title: Hepatitis B and C viruses infection, lifestyle and genetic polymorphisms as risk factors for hepatocellular carcinoma in Haimen, China.
abstract: A case-control study was carried out to investigate the impact of factors including virus infection, aflatoxin B1, microcystins, smoking/drinking and dietary habits as well as genetic polymorphisms of aldehyde dehydrogenase 2 (ALDH2) and cytochrome P4502E1 (CYP2E1), on susceptibility to hepatocellular carcinoma (HCC) in Haimen, China. A total of 248 patients with HCC and 248 sex-, age- and residence-matched population-based controls were recruited into the study. Virus infection, and ALDH2 and CYP2E1 gene polymorphisms were assessed in 134 paired cases and controls. By univariate analysis, hepatitis B virus (HBV) infection (odds ratio [OR]=9.75; 95% confidence interval [CI]=4.71-20.2), history of intravenous injection (OR=1.50; 95%CI=1.02-2.22), average income (OR=0.63; 95%CI=0.43-0.92), frequent intake of foods rich in protein, e.g., egg (OR=0.6; 95%CI=0.42-0.87), chicken (OR=0.53; 95%CI=0.35-0.79), pork (OR=0.67; 95%CI=0.46-0.98) and fresh fish (OR=0.58; 95%CI=0.39-0.87) significantly differed between cases and controls. However, peanut intake (OR=0.66; 95%CI=0.43-1.01), source of drinking water, including tap (OR=1.33; 95%CI=0.81-2.20), deep well (OR=0.94; 95%CI=0.56-1.55), shallow well (OR=0.85; 95%CI=0.55=1.30), river (OR=0.95; 95%CI=0.65-1.38), ditch (OR=1.09; 95%CI=0.76-1.55) and pond water (OR=1.0; 95%CI=0.14-7.10) were not significantly associated with risk. Univariate analysis also indicated that the 1-1 genotype of ALDH2 (OR=1.38; 95%CI=0.86-2.23) as well as the Pst1- and Rsa1-digested c1/c1 genotype of CYP2E1 (OR=1.36; 95%CI=0.81-2.28), was slightly more frequent in the case group. On multivariate analysis, HBV infection (OR=13.9; 95%CI=5.78-33.6) and history of intravenous injection (OR=2.72; 95%CI=1.24-6.00) were still associated with significantly increased risk of HCC, while frequent intake of fresh fish (OR=0.32; 95%CI=0.12-0.86) decreased this risk. These findings suggest that whereas peanut intake, water sources as well as genetic polymorphisms in ALDH2 and CYP2E1 do not significantly correlate with the risk of HCC, HBV infection is a main risk factor, and dietary items rich in protein, especially fresh fish, might protect against the risk of HCC in Haimen, China.
authors.affiliation: Department of Epidemiology, Shanghai Medical University, Shanghai, P. R. of China.
authors.forename: Shun-Zhang
authors.initials: SZ
authors.lastname: Yu
authors.forename: Xin-En
authors.initials: XE
authors.lastname: Huang
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Koide
authors.forename: Gang
authors.initials: G
authors.lastname: Cheng
authors.forename: Gong-Chao
authors.initials: GC
authors.lastname: Chen
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Harada
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ueno
authors.forename: Eisaburo
authors.initials: E
authors.lastname: Sueoka
authors.forename: Hideaki
authors.initials: H
authors.lastname: Oda
authors.forename: Fumio
authors.initials: F
authors.lastname: Tashiro
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizokami
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Ohno
authors.forename: Jin
authors.initials: J
authors.lastname: Xiang
authors.forename: Shinkan
authors.initials: S
authors.lastname: Tokudome
mesh_terms: D000328:Adult; D016604:Aflatoxin B1 / Q000633:toxicity; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D000444:Aldehyde Dehydrogenase / Q000235:genetics; D000071396:Aldehyde Dehydrogenase, Mitochondrial; D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D019392:Cytochrome P-450 CYP2E1 / Q000235:genetics; D005260:Female; D005506:Food Contamination; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008019:Life Style; D008113:Liver Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
chemical_list: D016604:Aflatoxin B1; D019392:Cytochrome P-450 CYP2E1; C096127:ALDH2 protein, human; D000444:Aldehyde Dehydrogenase; D000071396:Aldehyde Dehydrogenase, Mitochondrial