一步研究发现,吸烟开始的年龄、吸烟时间长短、吸烟量多少与原发性肝癌的发生密切相关。对饮酒的量进行分类发现,饮酒每天小于80mL乙醇无统计学意义(P＞0.05),而每天大于80mL乙醇危险性显著增加,其OR值为5.36;同时,随着饮酒时间越长、饮酒量的增加患原发性肝癌的风险相对越大,提示饮酒年数、饮酒量与原发性肝癌的发生关系密切。饮茶为一个保护性因素,饮茶的时间越长,相对无饮茶而言,其患原发性肝癌的风险越小;而饮茶浓度及是否喝隔夜茶与原发性肝癌的发生无关(P＞0.05)。在对HBV感染病程、肝吸虫病程及糖尿病病程进行分析发现,HBV感染和肝吸虫病病程小于10年者,其OR值分别为14.19、5.09;超过10年者,患原发性肝癌的风险性更大,其OR值分别为30.33、13.50。糖尿病病程小于5年者,其患原发性肝癌的危险性是无糖尿病的2倍。超过5年者,患原发性肝癌的风险性更大,OR值为7.51。
多因素分析发现,HBV感染、肝癌家族史、糖尿病、食鱼生、饮酒、常用药物、农药接触史、经济收入差、精神压抑、B血型和B性格为原发性肝癌的危险因素,其OR值及其95%CI分别是15.99(10.13-25.24)、3.72(2.01-6.88)、4.68(2.09-10.54)、6.43(3.96-10.44)、2.28(1.48-3.50)、2.92(1.85-4.63)、2.46(1.48-4.10)、2.60(1.56-4.34)、4.11(2.68-6.31)、3.43(2.00-5.87)、3.19(1.69-6.01)。
结论:广西地区原发性肝癌的发生与社会经济状况、当地居民的生活习惯、既往病史、家族史及心理因素等相关。HBV感染、肝癌家族史、糖尿病、食鱼生、饮酒、常用药物、农药、经济收入、精神压抑、B性格和B血型均为原发性肝癌的危险因素。经过近二十年来对肝癌的预防和控制,广西地区原发性肝癌的危险因素有所变迁,除乙型肝炎感染、肿瘤家族史、水污染等与原发性肝癌有关外,还发现了一些重要的新的危险因素,如精神压抑、食鱼生、常用药物等也应引起我们的注意。因此,预防和控制广西地区原发性肝癌,应针对高危人群采取戒烟限酒、不食鱼生等饮食习惯的宣传教育,改变不良的生活习惯,让居民保持良好的心理状态。进一步加强乙型肝炎疫苗的接种率等积极有效的措施,以降低原发性肝癌的发生率是有重要意义的。
第二部分
原发性肝癌危险因素的病因分值及其交互效应研究
目的:探讨原发性肝癌危险因素的病因分值以及HBV感染与其他各危险因素间的交互效应。为采取有效的综合防治措施提供依据。
方法:对来自于广西医科大学第一附属医院、附属肿瘤医院等肝胆外科,从2005年11月30日到2006年11月30日,所有参与调查的、经临床表现、血清肝癌标志物、病理及影像学检查等确诊的新发病例(原发性肝癌病人)500例和自于广西医科大学第一附属医院同期住院的脊柱骨病外科和创伤外科,从2005年11月30日到2006年11月30日,抽取并参与调查的所有非肿瘤患者500例进行以医院为基础的病例对照研究。利用面访的调查方式对病例和对照按调查表内容逐一询问,填写调查表格,收集相关资料。采用SPSS13.0建立数据库,在叉生分析和非条件Logistic回归的基础上,分析了原发性肝癌危险因素的病因分值及HBV感染与其他各危险因素间的交互效应。
结果:HBV感染、肝癌家族史、糖尿病、食鱼生、饮酒、常用药物、农药接触史、经济收入差、精神压抑、B性格和B血型为广西原发性肝癌的主要危险因素,病因分值分别为0.725、0.186、0.119、0.486、0.385、0.438、0.195、0.277、0.604、0.157、0.299;HBV感染与肝癌家族史、糖尿病、食鱼生、饮酒、常用药物、农药接触史、经济收入差、精神压抑、B性格和B血型之间存在正相加交互作用模式,其病因分值分别为0.736、0.643、0.849、0.551、0.592、0.316、0.618、0.902、0.597、0.577。交互指数分别为0.743、0.651、0.853、0.560、0.600、0.323、0.626、0.907、0.607、0.586。
结论:HBV感染、肝癌家族史、糖尿病、食鱼生、饮酒、常用药物、农药接触史、经济收入差、精神压抑、B性格和B血型可能为原发性肝癌重要的危险因素;HBV感染与肝癌家族史、糖尿病、食鱼生、饮酒、常用药物、农药接触史、经济收入差、精神压抑、B性格和B血型在原发性肝癌的发生中可能具有协同致病作用,能增加原发性肝癌的危险性。
Objective:To investigate the relation between social psychology factor, behavior factor and environmental factor and Primary hepatic carcinoma in Guangxi and to explore the major risk factors and etiological pattern of Primary hepatic carcinoma by case-control study,so as to provide the scientific basis for preventive measures.
Methods:A hospital-based case-control retrospective study was conducted among 500 PHC patients and 500 nontumorous patients.The subjects were enrolled at the First Affiliated Hospital and Tumor Hospital of Guangxi Medical University from December 2005 to December 2006 in accordance with clinical diagnosis criteria revised by professional committee of hepatoma association in 2001.The case group includes those diagnosed patients with PHC by clinical situation,blood serum,hepatoma marker,operation,imageology examination. The control group was selected from diagnosed nontumorous patients in Spine Surgery and Traumatic Surgery at the First Affiliated Hospital at the same time by simple random sampling.The subjects were interviewed face to face by trained interviewers based on the contents of the questionnaires.In single factor analysis result,Factor with significance level less than 0.10 was analyzed by stepwise regression and non-condition multiple factor Logistic regression.
Results:Social psychology factor,behavior factor and environmental factor are the important risk factors for the development of primary hepatic carcinoma.By univariate analysis,low income、heavy physical labor、adaptability、B blood type、B character、emotion、psychic trauma、mental oppression、smoking、alcohol consumption、drinking;、consumption of pieces of raw fish、raw water、mildew food、pickled vegetables、bake food、salting food、fried food、maize food、pesticide、mosquito-killer、frequently used drug、housing fitment、chimney soot、HBV infection history of HBV、history of PHC、distomatosis hepatis、 diabetes mellitus are associated with the development of primary hepatic carcinoma。Fresh vegetables、Fresh fruit、Light taste、Drinking tea、Purified water、Phreatic water have a protective effect to PHC.
Further research shows that age,the history and the packs of smoking are closely associated with the development of PHC.With regard to alcohol consumption,there was a statistical significance for those who consumed＜80 mL of ethanol per day(P＞0.05).Daily alcohol consumption of≥80 mL of ethanol per day resulted in a greater risk of PHC(OR:5.36).In addition,PHC risk increased in proportion to the increase in alcohol consumption and the extension of the history.It indicates that there was dose-response relation between the years of drinking and amount of alcohol and the development of PHC.Drinking tea is one of the protection factors.The duration of this habit can reduce the risk on the development of PHC.But there is no relation between tea concentration and the tea of previous day and the development of PHC(P＞0.05).Evidence from the analysis of the history of HBV infection, distomatosis hepatic and diabetes mellitus shows:The presence of the history of hepatic distomiasis and diabetes mellitus was also statistically associated with the development of PHC.OR for the people with the history of HBV infection and hepatic distomiasis less than ten years is14.19、5.09 respectively;OR for the people with the history of HBV infection and hepatic distomiasis more than ten years is 30.33、13.50,respectively;The risk for the patients with the history of hepatic distomiasis less than five years is three times that of those people without hepatic distomiasis.It would be greater for the patients with the history of diabetes,more than five years(OR=7.51),It showed that with the extension of the history of diabetes,can increase the risk on the development of PHC.
Multiple analysis shows that HBV infection,family history of PHC, diabetes mellitus,eating raw fish,alcohol consumption,frequently used drug, pesticide,low income,mental oppression,B-character and B blood-type are risk factors of PHC.Their OR value and 95%CI are 15.99(10.13-25.24), 3.72(2.01-6.88),4.68(2.09-10.54),6.43(3.96-10.44),2.28(1.48-3.50), 2.92(1.85-4.63),2.46(1.48-4.10),2.60(1.56-4.34),4.11(2.68-6.31), 3.43(2.00-5.87),3.19(1.69-6.01),respectively.
Conclusion:The occurrence of primary hepatic carcinoma in Guangxi is more associated with such risk factors as socioeconomic status,living habit,the history of disease,the history of PHC and psychological factor,etc.With the prevention and control of PHC in the past twenty years,the risk factors of PHC have been diversified.In addition of the risk factors such as HBV infection、family history of PHC and polluted water,other risk factors have been found such as eating raw fish,consumption of alcohol,blood type,mental oppression and drug.Therefore,the high risk group should be educated to maintain favorable mental status and get away from some bad living habits such as smoking,eating raw fish and heavy alcohol consumption in order to prevent and control the development of PHC.At the same time,it is important to take some active and effective measures,such as increasing the inoculation rate hepatitis B vaccine in order to decrease the incidence rate of PHC.
Objective:To explore etiologic fraction(EF)and interaction of HBV infection and other risk factors for primary hepatocellular carcinoma(PHC)in GuangXi,China.so as to provide the scientific basis for preventive measures.
Methods:A hospital-based case-control retrospective study was conducted among 500 PHC patients and 500 nontumorous patients.The subjects were enrolled at the First Affiliated Hospital and Tumor Hospital of Guangxi Medical University from December 2005 to December 2006.The case group includes those diagnosed patients with PHC by clinical situation,blood serum,hepatoma marker,operation,imageology examination.The control group was selected from diagnosed nontumorous patients at the same time by simple random sampling.The subjects were interviewed face to face by trained interviewers based on the contents of the questionnaires.EF and interactions of HBV infection and other risk factors for PHC were analyzed by crossover analysis and nonconditional multiple logistic regression.
Results:HBV infection,family history of PHC,diabetes mellitus,eating raw fish,heavy alcohol consumption,frequently used drug,pesticide,low income, B-character and blood type B all were risk factors for PHC.with EFs of 0.725, 0.186,0.119,0.486,0.385,0.438,0.195,0.277,0.604,0.157,0.299, respectively;There existed interactions of HBV infection with other risk factors including family history of PHC,diabetes mellitus,eating raw fish,heavy alcohol consumption,frequently used drug,pesticide,low income,B-character and blood type B.with etiologic fractions attributable to interaction[EF(A×B] of 0.736,0.643,0.849,0.551,0.592,0.316,0.618,0.902,0.597,0.577,and indices of interaction of 0.743,0.651,0.853,0.560,0.600,0.323,0.626, 0.907,0.607 and 0.586,respectively.
Conclusions:Main risk factors for PHC in GuangXi,China could include HBV infection,family history of PHC,diabetes mellitus,eating raw fish,heavy alcohol consumption,frequently used drug,pesticide,low income,B-character and blood type B.HBV infection with other risk factors including family history of PHC,diabetes mellitus,eating raw fish,heavy alcohol consumption,frequently used drug,pesticide,low income,B-character and blood type B could exert synergistic action on developing PHC and could increase the risk of PHC.
