- Associations between hepatitis B virus infection and risk of colorectal Cancer: a population-based prospective study. - However, research concerning the effect of HBV infection on the risk of colorectal cancer (CRC) is rare and inconsistent. - This study aims to determine the relationship between HBV infection and new-onset CRC.. - Methods: We prospectively examined the relationship between HBV infection and new-onset CRC among 93,390 participants from Kailuan Cohort study. - Cox proportional hazards regression models, subgroup analyses and competing risk analyses were used to evaluate the association between HBV infection and the risk of new-onset CRC.. - Subgroup analyses showed that the HBsAg seropositive group was associated with increased risk of new-onset CRC among male, middle-aged, normal weight, smokers and non-drinker participants, respectively. - A positive association of HBV infection with the risk of CRC was observed in the adjusted sub- distribution proportional hazards (SD) models (HR SD CI and cause-specific hazards (CS) models (HR CS CI . - Conclusions: Our results have found a significant association between HBV infection and the risk of incident CRC among Chinese participants.. - http://www.chictr.org.cn/showprojen.aspx?proj=8050. - To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.. - The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.. - WHO estimates that the global prevalence of HBV infection is 3.5%, with approximately 257 million people currently infected [1]. - HBV infection is estimated to be responsible for 56% of hepa- tocellular carcinoma (HCC) [4], which is the main histo- logical type of primary liver cancer. - Besides HCC, untreated patients with HBV infection are also at an elevated risk for liver fibrosis and liver cir- rhosis [5, 6].. - A few epidemiological studies have observed a positive relationship between HBV infection and the develop- ment of extrahepatic cancers such as non-Hodgkin’s lymphoma, pancreatic cancer, and gallbladder cancer [7–10]. - Only a few existing studies have demonstrated the positive association of chronic HBV infection and the occurrence of CRC. - Previous studies concerning the association be- tween HBV infection and CRC were conducted in countries with a relatively low prevalence of HBV infec- tion, making it difficult to draw a statistically significant conclusion. - The preventive strategies based on prognostic models that estimate the actual individual risk of CRC need to be as accurate as possible, allowing for more appropriate preventive measures and treatments to be implemented quickly and intensively.. - Due to the inconsistent results and inadequate evi- dence, we aimed to clarify the relationship between HBV infection and new-onset CRC by drawing data from Kai- luan Study.. - 0.001), and exhibited lower prevalence of HBV infection versus 2598(2.78. - HBV infection and laboratory assessment. - Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated by multi- variable Cox proportional hazards regression models to evaluate the association between HBV infection and the risk of new-onset CRC. - The interactions be- tween HBV infection status and these variables were fur- ther tested by multiplicative models.. - Conventional methods for sur- vival analysis such as standard Cox proportional hazards regression may neglect the competing events and over- estimate the absolute risk of the disease [25, 26]. - The baseline characteristics for participants stratified by HBV infection status are shown in Table 1.. - Association of HBV infection with the risk of CRC. - In the uni- variate analysis, compared with HBsAg Seronegative participants, no significant relationship between HBV infection and risk of CRC was observed (HR CI . - After adjustments were made for the potential confounders, participants with HBsAg seropositive had a significantly increased risk of devel- oping incident CRC (HR CI Table 2). - Table 3 demonstrated the effects of HBV infection on the risk of CRC after stratifying the par- ticipants by sex, age, BMI, smoking status and drink- ing status. - HR CI HR CI and 126% (HR CI increased risk of new-onset CRC among male, middle-aged, normal weight, smoker and non-drinker participants, respectively.. - Present results suggest that the interaction of smoking status and HBV infection on the risk of CRC is significant (P for interaction = 0.0247). - Association of HBV infection with the risk of CRC in the competing risk analysis. - 3 mg/L), hyperbilirubinemia, elevated alanine aminotransferase, diabetes, family income, educa- tional background, marital status, salt consumption, current smoker, drinking status, physical activity and fam- ily history of cancer, a statistically significant association of HBV infection with the risk of CRC was observed in the adjusted SD models (HR SD CI . - After excluding 39 CRC cases that occurred during the first year of follow-up, participants with HBV infection were associated with a 68% (HR CI:1.05–. - 2.69) increase in the risk of CRC in the univariate ana- lysis. - Table 2 The association of HBV infection with the risk of CRC among different regressions. - Table 3 Stratified analysis of the association