The rate of hepatocellular carcinoma (HCC) is increasing in Egypt where the major risk factors are chronic infections with hepatitis B and C viruses (HBV and HCV). A major segment of the population is employed in agriculture, raising the possibility that exposure to pesticides is an additional risk factor for HCC. The objective of this study is to investigate pesticides as environmental risk factors for HCC while taking into account viral risk factors. We conducted a case-control study of 236 subjects with confirmed HCC recruited from the National Cancer Institute, Cairo University, Egypt, and 236 controls matched on sex, age group and urban-rural status recruited from orthopedic department, Cairo University Hospital, Egypt. Patients who agreed to participate signed a consent form, answered a questionnaire and gave a blood sample for hepatitis virus testing. The manuals of the Ministry of Agriculture for approved use and type of pesticides since 1965 were linked to the questionnaire data for types of crops and pests that the subject had to combat, to attribute specific pesticides that were used by each subject. Subjects also reported duration of the exposure (years). Case-control comparisons in these data were stratified by sex, age group, and urban vs. rural residence. Data were analyzed using unconditional logistic regression models adjusting for age, HCV RNA, and current hepatitis B infection. Among rural males, the adjusted odds ratio (OR) for organophosphorus compounds was 2.7 (95% CI = 1.3-5.3) and for carbamates it was 2.9 (95% CI = 1.4-5.8). No statistically significant associations between HCC and pesticides were observed for urban males or for females. As expected, the strongest risk factors for HCC in this study were HCV RNA (OR = 16-17) and current HBV infection (OR = 27-28). This study therefore suggests that exposures to organophophorus and carbamate pesticides are additive risk factors to current HCV and HBV infection among rural males. Future investigation should address the possible hepatocarcinogenicity of pesticides using biomarkers of exposure and other techniques to better estimate dose-response relationships.

中文翻译：

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埃及的农药，HCV，HBV和肝细胞癌协会。

在埃及，肝细胞癌（HCC）的发病率正在上升，那里的主要危险因素是乙型和丙型肝炎病毒（HBV和HCV）的慢性感染。人口的很大一部分从事农业工作，这增加了接触农药成为HCC的另一个危险因素的可能性。这项研究的目的是研究农药作为HCC的环境危险因素，同时考虑到病毒危险因素。我们对埃及开罗大学国家癌症研究所招募的236名确诊HCC患者进行了病例对照研究，并从埃及开罗大学医院骨科招募了236名性别，年龄组和城乡状况相匹配的对照。同意参加的患者签署了同意书，回答了问卷，并提供了用于肝炎病毒检测的血液样本。自1965年以来，农业部关于农药的批准使用和农药类型的手册与该受试者必须抗击的农作物和害虫类型的调查表数据相关联，以归因于每个受试者使用的特定农药。受试者还报告了暴露时间（年）。这些数据中的病例对照比较按性别，年龄组以及城市和农村居民进行了分层。使用无条件逻辑回归模型对数据进行分析，这些模型针对年龄，HCV RNA和当前的乙型肝炎感染进行了调整。在农村男性中，有机磷化合物的校正比值比（OR）为2.7（95％CI = 1.3-5.3），氨基甲酸酯为2.9（95％CI = 1.4-5.8）。在城市男性或女性中，未观察到HCC与农药之间的统计学显着关联。不出所料，本研究中最强的HCC危险因素是HCV RNA（OR = 16-17）和当前的HBV感染（OR = 27-28）。因此，这项研究表明，有机磷和氨基甲酸酯农药的暴露是农村男性当前HCV和HBV感染的附加危险因素。未来的研究应使用暴露的生物标志物和其他技术来解决农药可能引起的肝致癌性，以更好地估计剂量反应关系。因此，这项研究表明，有机磷和氨基甲酸酯农药的暴露是农村男性当前HCV和HBV感染的附加危险因素。未来的研究应使用暴露的生物标志物和其他技术来解决农药可能引起的肝致癌性，以更好地估计剂量反应关系。因此，这项研究表明，有机磷和氨基甲酸酯农药的暴露是农村男性当前HCV和HBV感染的附加危险因素。未来的研究应使用暴露的生物标志物和其他技术来解决农药可能引起的肝致癌性，以更好地估计剂量反应关系。