社会心理行为及环境因素与原发性肝癌的关系研究
目的:探讨社会心理行为及环境因素与原发性肝癌的关系,阐明原发性肝癌的主要危险因素,探索其病因模型,为采取有效的综合防治措施提供科学依据。
方法:采用病例对照研究的方法进行回顾性调查。病例选择参照2001年中国肝癌协会专业委员会修订的临床诊断标准。从2005年11月到2006年11月,对来自于广西医科大学一附院、肿瘤医院等住院的所有参与调查的、经临床表现、血清肝癌标志物、手术、病理及影像学检查等确诊的新发病例,组成病例组;对照的选择首先根据对照选择标准选取来自于同期住院的脊柱、创伤外科经诊断为非肿瘤患者作为对照人群,组成对照组。制定专门的《调查员手册》,经过专门、严格、统一培训调查员,用统一制定的调查表,采用面访的调查方式对病例和对照按调查表内容逐一询问,填写调查表格,收集相关资料。将单因素分析结果中,显著性水平小于0.10的因素,通过逐步回归方法(STEPWISE)拟合肝癌的非条件Logistic回归模型,并计算标准回归系数(β)以判断模型中各因素作用的大小。
结果:社会心理行为因素及环境因素与原发性肝癌的发生密切相关。单因素分析发现,经济收入低,强体力劳动、适应能力差、O血型、B血型、A性格、B性格、情绪差、精神创伤、精神压抑、吸烟、饮酒、饮水(江河水或沟塘水)、食鱼生、喝生水、食物霉变、腌晒食品、烟薰食品、盐渍食品、油炸食品、喜食玉米、喜食花生油、喜食猪油、农药接触史、灭蚊药、常用药物、住房装修、厨房油烟、职业接触、乙型肝炎感染、肝炎家族史、肝癌家族史、肝吸虫病、糖尿病等34个因子为原发性肝癌的危险因素;而喜食新鲜蔬菜类、新鲜水果类、口味清淡、饮茶、纯净水、深井水等6个因子为保护性因素。进一步研究发现,吸烟开始的年龄、吸烟时间长短、吸烟量多少与原发性肝癌的发生密切相关。对饮酒的量进行分类发现,饮酒每天小于80mL乙醇无统计学意义(P＞0.05),而每天大于80mL乙醇危险性显著增加,其OR值为5.36;同时,随着饮酒时间越长、饮酒量的增加患原发性肝癌的风险相对越大,提示饮酒年数、饮酒量与原发性肝癌的发生关系密切。饮茶为一个保护性因素,饮茶的时间越长,相对无饮茶而言,其患原发性肝癌的风险越小;而饮茶浓度及是否喝隔夜茶与原发性肝癌的发生无关(P＞0.05)。在对HBV感染病程、肝吸虫病程及糖尿病病程进行分析发现,HBV感染和肝吸虫病病程小于10年者,其OR值分别为14.19、5.09;超过10年者,患原发性肝癌的风险性更大,其OR值分别为30.33、13.50。糖尿病病程小于5年者,其患原发性肝癌的危险性是无糖尿病的2倍。超过5年者,患原发性肝癌的风险性更大,OR值为7.51。
多因素分析发现,HBV感染、肝癌家族史、糖尿病、食鱼生、饮酒、常用药物、农药接触史、经济收入差、精神压抑、B血型和B性格为原发性肝癌的危险因素,其OR值及其95%CI分别是15.99(10.13-25.24)、3.72(2.01-6.88)、4.68(2.09-10.54)、6.43(3.96-10.44)、2.28(1.48-3.50)、2.92(1.85-4.63)、2.46(1.48-4.10)、2.60(1.56-4.34)、4.11(2.68-6.31)、3.43(2.00-5.87)、3.19(1.69-6.01)。
结论:广西地区原发性肝癌的发生与社会经济状况、当地居民的生活习惯、既往病史、家族史及心理因素等相关。HBV感染、肝癌家族史、糖尿病、食鱼生、饮酒、常用药物、农药、经济收入、精神压抑、B性格和B血型均为原发性肝癌的危险因素。经过近二十年来对肝癌的预防和控制,广西地区原发性肝癌的危险因素有所变迁,除乙型肝炎感染、肿瘤家族史、水污染等与原发性肝癌有关外,还发现了一些重要的新的危险因素,如精神压抑、食鱼生、常用药物等也应引起我们的注意。因此,预防和控制广西地区原发性肝癌,应针对高危人群采取戒烟限酒、不食鱼生等饮食习惯的宣传教育,改变不良的生活习惯,让居民保持良好的心理状态。进一步加强乙型肝炎疫苗的接种率等积极有效的措施,以降低原发性肝癌的发生率是有重要意义的。
第二部分
原发性肝癌危险因素的病因分值及其交互效应研究
目的:探讨原发性肝癌危险因素的病因分值以及HBV感染与其他各危险因素间的交互效应。为采取有效的综合防治措施提供依据。
方法:对来自于广西医科大学第一附属医院、附属肿瘤医院等肝胆外科,从2005年11月30日到2006年11月30日,所有参与调查的、经临床表现、血清肝癌标志物、病理及影像学检查等确诊的新发病例(原发性肝癌病人)500例和自于广西医科大学第一附属医院同期住院的脊柱骨病外科和创伤外科,从2005年11月30日到2006年11月30日,抽取并参与调查的所有非肿瘤患者500例进行以医院为基础的病例对照研究。利用面访的调查方式对病例和对照按调查表内容逐一询问,填写调查表格,收集相关资料。采用SPSS13.0建立数据库,在叉生分析和非条件Logistic回归的基础上,分析了原发性肝癌危险因素的病因分值及HBV感染与其他各危险因素间的交互效应。
结果:HBV感染、肝癌家族史、糖尿病、食鱼生、饮酒、常用药物、农药接触史、经济收入差、精神压抑、B性格和B血型为广西原发性肝癌的主要危险因素,病因分值分别为0.725、0.186、0.119、0.486、0.385、0.438、0.195、0.277、0.604、0.157、0.299;HBV感染与肝癌家族史、糖尿病、食鱼生、饮酒、常用药物、农药接触史、经济收入差、精神压抑、B性格和B血型之间存在正相加交互作用模式,其病因分值分别为0.736、0.643、0.849、0.551、0.592、0.316、0.618、0.902、0.597、0.577。交互指数分别为0.743、0.651、0.853、0.560、0.600、0.323、0.626、0.907、0.607、0.586。
结论:HBV感染、肝癌家族史、糖尿病、食鱼生、饮酒、常用药物、农药接触史、经济收入差、精神压抑、B性格和B血型可能为原发性肝癌重要的危险因素;HBV感染与肝癌家族史、糖尿病、食鱼生、饮酒、常用药物、农药接触史、经济收入差、精神压抑、B性格和B血型在原发性肝癌的发生中可能具有协同致病作用,能增加原发性肝癌的危险性。
Objective:To investigate the relation between social psychology factor, behavior factor and environmental factor and Primary hepatic carcinoma in Guangxi and to explore the major risk factors and etiological pattern of Primary hepatic carcinoma by case-control study,so as to provide the scientific basis for preventive measures.
Methods:A hospital-based case-control retrospective study was conducted among 500 PHC patients and 500 nontumorous patients.The subjects were enrolled at the First Affiliated Hospital and Tumor Hospital of Guangxi Medical University from December 2005 to December 2006 in accordance with clinical diagnosis criteria revised by professional committee of hepatoma association in 2001.The case group includes those diagnosed patients with PHC by clinical situation,blood serum,hepatoma marker,operation,imageology examination. The control group was selected from diagnosed nontumorous patients in Spine Surgery and Traumatic Surgery at the First Affiliated Hospital at the same time by simple random sampling.The subjects were interviewed face to face by trained interviewers based on the contents of the questionnaires.In single factor analysis result,Factor with significance level less than 0.10 was analyzed by stepwise regression and non-condition multiple factor Logistic regression.
Results:Social psychology factor,behavior factor and environmental factor are the important risk factors for the development of primary hepatic carcinoma.By univariate analysis,low income、heavy physical labor、adaptability、B blood type、B character、emotion、psychic trauma、mental oppression、smoking、alcohol consumption、drinking;、consumption of pieces of raw fish、raw water、mildew food、pickled vegetables、bake food、salting food、fried food、maize food、pesticide、mosquito-killer、frequently used drug、housing fitment、chimney soot、HBV infection history of HBV、history of PHC、distomatosis hepatis、 diabetes mellitus are associated with the development of primary hepatic carcinoma。Fresh vegetables、Fresh fruit、Light taste、Drinking tea、Purified water、Phreatic water have a protective effect to PHC.
Further research shows that age,the history and the packs of smoking are closely associated with the development of PHC.With regard to alcohol consumption,there was a statistical significance for those who consumed＜80 mL of ethanol per day(P＞0.05).Daily alcohol consumption of≥80 mL of ethanol per day resulted in a greater risk of PHC(OR:5.36).In addition,PHC risk increased in proportion to the increase in alcohol consumption and the extension of the history.It indicates that there was dose-response relation between the years of drinking and amount of alcohol and the development of PHC.Drinking tea is one of the protection factors.The duration of this habit can reduce the risk on the development of PHC.But there is no relation between tea concentration and the tea of previous day and the development of PHC(P＞0.05).Evidence from the analysis of the history of HBV infection, distomatosis hepatic and diabetes mellitus shows:The presence of the history of hepatic distomiasis and diabetes mellitus was also statistically associated with the development of PHC.OR for the people with the history of HBV infection and hepatic distomiasis less than ten years is14.19、5.09 respectively;OR for the people with the history of HBV infection and hepatic distomiasis more than ten years is 30.33、13.50,respectively;The risk for the patients with the history of hepatic distomiasis less than five years is three times that of those people without hepatic distomiasis.It would be greater for the patients with the history of diabetes,more than five years(OR=7.51),It showed that with the extension of the history of diabetes,can increase the risk on the development of PHC.
Multiple analysis shows that HBV infection,family history of PHC, diabetes mellitus,eating raw fish,alcohol consumption,frequently used drug, pesticide,low income,mental oppression,B-character and B blood-type are risk factors of PHC.Their OR value and 95%CI are 15.99(10.13-25.24), 3.72(2.01-6.88),4.68(2.09-10.54),6.43(3.96-10.44),2.28(1.48-3.50), 2.92(1.85-4.63),2.46(1.48-4.10),2.60(1.56-4.34),4.11(2.68-6.31), 3.43(2.00-5.87),3.19(1.69-6.01),respectively.
Conclusion:The occurrence of primary hepatic carcinoma in Guangxi is more associated with such risk factors as socioeconomic status,living habit,the history of disease,the history of PHC and psychological factor,etc.With the prevention and control of PHC in the past twenty years,the risk factors of PHC have been diversified.In addition of the risk factors such as HBV infection、family history of PHC and polluted water,other risk factors have been found such as eating raw fish,consumption of alcohol,blood type,mental oppression and drug.Therefore,the high risk group should be educated to maintain favorable mental status and get away from some bad living habits such as smoking,eating raw fish and heavy alcohol consumption in order to prevent and control the development of PHC.At the same time,it is important to take some active and effective measures,such as increasing the inoculation rate hepatitis B vaccine in order to decrease the incidence rate of PHC.
Objective:To explore etiologic fraction(EF)and interaction of HBV infection and other risk factors for primary hepatocellular carcinoma(PHC)in GuangXi,China.so as to provide the scientific basis for preventive measures.
Methods:A hospital-based case-control retrospective study was conducted among 500 PHC patients and 500 nontumorous patients.The subjects were enrolled at the First Affiliated Hospital and Tumor Hospital of Guangxi Medical University from December 2005 to December 2006.The case group includes those diagnosed patients with PHC by clinical situation,blood serum,hepatoma marker,operation,imageology examination.The control group was selected from diagnosed nontumorous patients at the same time by simple random sampling.The subjects were interviewed face to face by trained interviewers based on the contents of the questionnaires.EF and interactions of HBV infection and other risk factors for PHC were analyzed by crossover analysis and nonconditional multiple logistic regression.
Results:HBV infection,family history of PHC,diabetes mellitus,eating raw fish,heavy alcohol consumption,frequently used drug,pesticide,low income, B-character and blood type B all were risk factors for PHC.with EFs of 0.725, 0.186,0.119,0.486,0.385,0.438,0.195,0.277,0.604,0.157,0.299, respectively;There existed interactions of HBV infection with other risk factors including family history of PHC,diabetes mellitus,eating raw fish,heavy alcohol consumption,frequently used drug,pesticide,low income,B-character and blood type B.with etiologic fractions attributable to interaction[EF(A×B] of 0.736,0.643,0.849,0.551,0.592,0.316,0.618,0.902,0.597,0.577,and indices of interaction of 0.743,0.651,0.853,0.560,0.600,0.323,0.626, 0.907,0.607 and 0.586,respectively.
