Hepatitis B and C virus infection and the risk of biliary tract cancer: a population-based study in China.
Emerging data suggest that chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections may also play a role in extrahepatic bile duct cancers. To test the HBV hypothesis, we examined the relationship of HBV/HCV infection with risks of biliary tract cancer and biliary stones in a population-based case-control study conducted in Shanghai, China. Standard assays were used to detect HBV surface antigen (HBsAg) and antibodies against HBV core antigen (anti-HBc) and hepatitis C virus (anti-HCV) in sera from 417 patients with biliary tract cancers, 517 with biliary stones, and 762 healthy controls randomly selected from the population. Unconditional logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for each disease type. HBsAg seroprevalence was 7.3% among population controls and 14.2% among patients with extrahepatic bile duct cancer, resulting in a 2.4-fold risk of extrahepatic bile duct cancer (95% CI 1.2-4.5). No association was found for cancers of the gallbladder (prevalence 8.2%) or the ampulla of Vater (6.1%), or for stones in the gallbladder (10.1%) or bile duct (9.3%). Further adjustment for education, smoking, body mass index, diabetes and gallstones did not materially change the results. Prevalence of HCV infection in this population was low (2%), limiting our ability to detect an association with biliary diseases. In Shanghai, an HBV endemic area, chronic HBV infection was associated with a 2.4-fold risk of extrahepatic bile duct cancer. These results should be confirmed in other populations with varying risks of HBV and HCV infection.
Hsing
Ann W
AW
Division of Cancer Epidemiology and Genetics, National Cancer Institute, EPS 5024, MSC 7234, 6120 Executive Blvd., Bethesda, MD 20852-7234, USA. hsinga@mail.nih.gov
Zhang
Mingdong
M
Rashid
Asif
A
McGlynn
Katherine A
KA
Wang
Bing-Shen
BS
Niwa
Shelley
S
Ortiz-Conde
Betty A
BA
Goedert
James J
JJ
Fraumeni
Joseph F
JF
O'Brien
Thomas R
TR
Gao
Yu-Tang
YT
D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000821:virology*; D017734:Bile Ducts, Extrahepatic; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D016001:Confidence Intervals; D005260:Female; D042882:Gallstones / Q000150:complications; D006512:Hepatitis B Core Antigens / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D016036:Seroepidemiologic Studies
D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens