Tight association of hepatocellular carcinoma with HBV infection in North China.
BACKGROUND
Hepatocellular carcinoma (HCC) is the second most common cancer in China. Hepatitis B and C viruses (HBV and HCV) and aflatoxins are known risk factors for HCC, but the etiological status of these factors in HCC development is not clear. This study was undertaken to define the absolute importance of HBV in hepatocarcinogenesis of North China.


METHODS
A consecutive series of 119 patients with pathologically proven HCC were collected from North China during January 1998 to December 2000 by the Cancer Hospital of the Chinese Academy of Medical Sciences, Beijing. Serum HBsAg, anti-HBc and anti-HCV were negative HBV sero-markers. The HBV X gene was analyzed for its expression by PCR, DNA sequencing, and immunohistochemistry.


RESULTS
In the 119 HCC patients, 82.4% (98/119) were HBsAg seropositive. When a comprehensive set of HBV markers were detected, the HBV infection rate in these HCC patients was 99.2% (118/119). Of the patients, 11.8%(14/119) were found to be anti-HCV positive. But all the anti-HCV positive HCC patients were co-infected with HBV.


CONCLUSIONS
HBV infection is virtually ubiquitous in HCC patients in North China. The tight association of HBV with HCC strongly suggests the dominant role of HBV infection in causing hepatocellular carcinoma. About 11.8% of HCC patients being HCV-related are co-infected with HBV.
Gao
Ji-Dong
JD
Department of General Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Shao
Yong-Fu
YF
Xu
Yang
Y
Ming
Li-Hua
LH
Wu
Zhi-Yuan
ZY
Liu
Guo-Ting
GT
Wang
Xiao-Hong
XH
Gao
Wen-Hong
WH
Sun
Yun-Tian
YT
Feng
Xiao-Li
XL
Liang
Li-Ming
LM
Zhang
Yun-Hui
YH
Sun
Zong-Tang
ZT
D000328:Adult; D017677:Age Distribution; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006515:Hepatitis B virus / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D015996:Survival Rate
D004279:DNA, Viral