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目的:探讨广西肝癌高发区输血传播病毒(TTV)与乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)的重叠感染在原发性肝细胞癌(HCC)家庭聚集性中的作用。方法:分别采用巢式PCR和RT-PCR技术对研究对象外周血清中TTVDNA、HBVDNA和HCVRNA进行检测,应用χ2检验进行统计学分析。结果:HCC高发家庭成员组及无癌家庭成员组中TTVDNA、HBVDNA、HCVRNA阳性率分别为35.4%(46/130)、29.2%(38/130)、10.0%(13/130)和24.6%(32/130)、10.8%(14/130)、3.8%(5/130),两组间TTVDNA、HBVDNA、HCVRNA阳性率差异有统计学意义(χ2=4.12、P=0.04、RR=1.81、95%CI=1.018~3.219;χ2=14.97、P=0.0001、RR=3.765、95%CI=1.88~7.54;χ2=3.91、P=0.048、RR=2.84、95%CI=0.972~8.29)。两组TTV与HBV、HCV重叠感染率分别为7.7%(10/130)、3.8%(5/130)和1.5%(2/130)、1.5%(2/130),TTVDNA+HBVDNA感染率在两组间差异有统计学意义(χ2=5.5914、P=0.0180、RR=5.33、95%CI=1.15~24.84);而TTVDNA+HCVRNA阳性率在两组间差异无统计学意义(χ2=1.3213、P=0.2504、RR=2.56、95%CI=0.49~13.44)。结论:TTV、HBV、HCV感染以及TTV和HBV的重叠感染与广西HCC家庭聚集性存在一定的相关关系,但TTV和HBV重叠感染在致肝癌上无明显协同作用。
Objective: To explore the role of overlap infection of transfusion transmitted virus (TTV), hepatitis B virus (HBV) and hepatitis C virus (HCV) in the home of primary hepatocellular carcinoma (HCC) in high incidence area of liver cancer in Guangxi. Methods: The levels of TTVDNA, HBVDNA and HCVRNA in the peripheral blood of the study subjects were detected by nested PCR and RT-PCR, respectively. The chi-square test was used for statistical analysis. Results: The positive rates of TTVDNA, HBVDNA and HCVRNA were 35.4% (46/130), 29.2% (38/130), 10.0% (13/130) and 24.6% (13/130) in HCC patients and non-cancer family members respectively 32/130), 10.8% (14/130), 3.8% (5/130). There was significant difference in the positive rates of TTVDNA, HBVDNA and HCVRNA between the two groups (χ2 = 4.12, P = 0.04, RR = Χ2 = 3.91, P = 0.048, RR = 2.84, 95% CI = 0.972 ~ 8.29). The infection rates of TTV, HBV and HCV in two groups were 7.7% (10/130), 3.8% (5/130), 1.5% (2/130) and 1.5% (2/130) The difference between the two groups was statistically significant (χ2 = 5.5914, P = 0.0180, RR = 5.33, 95% CI = 1.15-24.84). There was no significant difference in the positive rates of TTVDNA + HCVRNA between the two groups (χ2 = 1.3213, P = 0.2504, RR = 2.56, 95% CI = 0.49 to 13.44). CONCLUSION: TTV, HBV, HCV infection and overlap infection of TTV and HBV have some correlation with HCC family aggregation in Guangxi, but there is no significant synergistic effect of TTV and HBV over infection on liver cancer.