of HBV infection with the risk of CRC. - In this large-scale prospective cohort study, we observed a significant association between HBV infection and the risk of incident CRC among Chinese participants. - To our knowledge, this is the first prospective co- hort study to investigate the relationship between HBV infection and the risk of new-onset CRC among Chinese participants by using competing risk analyses.. - The association between HBV infection and the risk of CRC has not been fully documented previously, despite this, our findings are in line with several population-based studies. - Results from a population-based study in Taiwan showed that participants with HBV infection could expect a 36% increase in the risk of CRC compared with HBsAg seronegative participants in an analysis adjusted for sex, age, region, occupation, level of urbanization, income and the presence of comorbidities [27]. - By analyzing the data of 496,732 participants in the China Kadoorie Biobank (CKB) prospective cohort [28], Ci Song et.al found that HBV infection was positively associated with an elevated risk of CRC (HR CI:1.09–1.70). - However, a retrospective chart review failed to find the association be- tween chronic HBV infection and colorectal adenoma [29]. - The association of HBV infection with the risk of CRC can be modified across categories of sex, age, BMI, smoking status and drinking status. - the fact that abnormally elevated estrogen concentra- tions are associated with the increased risk of endomet- rial carcinoma and breast cancer [30], a meta-analysis observed a consistent protective effect of estrogens against colorectal cancer risk in both case-control stud- ies and cohort studies [31]. - Second, CRC is rare among neonates and young people and the cause-effect rela- tionship may yield null results during short-term ex- posure to HBV infection among these participants. - In elderly participants (mean age long-term exposure to chronic HBV infection could lead to cir- rhosis and hepatocellular carcinoma. - However, we have no explanation for the negative asso- ciation between HBV infection and CRC among drink- ing participants. - Further study should be conducted to explore whether alcohol can eliminate the effect of HBV infection on the risk of CRC.. - Table 4 The association of HBV infection with the risk of CRC (exclude participants who occurred HCC within 1 year). - However, no existing study has investigated the pathophysiological mechanism of the association between HBV infection and the risk of incident CRC. - Fourth, although we found an increased risk of CRC in chronic carriers of HBV, future studies should be con- ducted to detect the existence of HBV in colon tumors by using molecular biology, immunohistochemical methods to better elucidate the pathophysiological ex- planation of our findings.. - Our results have provided evidence that chronic HBV infection plays an important role in the occurrence of CRC. - https://doi.org/10.1016/S . - https://doi.org/10.1016/j.va ccine . - https://doi.org/10.101 6/j.jhep . - https://doi.org/10.1002/ijc.31280.. - https://doi.org/10.1 016/j.coviro . - Risk of pancreatic cancer in chronic hepatitis B virus infection: data from the REVEAL-HBV cohort study. - https://doi.org/10.1111/j x.. - doi.org/10.1002/hep.21642.. - Risk of all-type cancer, hepatocellular carcinoma, non-Hodgkin lymphoma and pancreatic cancer in patients infected with hepatitis B virus. - https://doi.org/10.1111/jvh.12391.. - Risk of hepatocellular carcinoma and cancers at other sites among patients diagnosed with chronic hepatitis B virus infection in Sweden. - https://doi.org/10.1002/. - https://doi.org/10.1136/gutjnl . - https://doi.org EPI-15-0578.. - https://doi.org CAN-09-3929.. - Association of adherence to lifestyle recommendations and risk of colorectal cancer: a prospective Danish cohort study. - https://doi.org/10.1136/bmj.c5504.. - https://doi.org/10.1093/. - https://doi.org/10.3390/v12010097.. - Low- density lipoprotein cholesterol and risk of intracerebral hemorrhage: a prospective study. - https://doi.org/10.1212/. - https://doi.org/10.1016/j.jacc . - https://doi.org/10.1186/s . - Relationship between high- sensitivity C reactive protein and the risk of gallstone disease: results from the Kailuan cohort study. - https://doi.org/1 0.1136/bmjopen . - https://doi.. - org/10.1016/S . - https://doi.org/10.1161/CIRCULATIONAHA . - https://doi.org/10.1038/nrendo.2017.151.. - https://doi.org/1 0.1093/aje/kwp107.. - https://doi.org/10.1097/EDE.0b013e3181a39056.. - org/10.1186/s . - Associations between hepatitis B virus infection and risk of all Cancer types. - https://doi.org/10.1001/jamanetworkopen.2019.5718.. - https://doi.org/10.3978/j.issn . - https://doi.org/10.1146/annurev-physiol . - https://doi.org/10.1097/MEG . - https://doi.org/10.1093/jn/nxz268.. - https://doi.org/10.1007/s . - https://doi.org/1 0.1007/s . - https://doi.org/1 0.1093/ndt/gft355.. - https://doi.org/1 0.1016/j.jhep . - https://doi.org/10.3389/fimmu . - https://doi.org . - https://doi.org/10.1002/hep . - https://doi.org/10.1006/jmbi.2000.4481.. - https://doi.org/10.1128/jvi
Xem thử không khả dụng, vui lòng xem tại trang nguồn hoặc xem
Tóm tắt