Conclusions:Main risk factors for PHC in GuangXi,China could include HBV infection,family history of PHC,diabetes mellitus,eating raw fish,heavy alcohol consumption,frequently used drug,pesticide,low income,B-character and blood type B.HBV infection with other risk factors including family history of PHC,diabetes mellitus,eating raw fish,heavy alcohol consumption,frequently used drug,pesticide,low income,B-character and blood type B could exert synergistic action on developing PHC and could increase the risk of PHC.
引文
1 吴孟超,沈锋.肝癌研究的现状和进展.国外医学肿瘤学分册,2000,27(1):17-19.
2 吴孟超.原发性肝癌的诊断和治疗进展.中华外科杂志,1998,36(9):515-517.
3 陈建国,宋新明.中国肝癌发病水平的估算及分析[J]中国肿瘤,2005,14(1):28-31.
4 McGlynn KA,Tsao L,Hsing AW,Devesa SS,et al.International trends and patterns of primary liver cancer.Int J Cancer 2000,94:290-296.
5 张思维,李连弟,鲁凤珠,等.中国1990-1992年原发性肝癌死亡调查分析[J].中华肿瘤杂志,1999,21(4):245-247.
6 Kuntz E,Kuntz HD.Malignant liver tumours.See:Kuntz E,Kuntz HD.Hepatology Principles and Practice[M].Springer-verlag Berlin,Heidelberg,2002:699-730.
7 Yuan JM,Govindarajan S,Arakawa K,et al.Synergism of alcohol,diabetes,and viral hepatitis on the risk of hepatocellular carcinoma in blacks and whites in the U.S[J].Cancer.2004,101(5):1009-1017.
8 Bedard LL,Alessi M,Davey S,et al.Susceptibility to aflatoxin Bl-induced carcinogenesis correlates with tissue-specific differences in DNA repair activity in mouse and in rat.Cancer Res.2005;65(4):1265-1270.
9 Kirk GD,Lesi OA,Mendy M,et al.249(ser)TP53 mutation in plasma DNA,hepatitis B viral infection,and risk of hepatocellular carcinoma.Oncogene.2005;24(38):5858-5867.
10 Rao PV,Gupta N,Bhaskar AS,et al.Toxins and bioactive compounds from cyanobacteria and their implications on human health.J Environ Biol,2002,23(3):215-224.
11 Figuiredo DR,Azeiteiro UM,Esteves SM,et al.Microcystin-producing blooms--a serious global public health issue.[J]Ecotoxicol Environ Saf,2004,59(2):151-163.
12 Shimizu I,Impact of oestrogens on the progression of live disease.Liver Int,2003,23(1):63-69.
13 Khan KN,Yatsuhashi H.Effect of alcohol consumption on the progression of hepatitis C virus infection and risk of hepatocellular carcinoma in Japanese patients,Alcohol,2000,35(3):286-295.
14 俞顺章,赵宁,资晓林,等.饮水中微囊藻类毒素与我国原发性肝癌关系的研究[J].中华肿瘤杂志,2001,23(2):96-99.
15 Tao P,Zhi-Ming L,Tang-Wei L,et al.Associated factors in modulating aflatoxin B1-albumin adduct level in three Chinese populations.Dig Dis Sci.2005,50(3):525-532.
16 汤伯明,边建超,王其军,等.洛阳市肝癌危险因素的病例对照研究[J].现代预防医学,2002;29(5):723-725.
17 曾运红,谭卫仙.原发性肝癌发病主要危险因素的Meta分析[J].现代预防医学2004,31(2):172-174.
18 袁萍,唐伟,文进,等.中国四川和日本东京两地原发性肝癌手术患者肝炎病毒感染状况[J].中华预防医学杂志,2005,39(5):332-334.
19 张竹梅,边建超.饮酒与肝癌研究进展[J].中华流行病学杂志,2002,23(6):477-479.
20 吴继周,时馥荪,莫志纯.广西原发性肝细胞癌病因探讨:118例配对病例一对照的条件Logistic回归分析[J].癌症,1990,9(1):25-28.
21 张明东,俞顺章,梁任祥,等.广西扶绥县原发性肝癌病例对照研究[J].中华流行病学杂志,1993,14(1):14-18.
22 黄天壬,韦忠亮,汪凯波,等.广西扶绥县居民1997-2003年肝癌发病率分析[J].广西医学2006,28(9):1336-1339.
23 李连弟,鲁凤珠,张思维,等.1990-1992年中国恶性肿瘤死亡流行分布情况分析[J].中华肿瘤杂志,1996,18(6):403-407.
24 黄天壬,余家华,张振权,等.广西肝癌流行特征和流行趋势分析[J].广西医学,2000,22(4):677-678.
25 任宏轩,沈丽达.社会心理因素对癌症的影响[J].中国肿瘤,2005,14(10):639-641.
26 Tomatis L.Between the body and the mind the involvement of psychological factors in the development of multifactorial diseases[J]EurJ Cancer,2001,37(85):148-152.
27 中华抗癌协会肝癌专业委员会.原发性肝癌的临床诊断与分期标准(2001年广州第八届肝癌学术会议)[J].现代实用医学,2002,15(4):213.
28 Ferlay J,Bray F,Pisani P,et al.Globocan 2000:Cancer incidence mortality and prevalence worldwide[DB/CD].Lyon:IARC,2001.
29 孙喜文,戴旭东,石于波.哈尔滨市居民肝癌危险因素的病例对照研究[J].实用肿瘤学杂志,2000,14(3):181-185.
30 邹长林,陈哲京,金文扬,等.温州地区原发性肝癌危险因素的病因分值及其交互效应[J].中华预防医学杂志,2003,37(5):355-357.
31 丁建华,李苏平,高长明,等.泰兴市全人群肝癌病例对照研究[J].中国肿 瘤,2001,10(2):102-105.
32 Sinhoven P,Kooiman CG.Defense style in depressed and anxious psychiatric outpatients:An explorative study.The journal of nervous and mental disease,1997;185(2):87.
33 王珊珊,姜普林,庞红霞,等.广州市原发性肝癌的病因流行病学调查[J]中华流行病学杂志,1997,18(1):36.
34 林静,张安玉,梁仲华.天津市原发性肝癌的危险因素[J].中华流行病学杂志,1991,12(6):346-349.
35 何启杰,杨艳杰,彭涛.浅谈女性恶性肿瘤与社会心理[J].中国妇幼保健,2002,17:414-415.
36 Helgeson V,Cohen S.Group support intervention for women with breast cancer,who benefit from what?[J].Health Psychology,2000,19:107-114.
37 卢岳华,易建纯,陈大舜,等.原发性肝癌郁症患者人格特征的研究[J].中国医药学报,1988,3(2):62.
38 朱健,李文广,姚红玉,等.启东原发性肝癌危险因素病例对照研究[J]中国肿瘤 2001,10(11):630-632.
39 李晓凤.包头地区常见恶性肿瘤与社会心理因素关系的调查[J].肿瘤防治杂志,2003,10(2):113-115.
40 李武,邓云龙.癌症患者的抑郁特点及相关因素[J].中国心理卫生杂志2003,17(9):641-643.
41 刘涛.癌症与心理因素[J].中国社会医学,1988,1:14.
42 丁保国,樊冬梅,王飞霞,等.不良精神因素、家族史及肝脏疾病史与肝癌[J].中国慢性病预防与控制,2003,11(1):3-4.
43 张宗卫.社会心理与肿瘤[J].中国慢性病预防与控制,1995,3(5):238.
44 Perissin L,Rapozzi V,Zorzel S,et al.Survival time in mice hearing TLX5 lymphoma subjected to rotational stree and chemotherapy with CCNU.Anticancer Res,1997;17(6):4355-4357.
45 Palermo Nelo J,Robespierre W.Effects of physical and psychological stressors on behavior,macrophage activity,and Ehrlich tumor growth.Brain Behav Immun,2003;17(1):43-54.
46 Ben Eliyahu S,Page CG,Yirmiya R,et al.Evidence that stress and surgical interventions promote tumor development by suppressing natural killer cell activity.Int J Cancer,1999;80(6):880-888.
47 黄根牙,马兴刚,王昌成.重度饮酒与HBV相关肝癌危险性的关系[J].肿瘤防治杂志2005 12(6):405-408.
48 Tagger A,Donato F,Ribero ML,Chiesa R,Portera G,Gelatti U,Albertini A,et al.Case-control study on hepatitis C virus(HCV)as a risk factor for hepatocellular carcinoma:the role of HCV genotypes and the synergism with hepatitis B virus and alcohol.Brescia HCC Study.Int J Cancer 1999;81:695-699.
49 Hassan MM,Hwang LY,Hatten CJ,et al.Risk factors for hepatocellular carcinoma:synergism of alcohol with viral hepatitis and diabetes mellitus[J].Hepatology,2002,36(5):1206-1213.
50 Morgan TR,Mandayam S,Jamal MM.Alcohol and hepatocellular carcinoma[J].Gastroenterology.2004;127(5 Suppl 1):S87-96.
51 Yu H,Harris RE,Kabat GC,et al.Cigarette smoking,alcohol consumption and primary liver cancer:a case-control study in the USA.Int J Cancer,1998;42(3):325-328.
52 Takeshita M,Susumu H.Alcohol consumption as a major risk factor for the rise in liver cancer mortality rates in Japanese men.Int J Epidemiol.1999;28:30-34.
53 Mori M,Hara M,Wada L,et al.Prospective study of hepatitis B and C virus infections,cigarette smoking,alcohol consumption and other factors associated with hepatocellular carcinoma risk in Japan.Am J Epidemiol,2000;151:131-139.
54 Jian-sen LI,Wen-jun MA,Yan-jun XU,etal.Investigation on drinking behaviors among inhabitants aged over 15 years in Guang dong province[J]Chin J Public Health,2006,22(7):775-776.
55 Yu MW,Hsu FC,Sheen IS,et al.Prospective study of hepatocellular carcinoma and liver cirrhosis in asymptomatic chronic hepatitis B virus carriers[J].Am J Epidemiology 1997;145(11):1039-1047.
56 Donato F,Tagger A,Gelatti U,et al.Alcohol and hepatocellular carcinoma:the effect of lifetime intake and hepatitis virus infections in men and women.Am J Epidemiol.2002;155:323-331.
57 Monto A,Patel K,Bostrom A,et al.,Risk of a range of alcohol intake on hepatitis C-related fibrosis,Hepatology 39(2004),pp.826-834.
58 Poschl G,Seitz HK.Alcohol and cancer[J].Alcohol Alcohol 2004,39(3):155-165.
59 李苏平,丁建华,吴建中,等.乙醛脱氢酶2基因多态性和饮酒习惯与肝癌发生的关系研究[J].月中瘤防治杂志,2002,9(3):228-230.
60 Tsutsumi M,Matsuda Y,Takada A.Role of ethanol-inducible cytochrome P-450-E1 in the development of hepatocellular carcinoma by the chemical carcinogen,N-pnitrosodimethylaniline[J].Hepatology,1993,18(6):1483-1489
61 Yotsuyanagi H,Hashidume K,Suzuki M,et al.Role of Hepatitis B Virus in Hepatocarcinogenesis in Alcoholics[J].Alcohol Clin Exp Res,2004,28(8):S181-S185.
62 D.P.Agarwal,Cardioprotective effects of light-moderate consumption of alcohol:a review of putative mechanisms,Alcohol Alcoholism 37(2002),pp.409-415.
63 Lieber CS.Mechanism of ethanol induced hepatic injury.Pharmacol Ther 1990;46:1-41.
64 Liu BQ,Peto R,Chen ZM.Emerging tobacco hazards in China:Retrospective proportional mortality study of on million deaths[J].Br Med J,1998,317:1411.
65 Mukaiya M,Nishi M,Miyake H,et al.Chronic liver disease for the risk of hepatocellular carcinoma:a case-control study in Japan.Etiologic association of alcohol consumption,cigarette smoking and the development of chronic liver diseases[J].Hepto-gastroenterology,1998,45(24):2328-2332.
66 Kuper H,Tzonou A,Kaklamani E,et al.Tobacco smoking,alcohol consumption and their interaction in the causation of hepatocellular carcinoma[J].Int J Cancer 2000,85(4):498-502.
