尿液黃麴毒素代謝產物和肝細胞癌之重疊病例對照研究

為探討台灣地區黃麴毒素暴露和肝細胞癌發生的關孫，本研究係以民國77-81年收案自公保健診中心和長庚醫院肝病中心的4841名男性B型肝炎病毒帶原者和2501名男性非帶原者為研究世代，利用追蹤期間發生肝細胞癌且有庫存尿液檢體的43名個案為病例組，每名病例選取一名B型肝炎表面抗原(HBsAg)陽性及一名HBsAg陰性未罹患肝細胞癌個案為對照組。研究結果顯示，尿液黃麴毒素代謝產物間的相關性在肝細胞癌病例組，HBsAg陽性對照組及HBsAg陰性對照組不同，且各種尿液代謝產物佔黃麴毒素總量的百分比在三組中亦有差異，AFM1%在HBsAg陰性對照組最高，AFP1%在HBsAg陰性對照組最低，AFB1%在病例組聶高。黃麴毒素總量及大多數代謝產物濃度念高，罹患肝細胞癌的相對危險性愈高，在控制了其它重要危險因子作用後，尿液黃麴毒素總量及黃麴毒素M1(AFM1)和罹患肝細胞癌的危險性有相關。AFM1和肝細胞癌的相對危險性在不抽菸、不喝酒、或年齡50歲以下者較高。

關鍵字

黃麴毒素；肝細胞癌；重疊病例對照研究

並列摘要

In order to elucidate the association between aflatoxin exposure and hepatocellular carcinoma (HCC), a cohort of 4841 male asymptomatic chronic hepatitis B virus (HBV) carriers and 2501 male non-carriers aged 30 years or above was recruited from Government Employees Central Clinics and the Liver Unit of Chung-Gung Memorial Hospital between August, 1988 and June, 1992. There were 43 newly-developed HCC cases identified during follow-up periods. For each case, one HBV carrier and one HBV non-carrier were randomly selected as controls from cohort members without HCC. Cases and controls were matched with respect to age (within 3 years) and the season of urine collection. Correlation among various urinary aflatoxin metabolites were quite different for HCC cases, chronic HBV carriers, and HBV non-carriers. The relative risk of developing HCC was increased with urinary levels of total aflatoxins, aflatoxin P,. aflatoxin Mi, aflatoxin-N7-guanine, and aflatoxin Bi. After adjusting for other risk factors, urinary level of total aflatoxins and aflatoxin Mi were associated with the development of HCC. The relative risks of HCC associated with urinary atlatoxin M1 were more marked among individuals aged less than 50 years and those who smoked or drunk.

並列關鍵字

Aflatoxin ； Hepatocellular carcinoma ； Nested case-control study

國際替代計量

尿液黃麴毒素代謝產物和肝細胞癌之重疊病例對照研究

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