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我们利用最近建立的检测尿液黄曲霉毒素(AF)B_1及其代谢产物(AFP_1、AFM_1)和DNA加成物(AFB_1-N~7-Guanine)的方法,分别检测上海市区队列研究中发现的22例肝癌及其140名对照尿液AFB_1、AFP_1、AFM_1和DNA加成物,同时测定血清乙型肝炎病毒表面抗原(HBsAg)。肝癌病例尿液AF检出率(59％)比对照高(38％)。DNA加成物阳性者肝癌相对危险度估计值(OR)为4.9。尽管AFP_1(OR=6.1)、AFM_1(OR=3.0)和AFB_1(OR=2.3)均与OR显著或接近显著增高有关,但伴随DNA加成物阴性时,AFP_1、AFM_1或AFB_1阳性并不显著增高OR。本文还发现HBsAg阴性者尿AF阳性OR仅增高1倍,而HBsAg阳性者伴尿AF阳性使OR增高11.5倍。以条件Logistic回归模型调整HBsAg、受教育程度、吸烟和重度饮酒等因素后,尿液检出AF的OR为3.8(95％CI:1.2～12.2)。
We used the recently established method to detect urinary aflatoxin (AF) B_1 and its metabolites (AFP_1, AFM_1) and DNA adducts (AFB_1-N~7-Guanine), respectively. Twenty-two cases of hepatocellular carcinoma and 140 control urine AFB_1, AFP_1, AFM_1, and DNA adducts were simultaneously tested for serum hepatitis B virus surface antigen (HBsAg). The detection rate of urine AF in cases of liver cancer (59%) was higher than that of the control (38%). The relative risk of liver cancer (OR) was 4.9 for those with positive DNA adducts. Although AFP_1 (OR=6.1), AFM_1 (OR=3.0), and AFB_1 (OR=2.3) were all significantly or nearly significantly associated with OR, the presence of AFP_1, AFM_1, or AFB_1 did not significantly increase with negative DNA adducts. OR. This article also found that HBsAg-negative urine AF positive OR only increased 1 times, while HBsAg-positive persons with urine AF positive OR increased by 11.5 times. After adjustment for factors such as HBsAg, education level, smoking, and heavy alcohol consumption using conditional logistic regression models, the OR of urine detected AF was 3.8 (95% CI: 1.2 to 12.2).