To Investigate The Relation Between Social, Psychological, Behavial And Environmental Factors And Primary Hepatic Carcinoma

Objective:To investigate the relation between social psychology factor, behavior factor and environmental factor and Primary hepatic carcinoma in Guangxi and to explore the major risk factors and etiological pattern of Primary hepatic carcinoma by case-control study,so as to provide the scientific basis for preventive measures.Methods:A hospital-based case-control retrospective study was conducted among 500 PHC patients and 500 nontumorous patients.The subjects were enrolled at the First Affiliated Hospital and Tumor Hospital of Guangxi Medical University from December 2005 to December 2006 in accordance with clinical diagnosis criteria revised by professional committee of hepatoma association in 2001.The case group includes those diagnosed patients with PHC by clinical situation,blood serum,hepatoma marker,operation,imageology examination. The control group was selected from diagnosed nontumorous patients in Spine Surgery and Traumatic Surgery at the First Affiliated Hospital at the same time by simple random sampling.The subjects were interviewed face to face by trained interviewers based on the contents of the questionnaires.In single factor analysis result,Factor with significance level less than 0.10 was analyzed by stepwise regression and non-condition multiple factor Logistic regression.Results:Social psychology factor,behavior factor and environmental factor are the important risk factors for the development of primary hepatic carcinoma.By univariate analysis,low income,heavy physical labor,adaptability,B blood type,B character,emotion,psychic trauma,mental oppression,smoking,alcohol consumption,drinking;,consumption of pieces of raw fish,raw water,mildew food,pickled vegetables,bake food,salting food,fried food,maize food,pesticide,mosquito-killer,frequently used drug,housing fitment,chimney soot,HBV infection history of HBV,history of PHC,distomatosis hepatis, diabetes mellitus are associated with the development of primary hepatic carcinoma。Fresh vegetables,Fresh fruit,Light taste,Drinking tea,Purified water,Phreatic water have a protective effect to PHC.Further research shows that age,the history and the packs of smoking are closely associated with the development of PHC.With regard to alcohol consumption,there was a statistical significance for those who consumed＜80 mL of ethanol per day(P＞0.05).Daily alcohol consumption of≥80 mL of ethanol per day resulted in a greater risk of PHC(OR:5.36).In addition,PHC risk increased in proportion to the increase in alcohol consumption and the extension of the history.It indicates that there was dose-response relation between the years of drinking and amount of alcohol and the development of PHC.Drinking tea is one of the protection factors.The duration of this habit can reduce the risk on the development of PHC.But there is no relation between tea concentration and the tea of previous day and the development of PHC(P＞0.05).Evidence from the analysis of the history of HBV infection, distomatosis hepatic and diabetes mellitus shows:The presence of the history of hepatic distomiasis and diabetes mellitus was also statistically associated with the development of PHC.OR for the people with the history of HBV infection and hepatic distomiasis less than ten years is14.19,5.09 respectively;OR for the people with the history of HBV infection and hepatic distomiasis more than ten years is 30.33,13.50,respectively;The risk for the patients with the history of hepatic distomiasis less than five years is three times that of those people without hepatic distomiasis.It would be greater for the patients with the history of diabetes,more than five years(OR=7.51),It showed that with the extension of the history of diabetes,can increase the risk on the development of PHC.Multiple analysis shows that HBV infection,family history of PHC, diabetes mellitus,eating raw fish,alcohol consumption,frequently used drug, pesticide,low income,mental oppression,B-character and B blood-type are risk factors of PHC.Their OR value and 95%CI are 15.99(10.13-25.24), 3.72(2.01-6.88),4.68(2.09-10.54),6.43(3.96-10.44),2.28(1.48-3.50), 2.92(1.85-4.63),2.46(1.48-4.10),2.60(1.56-4.34),4.11(2.68-6.31), 3.43(2.00-5.87),3.19(1.69-6.01),respectively.Conclusion:The occurrence of primary hepatic carcinoma in Guangxi is more associated with such risk factors as socioeconomic status,living habit,the history of disease,the history of PHC and psychological factor,etc.With the prevention and control of PHC in the past twenty years,the risk factors of PHC have been diversified.In addition of the risk factors such as HBV infection,family history of PHC and polluted water,other risk factors have been found such as eating raw fish,consumption of alcohol,blood type,mental oppression and drug.Therefore,the high risk group should be educated to maintain favorable mental status and get away from some bad living habits such as smoking,eating raw fish and heavy alcohol consumption in order to prevent and control the development of PHC.At the same time,it is important to take some active and effective measures,such as increasing the inoculation rate hepatitis B vaccine in order to decrease the incidence rate of PHC. Objective:To explore etiologic fraction(EF)and interaction of HBV infection and other risk factors for primary hepatocellular carcinoma(PHC)in GuangXi,China.so as to provide the scientific basis for preventive measures.Methods:A hospital-based case-control retrospective study was conducted among 500 PHC patients and 500 nontumorous patients.The subjects were enrolled at the First Affiliated Hospital and Tumor Hospital of Guangxi Medical University from December 2005 to December 2006.The case group includes those diagnosed patients with PHC by clinical situation,blood serum,hepatoma marker,operation,imageology examination.The control group was selected from diagnosed nontumorous patients at the same time by simple random sampling.The subjects were interviewed face to face by trained interviewers based on the contents of the questionnaires.EF and interactions of HBV infection and other risk factors for PHC were analyzed by crossover analysis and nonconditional multiple logistic regression.Results:HBV infection,family history of PHC,diabetes mellitus,eating raw fish,heavy alcohol consumption,frequently used drug,pesticide,low income, B-character and blood type B all were risk factors for PHC.with EFs of 0.725, 0.186,0.119,0.486,0.385,0.438,0.195,0.277,0.604,0.157,0.299, respectively;There existed interactions of HBV infection with other risk factors including family history of PHC,diabetes mellitus,eating raw fish,heavy alcohol consumption,frequently used drug,pesticide,low income,B-character and blood type B.with etiologic fractions attributable to interaction[EF(A×B] of 0.736,0.643,0.849,0.551,0.592,0.316,0.618,0.902,0.597,0.577,and indices of interaction of 0.743,0.651,0.853,0.560,0.600,0.323,0.626, 0.907,0.607 and 0.586,respectively.Conclusions:Main risk factors for PHC in GuangXi,China could include HBV infection,family history of PHC,diabetes mellitus,eating raw fish,heavy alcohol consumption,frequently used drug,pesticide,low income,B-character and blood type B.HBV infection with other risk factors including family history of PHC,diabetes mellitus,eating raw fish,heavy alcohol consumption,frequently used drug,pesticide,low income,B-character and blood type B could exert synergistic action on developing PHC and could increase the risk of PHC.