67 Chiesa R,Donato F,Tagger A,et al.Etiology of hepatocellular carcinoma in Italian patients with and without cirrhosis[J]Cancer Epidemiol Biomarkers Prev,2000,9(2):213-216.
68 汤伯明,边建超,王其军,等.洛阳市肝癌危险因素的病例对照研究[J].现代预防医学,2002;29(5):723-725.
69 陈茹琴,马中富.我国居民吸烟与肝癌关系的Meta分析研究[J].实用预防医学,2000,7(6):427-428.
70 Yu MW,Pai CL,Yang Y,et al.Role of N-acetyltransferase polymorphisma in hepatitis B related hepaocellular carcinoma:impact of smoking on risk J].Gut,2000,47:703.
71 Yu MW,Yang SY,Chiu YH,et al.A p53 genetic polymorphism as a modulator of hepatocellular carcinoma risk in relation to chronic liver disease,familial tendency,and cigarette smoking in hepatitis B carriers[J].Hepatology,1999,29(3):697-702.
72 Masami S,Sachiko O,Naoko S,et al.Green tea and cancer chemoprevention,Mutation Research,2002;428(1999):339-344.
73 穆丽娜,周学富,丁保国,等.饮绿茶降低吸烟、饮酒者消化系统癌发病的病例对照研究[J].中华流行病学杂志,2003,24(3):192-195.
74 Setiawan VW,Zhang ZF,Yu GP,et al.Protective effect of green tea on the risks of chronic gastritis and stomach cancer.Int J Cancer 2001,92:600-604.
75 Inoue M,Tajima K,Hirose K,et al.Tea and coffee consumption and the risk of digestive tract cancers:data from acomparative case-referent study in Japan.Cancer Causes Control,1998,9:209-216.
76 Yamane T,Takahashi T,Kuwata K,et al.Inhibition of N-methyl-N-nitron-N-nitrosoguanidine-induced carcinogensis by epigallocatechin gallate in the rat glandular stomach.Cancer-Res,1995,55(10):2081-2084.
77 贾旭东,韩驰,陈君石.茶多酚与茶色素对大鼠肝癌前病变组织细胞周期调节因子的影响[J].中华预防医学杂志,2002,36(4):225.
78 Suga K,Imai N,Sueoka K,et al.Phase I clinical trial with green tea tablets in Japanese healthy population,Cancer prey,1998;79-88
79 张建军,黄育华,晏雪生,等.富硒绿茶对人肝癌细胞株恶性表型逆转作用的血清药理学研究[J].微量元素与健康研究2002;19(2):3-5.
80 苏德隆.饮水与肝癌.中华预防医学杂志,1980;14(2):65-73.
81 俞顺章,赵宁,资晓林,等.饮水中微囊藻毒素与我国原发性肝癌关系的研究[J].中华肿瘤杂志,2001,23(2):96-99.
82 陈华,孙昌盛,胡志坚,等.饮水微囊藻毒素在大鼠肝癌发生期间对细胞增殖与凋亡的影响[J].癌变.畸形.突变,2002;14(4):214-217.
83 Guzman RE,Solter PF,unnegar MT.Inhibition of uclear protein phosphatase activity in mouse hepatocytes by the cyanobacterial toxin microcystin-LR.Toxicon,2003,41:773-781.
84 胡志坚,陈华,李一伟,等.微囊藻毒素促肝癌过程中肝细胞bcl-2及bax基因表达研究[J].中华预防医学杂志,2002,36(4):239-242.
85 宋瑞霞,刘征涛,沈萍萍.太湖中微囊藻毒素的遗传毒性研究.环境科学研究,2003,16(2):51-53.
86 周珏平,沈建国,童建.微囊藻毒素LR对小鼠肝脏和淋巴细胞的损伤效应[J].环境与职业医学,2003,20(1):41-42.
87 许川.微囊藻毒素污染状况!检测及其毒效应[J].国外医学卫生学分册,2005,32(1):56-60.
88 Zegura B,Sedmak B,Filipic M.Microcystin-LR induces oxidative DNA damage in human hepatoma cell line HepG2.Toxicon,2003,41:41-48.
89 Dankesreiter S,Hoess A,Schneider-Mergener J,et al.Synthetic endotoxin-blinding peptides block endotox in-triggered TNT-alpha production by macrophagea in vitro and prevent endotoxin-mediated toxic shock.J Immunol,2000;164:4804.
90 Prelack K,Dwyer J,Sheridan R,et al.Body Water in Children During Recovery from Severe Burn Injury Using a Combined Tracer Dilution Method.J Burn Care Rehabil,2005;26(1):67-74.
91 Sauvaget C,Nagano J,Hayashi M,et al.Vegetables and fruit intake and cancer mortality in the Hiroshima/Nagasaki Life Span Study.Br J Cancer.2003;88(5):689-694.
92 么鸿雁,杨念念,方亚,等.中国人群肺癌、肝癌、乳腺癌危险因素的综合研究[J].中国肿瘤 2002,11(12):695-696.
93 Hara A,Sakata K,Yamada Y,et al.Suppression of beta-catenin mutation by dietary exposure of auraptene,a citrus antioxidant,in N,N-diethylnitrosamine-induced hepatocellular carcinomas in rats.Oncol Rep.2005;14(2):345-351.
94 Singh G,Driever PH,Sander JW.Cancer risk in people with epilepsy:the role of antiepileptic drugs[J].Brain.2005;128(1):7-17.
95 Green T,Toghill A,Lee R,et al.Thiamethoxam induced mouse liver tumors and their relevance to humans.Part 1:mode of action studies in the mouse[J].Toxicol Sci.2005;86(1):36-47.
96 Macanas-Pirard P,Yaacob NS,Lee PC,et al.Glycogen synthase kinase-3 mediates acetaminophen-induced apoptosis in human hepatoma cells[J].J Pharmacol Exp Ther.2005;313(2):780-789.
97 Velazquez I,Alter BP.Androgens and liver tumors:Fanconi's anemia and non-Fanconi's conditions[J].Am J Hematol.2004;77(3):257-267.
98 柯常禄.生食鱼虾,小心肝吸虫病.医学动物防制,2006,22(1):76
99 刘小宁,冯月菊,任文锋.华支睾吸虫病流行区流行病学研究[J].热带医学杂志,2003:3(4):406.
100 陈佳鹏,周宝森.农业地区人群恶性肿瘤发病率和死亡率与环境中农药暴露的生态学研究[J].中国慢性病预防与控制,2004,12(2):52-54.
101 Medina-Diaz IM,Elizondo G.Transcriptional induction of CYP3A4 by o,p'-DDT in HepG2 cells.Toxicol Lett.2005,157(1):41-47.
102 俞顺章,穆丽娜.乙型肝炎与肝癌[J].上海预防医学杂志,2005,17(9):417-418.
103 Arbuthnot P,Kew M.Hepatitis B Virus and hepatocellular carcinoma[J].International journal of experimental pathology,2001,82(2):77-100.
104 Evans AA,Chen G,Ross EA,et al.Eight-year follow-up of the 90,000-person Haimen City cohort:Ⅰ.Hepatocellular carcinoma mortality,risk factors,and gender differences.Cancer Epidemiol Biomarkers Prev.2002,11(4):369-376.
105 Chung TW,Lee YC,Kim CH.Hepatitis B viral HBx induce matrix metalloproteinase-9gene expression through activation of ERK and PI23K/AKT pathways:involvement of invasive potential[J].FASEBJ,2004,18(10):1123-1125.
106 李刚.病毒性肝炎.见:杨绍基主编.传染病学[M].第一版.北京:人民卫生出版社,2002:22-41.
107 Elsammak MY,Amin GM,Khalil GM,et al.Possible contribution of serum activin A and IGF-1 in the development of hepatocellular carcinoma in Egyptian patients suffering from combined hepatitis C virus infection and hepatic schistosomiasis.Clin Biochem.2006 Jun;39(6):623-629.
108 Cutroneo KR,Boros DL.Rational basis for oligodeoxynucleotides to inhibit collagen synthesis in lung fibroblasts and primary fibroblasts from liver granulomas of Schistosoma mansoni-infected mice.Cancer Lett.2002 Jun 28;180(2):145-151.
109 王磊,肖锡昌,唐永煌,等.华枝睾吸虫与二甲基亚硝胺诱发动物肝癌的初步实验研究[J].中国寄生虫病防治杂志,1994;7:201-203.
110 Abdel-Rahim AY.Parasitic infections and hepatic neoplasia.Digestive Diseases 2001;19:288-291.
111 薛开先.肝癌发生的分子遗传学和表遗传学研究[J].癌症.2005,24(6):757-768
112 周汉高,顾公望.肝癌分子流行病学的研究[J].世界华人消化杂志,1998,6(5):432
113 吴燕,刘耳,张宝初.不同地区原发性肝癌患者家族史分析[J].华人消化杂志,1998,6(2):178-179.
114 吴一迁,陆培新,王加生,等.EPHX代谢酶的遗传多态性和肝癌易感性的相关性研究[J].肿瘤,2003,23(4):287-289.
115 Bian JC,Shen FM,LiS,etal.Susceptibility to hepatocellular carcinoma associated with nullgenotypes of GSTM1 and GSTT1.Word J Gastroentero,2000,6(2):228.
116 覃甲仁,顾永耀,钟卫干,等.Ⅱ相代谢酶基因多态性与广西肝癌发生的关系[J].实用癌症杂志,2004,19(5):460-473.
117 Kirk GD,Tumer PC,Gong Y,et al.Hepatocellular carcinoma and polymorphisms in carcinogen-metabolizing and DNA repair enzymes in a population with aflatoxin exposure and hepatitis B virus endemicity.Cancer Epideminol Biomarkers Prev.2005,14(2):373-379
118 许丽,吴一迁,金晏,等.DNA修复基因XPD多态性和肝细胞肝癌危险性的病例对照研究[J].肿瘤,2004,24(6):526-529.
119 EI-Serag HB,Tran T,Everhare JE.Diabetes increases the risk if chrionic liver disease and heaptocellular carcinoma.Gastroenterology,2004,126:460-468.
120 Jean M Regimbeau,Magali Colombat,Philippe Mognol et al.Obesity and diabetes as a risk factor for heaptocellular carcinoma.Liver transplantation 2004;S1:S69-S73.
121 Jian MY,Sugantha G,Kazuko A,Mimi CY.Synergism of alcohol,diabetes,and viral hepatitis on the risk of hepatocellular carcinoma in Blacks and Whites in the U.S.Cancer.2004;101:1009-1017.
122 周里琳,苏东星,陈庆州.糖尿病与慢性乙型肝炎患者发生原发性肝癌的关系[J].华夏医学,2005,18(1):52-53.
123 Yoshihisa Fujino,Tetsuya Mizoue,Noritaka Tokui et al.Prospective study of diabetes mellituss and liver cancer in Japan.Diabetes Meta Res Rev 2001;17:374-379.
124 Lagiou P,Kuper H,Stuver SO et al.Role of diabetes mellitus in the etiology if hepatocellular carcinoma.J Natl Caner Inst 2000,92:1096-1099.
125 EI-Serag HB,Richardson PA,Everhare JE.Theroleof diabetes in hepatocellular carcinoma:a case-control study among United States veterans.Am J Gastroenterol 2001;96:2462-2467.
126 季尚玮,郭宏华,王江滨.糖尿病与消化系肿瘤关系的研究进展[J].国际消化病杂志,2006,26(1):61-63.
127 Teh-Ia Huo,M.D,Jaw-Ching Wu,et al.Differential mechanism and prognostic impact of diabetes mellitus on patients with hepatocellular carcinoma undergoing surgical and nonsurgical treatment.Am J Gastroenterology 2004;99:1479-1487.
128 Devi GR,Sprenger CC,Plymate SR.Insulin like growth factor binding protein3 induce searly apoptosis in malignant prostate cancer cells and inhibits tumor formation invivo[J].Prostate 2002,51(2):141-152.
129 Williams AC,Collard TJ,Perks CM,et al.Increased P53 dependent apoptosis by the IGFBP3 in human colonic adenoma derivedlines[J]Cancer Res 2000,60(1):22-27.
130 Grimberg A,Liu B,Bannerman P,et al.IGFBP3 mediates P53 induced apoptosis during serums tarvation[J].Int J Oncol 2002,21(2):327-335.
131 Adams TE,Epa VC,Garrett TP,et al.Structure and function of the type-1 insulin like growth factor receptor[J].Cell Mol Life Sci 2000,57(7):1050-1093.
132 Grimberg A Cohen P.Role of insulin like growth factors and the binding proteins in growth control and carcinogenesis.[J].J Cell Physiol 2000,183(1):1-9.
1 王天爵.交互作用的估计及其应用(一)[J].中国卫生统计,1989,6(6):56-58.
2 王天爵.交互作用的估计及其应用(二)[J].中国卫生统计,1990,7(1):62-64.
3 李辉.临床流行病学研究中交互作用的判别及测量(一)[J].中华流行病学杂志,1996,17(4):243-247.
4 李辉.临床流行病学研究中交互作用的判别及测量(二)[J].中华流行病学杂志,1996,17(5):305-307.
5 Kleinbaum DG,Epidemiologic Research:Principles and Quantitative Methods,Belmont,California,Lifetime Learning Publications.1982,404-414.
6 黄悦勤.临床流行病学.第七章:交互作用.人民卫生出版社,2002年8月.第一版.P143-146.
7 曾运红,谭卫仙.原发性肝癌发病主要危险因素的Meta分析[J].现代预防医学,2004;31(2):172-174.
8 张思维,李连弟,鲁凤珠,等.中国1990-1992年原发性肝癌死亡调查分析[J].中华肿瘤杂志,1999,21(4):245-247.
9 黄天壬,张振权,石建基,等.广西恶性肿瘤死亡的流行特点及趋势[J].陕西肿瘤医学,2001,9(3):200-201.
10 Walker AM.Proportion of disease attributable to the combined effect of two factors.Int J Epidemiol,1981,10:81-85.
11 Rothman KJ,Greenland S.Modern Epidemiology Second Edition.Lippincott-Raven Publishers,1998.
12 Mitchell H.Gail,Jacques Benichou.Encyclopedia of epidemiologic methods[J].John Wiley § Sons Ltd,2000.
13 向惠云,余松林,孙奕,等.疾病资料多元分析中交互作用指标及可信区间的估计[J].中国卫生统计,1999,16(3):130-132.
14 贺晓新,金水高.个体匹配病例对照研究中交互作用及处理方法[J].中国卫生统计,2002,19(1):43-45.
15 丁保国,樊冬梅,穆丽娜,等.乙型肝炎、丙型肝炎病毒感染与肝癌的病例对照研究[J].中华流行病学杂志,2004,25(1):22.
16 俞顺章,穆丽娜.乙型肝炎与肝癌[J].上海预防医学杂志,2005,17(9):417-418.
17 Feher J,Lengyel G.Risk factors of liver tumors[J].Orv Hetil,2004,145(7Suppl):365-367.
18 袁萍,唐伟,文进,等.中国四川和日本东京两地原发性肝癌手术患者肝炎病毒感染状况[J].中华预防医学杂志,2005,39(5):332-334.
19 张明东,俞顺章,梁任祥,等.广西扶绥县原发性肝癌病例对照研究[J].中华流行病学杂志,1993,14(1):14-18.
20 吴继周,时馥荪,莫志纯.广西原发性肝细胞癌病因探讨:118例配对病例一对照的条件Logistic回归分析[J].癌症,1990,9(1):25-28.
21 李晓凤.包头地区常见恶性肿瘤与社会心理因素关系的调查[J].肿瘤防治杂志,2003,10(2):113-115.
22 Helgeson V,Cohen S.Group support intervention for women with breast cancer,who benefit from what?[J].Health Psychology,2000,19:107-114.
23 任宏轩,沈丽达.社会心理因素对癌症的影响[J].中国肿瘤,2005,14(10):639-641.
24 刘小宁,冯月菊,任文锋.华支睾吸虫病流行区流行病学研究[J].热带医学杂志,2003;3(4):406.
25 王磊,肖锡昌,唐永煌,等.华枝睾吸虫与二甲基亚硝胺诱发动物肝癌的初步实验研究[J].中国寄生虫病防治杂志,1994:7:201-203.
26 Abdel-Rahim AY.Parasitic infections and hepatic neoplasia.Digestive Diseases 2001,19:288-291.
27 丁建华,李苏平,吴建中,等.泰兴市HBsAg与其它危险因素致肝癌交互作用的研究[J].中国肿瘤,2001,10(12):709-711.
28 Hassan MM,Hwang LY,Hatten CJ,et al.Risk factors for hepatocellular carcinoma:synergism of alcohol with viral hepatitis and diabetes mellitus.Hepatology.2002,36:1206-1213.
29 邹长林,陈哲京,金文扬,等.温州地区原发性肝癌危险因素的病因分值及其交互效应[J].中华预防医学杂志,2003,37(5):355-357.
30 Yuan JM,Govindarajan S,Arakawa K,et al.Synergism of alcohol,diabetes,and viral hepatitis on the risk of hepatocellular carcinoma in blacks and whites in the U.S.Cancer.2004;101(5):1009-1017.
31 Marrero JA,Fontana RJ,Fu S,et al.Alcohol,tobacco and obesity are synergistic risk factors for hepatocellular carcinoma.J Hepatol.2005,42(2):218-224.
32 卢岳华,易建纯,陈大舜,等.原发性肝癌郁症患者人格特征的研究[J].中国医药学报,1988,3(2):62.
33 Tomatis L Between the body and the mind the involvement of psychological factors in the development of multifactorial diseases[J].EurJ Cancer,2001,37(85):148-152.
34 丁保国,樊冬梅,王飞霞,等.不良精神因素、家族史及肝脏疾病史与肝癌[J].中国慢性病预防与控制,2003,11(1):3-4.
35 Kleinbaum DG,Kupper LL,Morgenstem H.Interactions.Effect modification and synergism.In:Epidemiologic Research.New York:Van Nostrand Reinhold,1982:407-417.
1 陈建国,宋新生明.中国肝癌发病水平的估算及分析[J]中国肿瘤,2005,14(1):28-31
2 Evans AA,Chen G,Ross EA,et al.Eight-year follow-up of the 90,000-person Haimen City cohort:Ⅰ.Hepatocellular carcinoma mortality,risk factors,and gender differences[J].Cancer Epidemiol Biomarkers Prev.2002;11(4):369-376.
3 Kuntz E,Kuntz HD.Malignant liver tumours.See:Kuntz E,Kuntz HD.Hepatology Principles and Practice[M].Springer-verlag Berlin,Heidelberg,2002:699-730
4 Yuan JM,Govindarajan S,Arakawa K,et al.Synergism of alcohol,diabetes,and viral hepatitis on the risk of hepatocellular carcinoma in blacks and whites in the U.S[J].Cancer.2004;101(5):1009-1017.
5 丁保国,樊冬梅,王飞霞,等,乙型肝炎、丙型肝炎病毒感染与肝癌的病例对照研究[J]中国预防医学杂志,2004,5(2):122-124
6 Jia-Sheng Wang,Tiren Huang,Jianjia Su,et al.Hepatocellular Carcinoma and Aflatoxin Exposure in Zhuqing Village,Fusui County,People' s Republic of China.Cancer Epideminol Biomarkers Prev.2001,10:143-146
7 Tao P,Zhi-Ming L,Tang-Wei L,et al.Associated factors in modulating aflatoxin B1-albumin adduct level in three Chinese populations[J].Dig Dis Sci.2005;50(3):525-532.
8 Kirk GD,Lesi OA,Mendy M,et al.249(ser)TP53 mutation in plasma DNA,hepatitis B viral infection,and risk of hepatocellular carcinoma.Oncogene.2005;24(38):5858-5867.
9 Qiu DC,Hubbard AE,Zhong B,et al.A matched,case-control study of the association between Schistosoma japonicum and liver and colon cancers,in rural China[J].Ann Trop Med Parasitol.2005;99(1):47-52.
10 Hassoba H,Mahmoud M,Fahmy H,et al.TT virus infection among Egyptian patients with hepatocellular carcinoma[J].Egypt J Immunol.2003;10(1):9-16.
11 Nilsson HO,Mulchandani R,Tranberg KG,et al.Helicobacter species identified in liver from patients with cholangiocarcinoma and hepatocellular carcinoma [J].Gastroenterology,2001,120(1):323-324
12 张世强,鲍勇,祖茂衡。幽门螺杆菌感染与原发性肝癌关系的相关性研究[J]中国肿瘤临床,2004,31(13):761-764
13 俞顺章,赵宁,资晓林,等.饮水中微囊藻毒素与我国原发性肝癌关系的研究[J].中 华肿瘤杂志,2001,23(2):96-99.
14 Singh G,Driever PH,Sander JW.Cancer risk in people with epilepsy:the role of antiepileptic drugs[J].Brain.2005;128(1):7-17.
15 Green T,Toghill A,Lee R,et al.Thiamethoxam induced mouse liver tumors and their relevance to humans.Part 1:mode of action studies in the mouse[J].Toxicol Sci.2005;86(1):36-47.
16 Macanas-Pirard P,Yaacob NS,Lee PC,et al.Glycogen synthase kinase-3 mediates acetaminophen-induced apoptosis in human hepatoma cells[J].J Pharmacol Exp Ther.2005;313(2):780-789
17 Velazquez I,Alter BP.Androgens and liver tumors:Fanconi's anemia and non-Fanconi's conditions[J].Am J Hematol.2004;77(3):257-267.
18 Hara A,Sakata K,Yamada Y,et al.Suppression of beta-catenin mutation by dietary exposure of auraptene,a citrus antioxidant,in N,N-diethylnitrosamine-induced hepatocellular carcinomas in rats[J].Oncol Rep.2005;14(2):345-351.
19 陈佳鹏,周宝森.农业地区人群恶性肿瘤发病率和死亡率与环境中农药暴露的生态学研究中国慢性病预防与控制 2004,12(2):52-54
20 Chiu HF,Ho SC,Wang LY,et al.Does arsenic exposure increase the risk for liver cancer[J]? J Toxicol Environ Health A.2004;67(19):1491-1500.
21 Marrero JA,Fontana RJ,Fu S,et al.Alcohol,tobacco and obesity are synergistic risk factors for hepatocellular carcinoma.J Hepatol.2005;42(2):218-224.
22 Morgan TR,Mandayam S,Jamal MM.Alcohol and hepatocellular carcinoma[J].Gastroenterology.2004;127(5 Suppl 1):S87-96.
23 Davila JA,Morgan RO,Shaib Y,et al.Diabetes increases the risk of hepatocellular carcinoma in the United States:a population based case control study[J].Gut.2005;54(4):533-539.
24 Chen WC,Lo GH,Lai KH,et al.Development of hepatocellular carcinoma after successful management of esophageal variceal bleeding[J].J Chin Med Assoc.2004;67(11):557-564.
25 Kowdley KV.Iron,hemochromatosis and hepatocellular carcinoma[J].Gastroenterology.2004;127(5 Suppl 1):S79-86.
26 Sauvaget C,Nagano J,Hayashi M,et al.Vegetables and fruit intake and cancer mortality in the Hiroshima/Nagasaki Life Span Study.Br J Cancer.2003;88(5):689-694.
27 Gelatti U,Covolo L,Franceschini M,et al.Coffee consumption reduces the risk of hepatocellular carcinoma independently of its aetiology:a case-control study[J].J Hepatol.2005;42(4):528-534.
28 么鸿雁,杨念念,方亚,等,中国人群肺癌、肝癌、乳腺癌危险因素的综合研究[J]中国肿瘤 2002,11(12):695-696.
29 吴一迁,陆培新,王加生等,EPHX代谢酶的遗传多态性和肝癌易感性的相关性研究[J]肿瘤 2003,23(4):287-289.
30 覃甲仁 顾永耀 钟卫干,Ⅱ相代谢酶基因多态性与广西肝癌发生的关系[J].实用癌症杂志[J]2004,19(5):460-473.
31 Kirk GD,Tumer PC,Gong Y,et al.Hepatocellular carcinoma and polymorphisms in carcinogen-metabolizing and DNA repair enzymes in a population with aflatoxin exposure and hepatitis B virus endemicity.Cancer Epideminol Biomarkers Prev.2005,14(2):373-379.
