459
JOURNAL OF SCIENCE, Hue University, N
0
61, 2010 RESEARCH ON CHRONIC HBV INFECTION AND
RISK FACTORS IN PATIENTS WITH LIVER CANCER IN
THE HOSPITAL OF HUE COLLEGE OF MEDICINE AND PHARMACY
Vo Dang Anh Thu, Nguyen Thi Kim Hoa, Pham Van Linh
College of Medicine and Pharmacy, Hue University
SUMMARY
Research on the risk factors of liver cancer, particularly HBV infection is necessary for
preventing liver cancer and to reduce the prevalence of this cancer in future. Objectives: To
identify the risk factors among patients with liver cancer in Hue college of Medicine and
Pharmacy. Methods: A case-control study was conducted from May 2007 to May 2008 in which
there were 40 patients with liver cancer and 40 people without any liver diseases. For each
patient, there was a person in the control group has the same age, gender and living areas.
Results: (1) The average age of the study subjects was 53.7±8.9 in which age 54.3±12.1 was the
mean for men and age 52.9±8.9 for women, 50% of liver cancer patients aged from 45 to 60.
The ratio of men to women was 3 to 1. (2) The risk factors of liver cancer include: HBsAg (+)
(OR = 17.0), history of alcohol consumption (OR=7.0), drinking frequency (OR=4.5), the
volume of alcohol intake (OR=5.18), tobacco consumption (OR = 2.51), familial history of liver
cancer (OR = 5.52). (3) The exposure to organic pesticides is not associated with liver cancer
(OR=1.48, p>0.05, χ
2
= 0.39). Conclusion: This research was useful in identifying risk factors
of liver cancer. The results from this research will be used to inform the community and future
study of the risk factors of liver cancer.


Predicted: f = 0.35; OR = 3.5; accepted:  = 0.05;  = 0.2; → n

40
2.2. Selection of cases and controls
The cases were 40 patients with liver cancer who were under treatment at the
hospital of Hue college of Medicine and Pharmacy. Under the principle of the same
living area, sex and age, 40 non-liver cancer subjects were selected as controls.
Consequently, the study subjects include 40 cases and 40 controls.
2.3. Contents of the study
The study contents composed of three parts as follow: (1).General
characteristics; (2). Personal habits: including alcohol consumption and cigarette
smoking; (3). Symptoms and disease history related with liver cancer.
2.4. Investigation methods
the constructed questionnaire was used to collect data. All interviewers were
trained focusing on the skills of interviewing the subjects. No subjects refused to be
interviewed.
2.5. Statistical analysis
Classical analysis methods of case-control study was used to analyze data. OR
value and χ
2
were calculated. In this study, the EPI INFO 6.04 was used for completing
all the statistical analyses.

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2
3


33
p1q 461
3. Results
Table 1. Age
Age Frequency %
15 - 30 0 0
> 30 - 45 10 25
> 45 - 60 20 50
> 60 10 25
Sum 40 100
*There was 50% liver cancer patients aged 45-60.
Table 2. Sex
Sex Frequency %
Male 30 75.0
Female 10 25.0
Sum 40 100
*Men have higher proportion of liver cancer than women; the ratio of men to
women is three to one.
Table 3. The situation of hepatitis B infection among patients with liver cancer
HBsAg
Cases
n %
(+) 30 75.0
(-) 10 25.0
Sum 40 100
*75% patients with liver cancer have HBsAg (+)

40 40 80
OR = 7.00
95%CI of OR = (2.36 – 21.39)
χ
2
= 16.24
p < 0.001
Table 7. The relation between alcohol drinking frequency and liver cancer
Cases Controls
Frequent 18 3 21
No frequent 12 9 21
30 12 42
OR = 4.50
95%CI of OR = (0.84 – 26.75) 463
χ
2
= 4.20
p < 0.05
Table 8. The relation between the daily volume of alcohol intake and liver cancer
Cases Controls
≥ 30 gammes 19 3 22
< 30 gammes 11 9 20
30 12 42
OR = 5.18
95%CI of OR = (0.96 – 31.12)
χ
2

No 31 38 69
40 40 80
OR = 5.52
95%CI of OR = (0.99 – 40.12)
χ
2
= 5.16
p < 0.05
4. Discussion
4.1 General characteristics
Age
In this study, there was no patient under thirty years old and the average age of
the subjects was 53.7±8.9 in which 54.3±12.1 for men and 52.9±8.9 for women. Of the
40 cases, there were 20 (50%) patients aged from 46 to 50. This figure is approximate
with previous national and international studies.
Sex
Men are more likely to contract liver cancer than women. The ratio of male
patients to female patients in this study was 3 to 1. Several studies have suggested that
hormone androgen facilitates the development of the tumors, whereas oestrogen in
women has a protective effect. In addition, men have greater risk factors of liver cancer
than women including smoking and alcohol consumption.
4.2 The relation between chronic hepatitis B virus infection and liver cancer
The prevalence of patients with liver cancer having HBsAg (+) was 75 percent.
Meanwhile, in the control groups, there were only 15 percent of the subjects having
HBsAg (+). Therefore, patients who have HBsAg (+) get the higher risk of contracting
liver cancer than people with HBsAg (-) (OR = 17, p <0.01, χ2 = 29.1).
4.3. Other risk factors of liver cancer
Alcohol consumption
Research has shown that there was an association between drinking frequency
and the volume of alcohol intake with liver diseases. To examine the association

2
=5.18).
Tobacco consumption
Though toxic components of tobacco are transformed in the liver, little research
has been done on the relationship between tobacco consumption and the liver’s lesions.
In this study, patients with a history of tobacco consumption (accounted for 42.5%) had
a 2.51 times higher risk of liver cancer than non-smokers (OR = 2.51, p < 0.05, χ
2
=
4.07).
Exposure to chemicals
In the world, there are 6,000 cases of cancer of all kinds due to pesticides
annually. The halogenated organic pesticides is not a harmful carcinogen for the liver,
but is a promoter stimulating unlimited liver cell proliferation which is believed to play
an important role in the development of liver cancer. However, this study showed that
the exposure to organic pesticides did not reveal a relationship to liver cancer (OR=1.48,
p>0.05, χ
2
= 0.39).
Familial history of liver cancer
Several studies have mentioned familial history as an important factor of liver
cancer. The results from table 11 shows that subjects who have relatives who contracted
liver cancer get more than 5.52 times higher at risk of liver cancer than those who have
not (OR = 5.52, p < 0.01, χ
2
= 5.16). Particularly, this happens more often among 466
patients having HBsAg(+).