Risk factors associated with hepatocellular carcinoma (HCC) are well documented, but the synergisms between these risk factors are not well examined.
In this study, researchers from Texas, USA, conducted a hospital-based, case-control study among 115 HCC patients and 230 non-liver cancer controls.
Cases and controls were pathologically diagnosed at The University of Texas M. D. Anderson Cancer Center, Texas.
|22%, 16%, and 20% of cases explained by HCV, HBV, and diabetes mellitus, respectively.|
They were matched by 5-year age groups, sex, and year of diagnosis.
The research team collected information on risk factors using personal interviews and by reviewing medical records.
The team tested blood samples for the presence of antibodies to hepatitis C virus antigen (anti-HCV), hepatitis B surface antigen (HBsAg), and antibodies to hepatitis B core antigen (anti-HBc).
They used conditional logistic regression to determine odds ratios by the maximum likelihood method.
The team found that multivariate odds ratios were 15.3, 12.6, 4.5, and 4.3 for anti-HCV, HBsAg, heavy alcohol consumption (80 ml ethanol/d), and diabetes mellitus, respectively.
The research team observed synergistic interactions between heavy alcohol consumption, chronic hepatitis virus infection (OR, 53.9), and diabetes mellitus (OR, 9.9).
In addition, they found that the independent of the effect of HCV, HBV, and diabetes mellitus, heavy alcohol consumption contributes to the majority of HCC cases (32%).
Whereas 22%, 16%, and 20% of HCC cases were explained by HCV, HBV, and diabetes mellitus, respectively.
Dr Manal Hassan's team concluded "The significant synergy between heavy alcohol consumption, hepatitis virus infection, and diabetes mellitus may suggest a common pathway for hepatocarcinogenesis".
"Exploring the underlying mechanisms for such synergisms may indicate new HCC prevention strategies in high-risk individuals".
In a related editorial, Dr Chien-Jen Chen and Dr Ding-Shinn Chen, from Taiwan, also discuss the complicated multiple risk factors for hepatocarcinogenesis.
"Chronic infection with HBV and HCV, chemical carcinogens, and susceptibility genes interplay with each other in the development of HCC", they conclude.