32 许丽,吴一迁,金晏,等.DNA修复基因XPD多态性和肝细胞肝癌危险性的病例对照研究.月中瘤.2004,24(6):526-529.
2 吴孟超.原发性肝癌的诊断和治疗进展.中华外科杂志,1998,36(9):515-517.
3 陈建国,宋新明.中国肝癌发病水平的估算及分析[J]中国肿瘤,2005,14(1):28-31.
4 McGlynn KA,Tsao L,Hsing AW,Devesa SS,et al.International trends and patterns of primary liver cancer.Int J Cancer 2000,94:290-296.
5 张思维,李连弟,鲁凤珠,等.中国1990-1992年原发性肝癌死亡调查分析[J].中华肿瘤杂志,1999,21(4):245-247.
6 Kuntz E,Kuntz HD.Malignant liver tumours.See:Kuntz E,Kuntz HD.Hepatology Principles and Practice[M].Springer-verlag Berlin,Heidelberg,2002:699-730.
7 Yuan JM,Govindarajan S,Arakawa K,et al.Synergism of alcohol,diabetes,and viral hepatitis on the risk of hepatocellular carcinoma in blacks and whites in the U.S[J].Cancer.2004,101(5):1009-1017.
8 Bedard LL,Alessi M,Davey S,et al.Susceptibility to aflatoxin Bl-induced carcinogenesis correlates with tissue-specific differences in DNA repair activity in mouse and in rat.Cancer Res.2005;65(4):1265-1270.
9 Kirk GD,Lesi OA,Mendy M,et al.249(ser)TP53 mutation in plasma DNA,hepatitis B viral infection,and risk of hepatocellular carcinoma.Oncogene.2005;24(38):5858-5867.
10 Rao PV,Gupta N,Bhaskar AS,et al.Toxins and bioactive compounds from cyanobacteria and their implications on human health.J Environ Biol,2002,23(3):215-224.
11 Figuiredo DR,Azeiteiro UM,Esteves SM,et al.Microcystin-producing blooms--a serious global public health issue.[J]Ecotoxicol Environ Saf,2004,59(2):151-163.
12 Shimizu I,Impact of oestrogens on the progression of live disease.Liver Int,2003,23(1):63-69.
13 Khan KN,Yatsuhashi H.Effect of alcohol consumption on the progression of hepatitis C virus infection and risk of hepatocellular carcinoma in Japanese patients,Alcohol,2000,35(3):286-295.
14 俞顺章,赵宁,资晓林,等.饮水中微囊藻类毒素与我国原发性肝癌关系的研究[J].中华肿瘤杂志,2001,23(2):96-99.
15 Tao P,Zhi-Ming L,Tang-Wei L,et al.Associated factors in modulating aflatoxin B1-albumin adduct level in three Chinese populations.Dig Dis Sci.2005,50(3):525-532.
16 汤伯明,边建超,王其军,等.洛阳市肝癌危险因素的病例对照研究[J].现代预防医学,2002;29(5):723-725.
17 曾运红,谭卫仙.原发性肝癌发病主要危险因素的Meta分析[J].现代预防医学2004,31(2):172-174.
18 袁萍,唐伟,文进,等.中国四川和日本东京两地原发性肝癌手术患者肝炎病毒感染状况[J].中华预防医学杂志,2005,39(5):332-334.
19 张竹梅,边建超.饮酒与肝癌研究进展[J].中华流行病学杂志,2002,23(6):477-479.
20 吴继周,时馥荪,莫志纯.广西原发性肝细胞癌病因探讨:118例配对病例一对照的条件Logistic回归分析[J].癌症,1990,9(1):25-28.
21 张明东,俞顺章,梁任祥,等.广西扶绥县原发性肝癌病例对照研究[J].中华流行病学杂志,1993,14(1):14-18.
22 黄天壬,韦忠亮,汪凯波,等.广西扶绥县居民1997-2003年肝癌发病率分析[J].广西医学2006,28(9):1336-1339.
23 李连弟,鲁凤珠,张思维,等.1990-1992年中国恶性肿瘤死亡流行分布情况分析[J].中华肿瘤杂志,1996,18(6):403-407.
24 黄天壬,余家华,张振权,等.广西肝癌流行特征和流行趋势分析[J].广西医学,2000,22(4):677-678.
25 任宏轩,沈丽达.社会心理因素对癌症的影响[J].中国肿瘤,2005,14(10):639-641.
26 Tomatis L.Between the body and the mind the involvement of psychological factors in the development of multifactorial diseases[J]EurJ Cancer,2001,37(85):148-152.
27 中华抗癌协会肝癌专业委员会.原发性肝癌的临床诊断与分期标准(2001年广州第八届肝癌学术会议)[J].现代实用医学,2002,15(4):213.
28 Ferlay J,Bray F,Pisani P,et al.Globocan 2000:Cancer incidence mortality and prevalence worldwide[DB/CD].Lyon:IARC,2001.
29 孙喜文,戴旭东,石于波.哈尔滨市居民肝癌危险因素的病例对照研究[J].实用肿瘤学杂志,2000,14(3):181-185.
30 邹长林,陈哲京,金文扬,等.温州地区原发性肝癌危险因素的病因分值及其交互效应[J].中华预防医学杂志,2003,37(5):355-357.
31 丁建华,李苏平,高长明,等.泰兴市全人群肝癌病例对照研究[J].中国肿 瘤,2001,10(2):102-105.
32 Sinhoven P,Kooiman CG.Defense style in depressed and anxious psychiatric outpatients:An explorative study.The journal of nervous and mental disease,1997;185(2):87.
33 王珊珊,姜普林,庞红霞,等.广州市原发性肝癌的病因流行病学调查[J]中华流行病学杂志,1997,18(1):36.
34 林静,张安玉,梁仲华.天津市原发性肝癌的危险因素[J].中华流行病学杂志,1991,12(6):346-349.
35 何启杰,杨艳杰,彭涛.浅谈女性恶性肿瘤与社会心理[J].中国妇幼保健,2002,17:414-415.
36 Helgeson V,Cohen S.Group support intervention for women with breast cancer,who benefit from what?[J].Health Psychology,2000,19:107-114.
37 卢岳华,易建纯,陈大舜,等.原发性肝癌郁症患者人格特征的研究[J].中国医药学报,1988,3(2):62.
38 朱健,李文广,姚红玉,等.启东原发性肝癌危险因素病例对照研究[J]中国肿瘤 2001,10(11):630-632.
39 李晓凤.包头地区常见恶性肿瘤与社会心理因素关系的调查[J].肿瘤防治杂志,2003,10(2):113-115.
40 李武,邓云龙.癌症患者的抑郁特点及相关因素[J].中国心理卫生杂志2003,17(9):641-643.
41 刘涛.癌症与心理因素[J].中国社会医学,1988,1:14.
42 丁保国,樊冬梅,王飞霞,等.不良精神因素、家族史及肝脏疾病史与肝癌[J].中国慢性病预防与控制,2003,11(1):3-4.
43 张宗卫.社会心理与肿瘤[J].中国慢性病预防与控制,1995,3(5):238.
44 Perissin L,Rapozzi V,Zorzel S,et al.Survival time in mice hearing TLX5 lymphoma subjected to rotational stree and chemotherapy with CCNU.Anticancer Res,1997;17(6):4355-4357.
45 Palermo Nelo J,Robespierre W.Effects of physical and psychological stressors on behavior,macrophage activity,and Ehrlich tumor growth.Brain Behav Immun,2003;17(1):43-54.
46 Ben Eliyahu S,Page CG,Yirmiya R,et al.Evidence that stress and surgical interventions promote tumor development by suppressing natural killer cell activity.Int J Cancer,1999;80(6):880-888.
47 黄根牙,马兴刚,王昌成.重度饮酒与HBV相关肝癌危险性的关系[J].肿瘤防治杂志2005 12(6):405-408.
48 Tagger A,Donato F,Ribero ML,Chiesa R,Portera G,Gelatti U,Albertini A,et al.Case-control study on hepatitis C virus(HCV)as a risk factor for hepatocellular carcinoma:the role of HCV genotypes and the synergism with hepatitis B virus and alcohol.Brescia HCC Study.Int J Cancer 1999;81:695-699.
49 Hassan MM,Hwang LY,Hatten CJ,et al.Risk factors for hepatocellular carcinoma:synergism of alcohol with viral hepatitis and diabetes mellitus[J].Hepatology,2002,36(5):1206-1213.
50 Morgan TR,Mandayam S,Jamal MM.Alcohol and hepatocellular carcinoma[J].Gastroenterology.2004;127(5 Suppl 1):S87-96.
51 Yu H,Harris RE,Kabat GC,et al.Cigarette smoking,alcohol consumption and primary liver cancer:a case-control study in the USA.Int J Cancer,1998;42(3):325-328.
52 Takeshita M,Susumu H.Alcohol consumption as a major risk factor for the rise in liver cancer mortality rates in Japanese men.Int J Epidemiol.1999;28:30-34.
53 Mori M,Hara M,Wada L,et al.Prospective study of hepatitis B and C virus infections,cigarette smoking,alcohol consumption and other factors associated with hepatocellular carcinoma risk in Japan.Am J Epidemiol,2000;151:131-139.
54 Jian-sen LI,Wen-jun MA,Yan-jun XU,etal.Investigation on drinking behaviors among inhabitants aged over 15 years in Guang dong province[J]Chin J Public Health,2006,22(7):775-776.
55 Yu MW,Hsu FC,Sheen IS,et al.Prospective study of hepatocellular carcinoma and liver cirrhosis in asymptomatic chronic hepatitis B virus carriers[J].Am J Epidemiology 1997;145(11):1039-1047.
56 Donato F,Tagger A,Gelatti U,et al.Alcohol and hepatocellular carcinoma:the effect of lifetime intake and hepatitis virus infections in men and women.Am J Epidemiol.2002;155:323-331.
57 Monto A,Patel K,Bostrom A,et al.,Risk of a range of alcohol intake on hepatitis C-related fibrosis,Hepatology 39(2004),pp.826-834.
58 Poschl G,Seitz HK.Alcohol and cancer[J].Alcohol Alcohol 2004,39(3):155-165.
59 李苏平,丁建华,吴建中,等.乙醛脱氢酶2基因多态性和饮酒习惯与肝癌发生的关系研究[J].月中瘤防治杂志,2002,9(3):228-230.
60 Tsutsumi M,Matsuda Y,Takada A.Role of ethanol-inducible cytochrome P-450-E1 in the development of hepatocellular carcinoma by the chemical carcinogen,N-pnitrosodimethylaniline[J].Hepatology,1993,18(6):1483-1489
61 Yotsuyanagi H,Hashidume K,Suzuki M,et al.Role of Hepatitis B Virus in Hepatocarcinogenesis in Alcoholics[J].Alcohol Clin Exp Res,2004,28(8):S181-S185.
62 D.P.Agarwal,Cardioprotective effects of light-moderate consumption of alcohol:a review of putative mechanisms,Alcohol Alcoholism 37(2002),pp.409-415.
63 Lieber CS.Mechanism of ethanol induced hepatic injury.Pharmacol Ther 1990;46:1-41.
64 Liu BQ,Peto R,Chen ZM.Emerging tobacco hazards in China:Retrospective proportional mortality study of on million deaths[J].Br Med J,1998,317:1411.
65 Mukaiya M,Nishi M,Miyake H,et al.Chronic liver disease for the risk of hepatocellular carcinoma:a case-control study in Japan.Etiologic association of alcohol consumption,cigarette smoking and the development of chronic liver diseases[J].Hepto-gastroenterology,1998,45(24):2328-2332.
66 Kuper H,Tzonou A,Kaklamani E,et al.Tobacco smoking,alcohol consumption and their interaction in the causation of hepatocellular carcinoma[J].Int J Cancer 2000,85(4):498-502.
67 Chiesa R,Donato F,Tagger A,et al.Etiology of hepatocellular carcinoma in Italian patients with and without cirrhosis[J]Cancer Epidemiol Biomarkers Prev,2000,9(2):213-216.
68 汤伯明,边建超,王其军,等.洛阳市肝癌危险因素的病例对照研究[J].现代预防医学,2002;29(5):723-725.
69 陈茹琴,马中富.我国居民吸烟与肝癌关系的Meta分析研究[J].实用预防医学,2000,7(6):427-428.
70 Yu MW,Pai CL,Yang Y,et al.Role of N-acetyltransferase polymorphisma in hepatitis B related hepaocellular carcinoma:impact of smoking on risk J].Gut,2000,47:703.
71 Yu MW,Yang SY,Chiu YH,et al.A p53 genetic polymorphism as a modulator of hepatocellular carcinoma risk in relation to chronic liver disease,familial tendency,and cigarette smoking in hepatitis B carriers[J].Hepatology,1999,29(3):697-702.
72 Masami S,Sachiko O,Naoko S,et al.Green tea and cancer chemoprevention,Mutation Research,2002;428(1999):339-344.
73 穆丽娜,周学富,丁保国,等.饮绿茶降低吸烟、饮酒者消化系统癌发病的病例对照研究[J].中华流行病学杂志,2003,24(3):192-195.
74 Setiawan VW,Zhang ZF,Yu GP,et al.Protective effect of green tea on the risks of chronic gastritis and stomach cancer.Int J Cancer 2001,92:600-604.
75 Inoue M,Tajima K,Hirose K,et al.Tea and coffee consumption and the risk of digestive tract cancers:data from acomparative case-referent study in Japan.Cancer Causes Control,1998,9:209-216.
76 Yamane T,Takahashi T,Kuwata K,et al.Inhibition of N-methyl-N-nitron-N-nitrosoguanidine-induced carcinogensis by epigallocatechin gallate in the rat glandular stomach.Cancer-Res,1995,55(10):2081-2084.
77 贾旭东,韩驰,陈君石.茶多酚与茶色素对大鼠肝癌前病变组织细胞周期调节因子的影响[J].中华预防医学杂志,2002,36(4):225.
78 Suga K,Imai N,Sueoka K,et al.Phase I clinical trial with green tea tablets in Japanese healthy population,Cancer prey,1998;79-88
79 张建军,黄育华,晏雪生,等.富硒绿茶对人肝癌细胞株恶性表型逆转作用的血清药理学研究[J].微量元素与健康研究2002;19(2):3-5.
80 苏德隆.饮水与肝癌.中华预防医学杂志,1980;14(2):65-73.
81 俞顺章,赵宁,资晓林,等.饮水中微囊藻毒素与我国原发性肝癌关系的研究[J].中华肿瘤杂志,2001,23(2):96-99.
82 陈华,孙昌盛,胡志坚,等.饮水微囊藻毒素在大鼠肝癌发生期间对细胞增殖与凋亡的影响[J].癌变.畸形.突变,2002;14(4):214-217.
83 Guzman RE,Solter PF,unnegar MT.Inhibition of uclear protein phosphatase activity in mouse hepatocytes by the cyanobacterial toxin microcystin-LR.Toxicon,2003,41:773-781.
84 胡志坚,陈华,李一伟,等.微囊藻毒素促肝癌过程中肝细胞bcl-2及bax基因表达研究[J].中华预防医学杂志,2002,36(4):239-242.
85 宋瑞霞,刘征涛,沈萍萍.太湖中微囊藻毒素的遗传毒性研究.环境科学研究,2003,16(2):51-53.
86 周珏平,沈建国,童建.微囊藻毒素LR对小鼠肝脏和淋巴细胞的损伤效应[J].环境与职业医学,2003,20(1):41-42.
87 许川.微囊藻毒素污染状况!检测及其毒效应[J].国外医学卫生学分册,2005,32(1):56-60.
88 Zegura B,Sedmak B,Filipic M.Microcystin-LR induces oxidative DNA damage in human hepatoma cell line HepG2.Toxicon,2003,41:41-48.
89 Dankesreiter S,Hoess A,Schneider-Mergener J,et al.Synthetic endotoxin-blinding peptides block endotox in-triggered TNT-alpha production by macrophagea in vitro and prevent endotoxin-mediated toxic shock.J Immunol,2000;164:4804.
90 Prelack K,Dwyer J,Sheridan R,et al.Body Water in Children During Recovery from Severe Burn Injury Using a Combined Tracer Dilution Method.J Burn Care Rehabil,2005;26(1):67-74.
91 Sauvaget C,Nagano J,Hayashi M,et al.Vegetables and fruit intake and cancer mortality in the Hiroshima/Nagasaki Life Span Study.Br J Cancer.2003;88(5):689-694.
92 么鸿雁,杨念念,方亚,等.中国人群肺癌、肝癌、乳腺癌危险因素的综合研究[J].中国肿瘤 2002,11(12):695-696.
93 Hara A,Sakata K,Yamada Y,et al.Suppression of beta-catenin mutation by dietary exposure of auraptene,a citrus antioxidant,in N,N-diethylnitrosamine-induced hepatocellular carcinomas in rats.Oncol Rep.2005;14(2):345-351.
94 Singh G,Driever PH,Sander JW.Cancer risk in people with epilepsy:the role of antiepileptic drugs[J].Brain.2005;128(1):7-17.
95 Green T,Toghill A,Lee R,et al.Thiamethoxam induced mouse liver tumors and their relevance to humans.Part 1:mode of action studies in the mouse[J].Toxicol Sci.2005;86(1):36-47.
96 Macanas-Pirard P,Yaacob NS,Lee PC,et al.Glycogen synthase kinase-3 mediates acetaminophen-induced apoptosis in human hepatoma cells[J].J Pharmacol Exp Ther.2005;313(2):780-789.
97 Velazquez I,Alter BP.Androgens and liver tumors:Fanconi's anemia and non-Fanconi's conditions[J].Am J Hematol.2004;77(3):257-267.
98 柯常禄.生食鱼虾,小心肝吸虫病.医学动物防制,2006,22(1):76
99 刘小宁,冯月菊,任文锋.华支睾吸虫病流行区流行病学研究[J].热带医学杂志,2003:3(4):406.
100 陈佳鹏,周宝森.农业地区人群恶性肿瘤发病率和死亡率与环境中农药暴露的生态学研究[J].中国慢性病预防与控制,2004,12(2):52-54.
101 Medina-Diaz IM,Elizondo G.Transcriptional induction of CYP3A4 by o,p'-DDT in HepG2 cells.Toxicol Lett.2005,157(1):41-47.
102 俞顺章,穆丽娜.乙型肝炎与肝癌[J].上海预防医学杂志,2005,17(9):417-418.
103 Arbuthnot P,Kew M.Hepatitis B Virus and hepatocellular carcinoma[J].International journal of experimental pathology,2001,82(2):77-100.
104 Evans AA,Chen G,Ross EA,et al.Eight-year follow-up of the 90,000-person Haimen City cohort:Ⅰ.Hepatocellular carcinoma mortality,risk factors,and gender differences.Cancer Epidemiol Biomarkers Prev.2002,11(4):369-376.
105 Chung TW,Lee YC,Kim CH.Hepatitis B viral HBx induce matrix metalloproteinase-9gene expression through activation of ERK and PI23K/AKT pathways:involvement of invasive potential[J].FASEBJ,2004,18(10):1123-1125.
106 李刚.病毒性肝炎.见:杨绍基主编.传染病学[M].第一版.北京:人民卫生出版社,2002:22-41.
107 Elsammak MY,Amin GM,Khalil GM,et al.Possible contribution of serum activin A and IGF-1 in the development of hepatocellular carcinoma in Egyptian patients suffering from combined hepatitis C virus infection and hepatic schistosomiasis.Clin Biochem.2006 Jun;39(6):623-629.
108 Cutroneo KR,Boros DL.Rational basis for oligodeoxynucleotides to inhibit collagen synthesis in lung fibroblasts and primary fibroblasts from liver granulomas of Schistosoma mansoni-infected mice.Cancer Lett.2002 Jun 28;180(2):145-151.
109 王磊,肖锡昌,唐永煌,等.华枝睾吸虫与二甲基亚硝胺诱发动物肝癌的初步实验研究[J].中国寄生虫病防治杂志,1994;7:201-203.
110 Abdel-Rahim AY.Parasitic infections and hepatic neoplasia.Digestive Diseases 2001;19:288-291.
111 薛开先.肝癌发生的分子遗传学和表遗传学研究[J].癌症.2005,24(6):757-768
112 周汉高,顾公望.肝癌分子流行病学的研究[J].世界华人消化杂志,1998,6(5):432
113 吴燕,刘耳,张宝初.不同地区原发性肝癌患者家族史分析[J].华人消化杂志,1998,6(2):178-179.
114 吴一迁,陆培新,王加生,等.EPHX代谢酶的遗传多态性和肝癌易感性的相关性研究[J].肿瘤,2003,23(4):287-289.
115 Bian JC,Shen FM,LiS,etal.Susceptibility to hepatocellular carcinoma associated with nullgenotypes of GSTM1 and GSTT1.Word J Gastroentero,2000,6(2):228.
116 覃甲仁,顾永耀,钟卫干,等.Ⅱ相代谢酶基因多态性与广西肝癌发生的关系[J].实用癌症杂志,2004,19(5):460-473.
117 Kirk GD,Tumer PC,Gong Y,et al.Hepatocellular carcinoma and polymorphisms in carcinogen-metabolizing and DNA repair enzymes in a population with aflatoxin exposure and hepatitis B virus endemicity.Cancer Epideminol Biomarkers Prev.2005,14(2):373-379
118 许丽,吴一迁,金晏,等.DNA修复基因XPD多态性和肝细胞肝癌危险性的病例对照研究[J].肿瘤,2004,24(6):526-529.
119 EI-Serag HB,Tran T,Everhare JE.Diabetes increases the risk if chrionic liver disease and heaptocellular carcinoma.Gastroenterology,2004,126:460-468.
120 Jean M Regimbeau,Magali Colombat,Philippe Mognol et al.Obesity and diabetes as a risk factor for heaptocellular carcinoma.Liver transplantation 2004;S1:S69-S73.
121 Jian MY,Sugantha G,Kazuko A,Mimi CY.Synergism of alcohol,diabetes,and viral hepatitis on the risk of hepatocellular carcinoma in Blacks and Whites in the U.S.Cancer.2004;101:1009-1017.
122 周里琳,苏东星,陈庆州.糖尿病与慢性乙型肝炎患者发生原发性肝癌的关系[J].华夏医学,2005,18(1):52-53.
123 Yoshihisa Fujino,Tetsuya Mizoue,Noritaka Tokui et al.Prospective study of diabetes mellituss and liver cancer in Japan.Diabetes Meta Res Rev 2001;17:374-379.
124 Lagiou P,Kuper H,Stuver SO et al.Role of diabetes mellitus in the etiology if hepatocellular carcinoma.J Natl Caner Inst 2000,92:1096-1099.
125 EI-Serag HB,Richardson PA,Everhare JE.Theroleof diabetes in hepatocellular carcinoma:a case-control study among United States veterans.Am J Gastroenterol 2001;96:2462-2467.
126 季尚玮,郭宏华,王江滨.糖尿病与消化系肿瘤关系的研究进展[J].国际消化病杂志,2006,26(1):61-63.
127 Teh-Ia Huo,M.D,Jaw-Ching Wu,et al.Differential mechanism and prognostic impact of diabetes mellitus on patients with hepatocellular carcinoma undergoing surgical and nonsurgical treatment.Am J Gastroenterology 2004;99:1479-1487.
128 Devi GR,Sprenger CC,Plymate SR.Insulin like growth factor binding protein3 induce searly apoptosis in malignant prostate cancer cells and inhibits tumor formation invivo[J].Prostate 2002,51(2):141-152.
129 Williams AC,Collard TJ,Perks CM,et al.Increased P53 dependent apoptosis by the IGFBP3 in human colonic adenoma derivedlines[J]Cancer Res 2000,60(1):22-27.
130 Grimberg A,Liu B,Bannerman P,et al.IGFBP3 mediates P53 induced apoptosis during serums tarvation[J].Int J Oncol 2002,21(2):327-335.
131 Adams TE,Epa VC,Garrett TP,et al.Structure and function of the type-1 insulin like growth factor receptor[J].Cell Mol Life Sci 2000,57(7):1050-1093.
132 Grimberg A Cohen P.Role of insulin like growth factors and the binding proteins in growth control and carcinogenesis.[J].J Cell Physiol 2000,183(1):1-9.
1 王天爵.交互作用的估计及其应用(一)[J].中国卫生统计,1989,6(6):56-58.
2 王天爵.交互作用的估计及其应用(二)[J].中国卫生统计,1990,7(1):62-64.
3 李辉.临床流行病学研究中交互作用的判别及测量(一)[J].中华流行病学杂志,1996,17(4):243-247.
4 李辉.临床流行病学研究中交互作用的判别及测量(二)[J].中华流行病学杂志,1996,17(5):305-307.
5 Kleinbaum DG,Epidemiologic Research:Principles and Quantitative Methods,Belmont,California,Lifetime Learning Publications.1982,404-414.
6 黄悦勤.临床流行病学.第七章:交互作用.人民卫生出版社,2002年8月.第一版.P143-146.
7 曾运红,谭卫仙.原发性肝癌发病主要危险因素的Meta分析[J].现代预防医学,2004;31(2):172-174.
8 张思维,李连弟,鲁凤珠,等.中国1990-1992年原发性肝癌死亡调查分析[J].中华肿瘤杂志,1999,21(4):245-247.
9 黄天壬,张振权,石建基,等.广西恶性肿瘤死亡的流行特点及趋势[J].陕西肿瘤医学,2001,9(3):200-201.
10 Walker AM.Proportion of disease attributable to the combined effect of two factors.Int J Epidemiol,1981,10:81-85.
11 Rothman KJ,Greenland S.Modern Epidemiology Second Edition.Lippincott-Raven Publishers,1998.
12 Mitchell H.Gail,Jacques Benichou.Encyclopedia of epidemiologic methods[J].John Wiley § Sons Ltd,2000.
13 向惠云,余松林,孙奕,等.疾病资料多元分析中交互作用指标及可信区间的估计[J].中国卫生统计,1999,16(3):130-132.
14 贺晓新,金水高.个体匹配病例对照研究中交互作用及处理方法[J].中国卫生统计,2002,19(1):43-45.
15 丁保国,樊冬梅,穆丽娜,等.乙型肝炎、丙型肝炎病毒感染与肝癌的病例对照研究[J].中华流行病学杂志,2004,25(1):22.
16 俞顺章,穆丽娜.乙型肝炎与肝癌[J].上海预防医学杂志,2005,17(9):417-418.
17 Feher J,Lengyel G.Risk factors of liver tumors[J].Orv Hetil,2004,145(7Suppl):365-367.
18 袁萍,唐伟,文进,等.中国四川和日本东京两地原发性肝癌手术患者肝炎病毒感染状况[J].中华预防医学杂志,2005,39(5):332-334.
19 张明东,俞顺章,梁任祥,等.广西扶绥县原发性肝癌病例对照研究[J].中华流行病学杂志,1993,14(1):14-18.
20 吴继周,时馥荪,莫志纯.广西原发性肝细胞癌病因探讨:118例配对病例一对照的条件Logistic回归分析[J].癌症,1990,9(1):25-28.
21 李晓凤.包头地区常见恶性肿瘤与社会心理因素关系的调查[J].肿瘤防治杂志,2003,10(2):113-115.
22 Helgeson V,Cohen S.Group support intervention for women with breast cancer,who benefit from what?[J].Health Psychology,2000,19:107-114.
23 任宏轩,沈丽达.社会心理因素对癌症的影响[J].中国肿瘤,2005,14(10):639-641.
24 刘小宁,冯月菊,任文锋.华支睾吸虫病流行区流行病学研究[J].热带医学杂志,2003;3(4):406.
25 王磊,肖锡昌,唐永煌,等.华枝睾吸虫与二甲基亚硝胺诱发动物肝癌的初步实验研究[J].中国寄生虫病防治杂志,1994:7:201-203.
26 Abdel-Rahim AY.Parasitic infections and hepatic neoplasia.Digestive Diseases 2001,19:288-291.
27 丁建华,李苏平,吴建中,等.泰兴市HBsAg与其它危险因素致肝癌交互作用的研究[J].中国肿瘤,2001,10(12):709-711.
28 Hassan MM,Hwang LY,Hatten CJ,et al.Risk factors for hepatocellular carcinoma:synergism of alcohol with viral hepatitis and diabetes mellitus.Hepatology.2002,36:1206-1213.
29 邹长林,陈哲京,金文扬,等.温州地区原发性肝癌危险因素的病因分值及其交互效应[J].中华预防医学杂志,2003,37(5):355-357.
30 Yuan JM,Govindarajan S,Arakawa K,et al.Synergism of alcohol,diabetes,and viral hepatitis on the risk of hepatocellular carcinoma in blacks and whites in the U.S.Cancer.2004;101(5):1009-1017.
31 Marrero JA,Fontana RJ,Fu S,et al.Alcohol,tobacco and obesity are synergistic risk factors for hepatocellular carcinoma.J Hepatol.2005,42(2):218-224.
32 卢岳华,易建纯,陈大舜,等.原发性肝癌郁症患者人格特征的研究[J].中国医药学报,1988,3(2):62.
33 Tomatis L Between the body and the mind the involvement of psychological factors in the development of multifactorial diseases[J].EurJ Cancer,2001,37(85):148-152.
34 丁保国,樊冬梅,王飞霞,等.不良精神因素、家族史及肝脏疾病史与肝癌[J].中国慢性病预防与控制,2003,11(1):3-4.
35 Kleinbaum DG,Kupper LL,Morgenstem H.Interactions.Effect modification and synergism.In:Epidemiologic Research.New York:Van Nostrand Reinhold,1982:407-417.
1 陈建国,宋新生明.中国肝癌发病水平的估算及分析[J]中国肿瘤,2005,14(1):28-31
2 Evans AA,Chen G,Ross EA,et al.Eight-year follow-up of the 90,000-person Haimen City cohort:Ⅰ.Hepatocellular carcinoma mortality,risk factors,and gender differences[J].Cancer Epidemiol Biomarkers Prev.2002;11(4):369-376.
3 Kuntz E,Kuntz HD.Malignant liver tumours.See:Kuntz E,Kuntz HD.Hepatology Principles and Practice[M].Springer-verlag Berlin,Heidelberg,2002:699-730
4 Yuan JM,Govindarajan S,Arakawa K,et al.Synergism of alcohol,diabetes,and viral hepatitis on the risk of hepatocellular carcinoma in blacks and whites in the U.S[J].Cancer.2004;101(5):1009-1017.
5 丁保国,樊冬梅,王飞霞,等,乙型肝炎、丙型肝炎病毒感染与肝癌的病例对照研究[J]中国预防医学杂志,2004,5(2):122-124
6 Jia-Sheng Wang,Tiren Huang,Jianjia Su,et al.Hepatocellular Carcinoma and Aflatoxin Exposure in Zhuqing Village,Fusui County,People' s Republic of China.Cancer Epideminol Biomarkers Prev.2001,10:143-146
7 Tao P,Zhi-Ming L,Tang-Wei L,et al.Associated factors in modulating aflatoxin B1-albumin adduct level in three Chinese populations[J].Dig Dis Sci.2005;50(3):525-532.
8 Kirk GD,Lesi OA,Mendy M,et al.249(ser)TP53 mutation in plasma DNA,hepatitis B viral infection,and risk of hepatocellular carcinoma.Oncogene.2005;24(38):5858-5867.
9 Qiu DC,Hubbard AE,Zhong B,et al.A matched,case-control study of the association between Schistosoma japonicum and liver and colon cancers,in rural China[J].Ann Trop Med Parasitol.2005;99(1):47-52.
10 Hassoba H,Mahmoud M,Fahmy H,et al.TT virus infection among Egyptian patients with hepatocellular carcinoma[J].Egypt J Immunol.2003;10(1):9-16.
11 Nilsson HO,Mulchandani R,Tranberg KG,et al.Helicobacter species identified in liver from patients with cholangiocarcinoma and hepatocellular carcinoma [J].Gastroenterology,2001,120(1):323-324
12 张世强,鲍勇,祖茂衡。幽门螺杆菌感染与原发性肝癌关系的相关性研究[J]中国肿瘤临床,2004,31(13):761-764
13 俞顺章,赵宁,资晓林,等.饮水中微囊藻毒素与我国原发性肝癌关系的研究[J].中 华肿瘤杂志,2001,23(2):96-99.
14 Singh G,Driever PH,Sander JW.Cancer risk in people with epilepsy:the role of antiepileptic drugs[J].Brain.2005;128(1):7-17.
15 Green T,Toghill A,Lee R,et al.Thiamethoxam induced mouse liver tumors and their relevance to humans.Part 1:mode of action studies in the mouse[J].Toxicol Sci.2005;86(1):36-47.
16 Macanas-Pirard P,Yaacob NS,Lee PC,et al.Glycogen synthase kinase-3 mediates acetaminophen-induced apoptosis in human hepatoma cells[J].J Pharmacol Exp Ther.2005;313(2):780-789
17 Velazquez I,Alter BP.Androgens and liver tumors:Fanconi's anemia and non-Fanconi's conditions[J].Am J Hematol.2004;77(3):257-267.
18 Hara A,Sakata K,Yamada Y,et al.Suppression of beta-catenin mutation by dietary exposure of auraptene,a citrus antioxidant,in N,N-diethylnitrosamine-induced hepatocellular carcinomas in rats[J].Oncol Rep.2005;14(2):345-351.
19 陈佳鹏,周宝森.农业地区人群恶性肿瘤发病率和死亡率与环境中农药暴露的生态学研究中国慢性病预防与控制 2004,12(2):52-54
20 Chiu HF,Ho SC,Wang LY,et al.Does arsenic exposure increase the risk for liver cancer[J]? J Toxicol Environ Health A.2004;67(19):1491-1500.
21 Marrero JA,Fontana RJ,Fu S,et al.Alcohol,tobacco and obesity are synergistic risk factors for hepatocellular carcinoma.J Hepatol.2005;42(2):218-224.
22 Morgan TR,Mandayam S,Jamal MM.Alcohol and hepatocellular carcinoma[J].Gastroenterology.2004;127(5 Suppl 1):S87-96.
23 Davila JA,Morgan RO,Shaib Y,et al.Diabetes increases the risk of hepatocellular carcinoma in the United States:a population based case control study[J].Gut.2005;54(4):533-539.
24 Chen WC,Lo GH,Lai KH,et al.Development of hepatocellular carcinoma after successful management of esophageal variceal bleeding[J].J Chin Med Assoc.2004;67(11):557-564.
25 Kowdley KV.Iron,hemochromatosis and hepatocellular carcinoma[J].Gastroenterology.2004;127(5 Suppl 1):S79-86.
26 Sauvaget C,Nagano J,Hayashi M,et al.Vegetables and fruit intake and cancer mortality in the Hiroshima/Nagasaki Life Span Study.Br J Cancer.2003;88(5):689-694.
27 Gelatti U,Covolo L,Franceschini M,et al.Coffee consumption reduces the risk of hepatocellular carcinoma independently of its aetiology:a case-control study[J].J Hepatol.2005;42(4):528-534.
28 么鸿雁,杨念念,方亚,等,中国人群肺癌、肝癌、乳腺癌危险因素的综合研究[J]中国肿瘤 2002,11(12):695-696.
29 吴一迁,陆培新,王加生等,EPHX代谢酶的遗传多态性和肝癌易感性的相关性研究[J]肿瘤 2003,23(4):287-289.
30 覃甲仁 顾永耀 钟卫干,Ⅱ相代谢酶基因多态性与广西肝癌发生的关系[J].实用癌症杂志[J]2004,19(5):460-473.
31 Kirk GD,Tumer PC,Gong Y,et al.Hepatocellular carcinoma and polymorphisms in carcinogen-metabolizing and DNA repair enzymes in a population with aflatoxin exposure and hepatitis B virus endemicity.Cancer Epideminol Biomarkers Prev.2005,14(2):373-379.
32 许丽,吴一迁,金晏,等.DNA修复基因XPD多态性和肝细胞肝癌危险性的病例对照研究.月中瘤.2004,24(6):526-529.