Hepatitis C virus, non-Hodgkin's lymphomas and hepatocellular carcinoma

Tobacco smoking is a well-documented risk factor for several cancers, but the role of cigarette smoking in the etiology of non-Hodgkin lymphoma (NHL) is inadequately understood. Hepatitis C virus (HCV) has been associated with NHL, but the interaction between HCV and smoking habits has not yet been studied. Between 1999 and 2002, we conducted a case-control study on the association of HCV, smoking habits and NHL in 2 areas of northern and southern Italy. Cases were 225 consecutive patients (median age, 59 years) with a new diagnosis of NHL that were admitted to reference and general hospitals. Controls were 504 patients (median age, 63 years) admitted to the same hospitals as cases, for a wide spectrum of acute, nonneoplastic, nonimmune-, nor tobacco-related conditions. Current, heavy smokers (!20 cigarettes/day) had an odds ratio (OR) of NHL of 2.10 (95% confidence interval, CI: 1.07-4.12) compared to never smokers. The association between smoking and NHL was consistent across strata of sex and age. Compared to never smokers, current smokers of !20 cigarettes/day had ORs of 1.14 (95% CI: 0.37-3.56) for B-cell-low-grade, 2.10 (95% CI: 0.94-4.67) for B-cell-intermediate and high-grade, and 25.84 (95% CI: 1.95-342.17) for T-cell NHL. The effect of tobacco smoking and HCV were independent on the relative risk, leading a 4-fold elevated risk in current smokers HCV positive subjects. Tobacco smoking and hepatitis C virus (HCV) have been associated to non-Hodgkin lymphoma (NHL), but the interaction between HCV and smoking habits has not yet been studied. Our study confirms that tobacco is related to NHL, and reports on the combined effect of tobacco smoking and HCV. Infection acted together according to a multiplicative model, leading to a 4-fold elevated risk in current smokers HCV positive subjects. ' 2005 Wiley-Liss, Inc.

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“…[23][24][25][26][27] However, the interaction between tobacco smoking and HCVinfection remains an open issue.…”

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confidence: 99%

Smoking and non‐Hodgkin lymphoma: Case‐control study in Italy

Talamini

Polesel

Montella

et al. 2005

Intl Journal of Cancer

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“…However, based on the currently accepted models of gastric MALT lymphomagenesis and on recent clinical and experimental data, the possibility that HCV might be linked either to benign or malignant lymphoproliferation in MALT sites should be taken into account. 2,8,9,21 The evidence that HP eradication did not lead to lymphoma regression in one reported patient indicates that the low-grade malignant lymphoproliferation was not sustained by HP, as instead shown by the many gastric low-grade B-cell NHL regressing after HP eradication. 8,9 On the other hand, molecular analyses of the IgH genes expressed by the neoplastic B-cell clone (specific distribution of replacement and silent mutations in FR and CDR regions, in conjunction with the presence of intraclonal heterogeneity) indicated a role of ongoing antigenic stimulation in the local microenvironment, with the neoplastic B-cell clone still responsive to antigen stimulation.…”

Section: Discussionmentioning

confidence: 94%

“…2,3 In addition, in one report gastric lymphoma appeared to be a frequent neoplastic complication (after hepatocellular carcinoma) in hepatopatic patients. 36 Obviously, the localization of HCV in the gastric mucosa does not necessarily imply a pathogenetic role of the virus.…”

Section: Discussionmentioning

confidence: 98%

“…11,18,19 Furthermore, recent clinical and experimental results have linked the HCV to SS-like manifestations and acquisition of MALT. 2,[20][21][22] We herein report the gastric mucosa as a possible extrahepatic localization of HCV. Viral antigens and RNA were detected within a HP-positive low-grade B-cell NHL lesion, in an HCV-infected patient with clinical and pathological findings consistent with SS.…”

mentioning

confidence: 99%

“…1 The definition of the possible extrahepatic localizations of the virus may be relevant to better address the issue of some of the extrahepatic manifestations of chronic HCV infection. As regards the gastric microenvironment, gastric lymphoma has been reported in patients with HCV infection, [2][3][4][5][6] and a relationship was noticed between HCV infection and B-cell clonal expansion in chronic gastritis lesions in Sjö gren' s syndrome (SS). 7 At present, local infection by Helicobacter pylori (HP) in the gastric mucosa is considered a crucial step for the development of chronic gastritis and gastric low-grade B-cell non-Hodgkin' s lymphoma (NHL) of mucosa-associated lymphoid tissue (MALT).…”

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confidence: 99%

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Gastric mucosa as an additional extrahepatic localization of hepatitis C virus: Viral detection in gastric low-grade lymphoma associated with autoimmune disease and in chronic gastritis

Vita

Sansonno

et al. 2000

Hepatology

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Hepatitis C virus (HCV) has been localized in several tissues besides the liver. 1 The definition of the possible extrahepatic localizations of the virus may be relevant to better address the issue of some of the extrahepatic manifestations of chronic HCV infection. As regards the gastric microenvironment, gastric lymphoma has been reported in patients with HCV infection, 2-6 and a relationship was noticed between HCV infection and B-cell clonal expansion in chronic gastritis lesions in Sjö gren' s syndrome (SS). 7 At present, local infection by Helicobacter pylori (HP) in the gastric mucosa is considered a crucial step for the development of chronic gastritis and gastric low-grade B-cell non-Hodgkin' s lymphoma (NHL) of mucosa-associated lymphoid tissue (MALT). [8][9][10] However, important issues regarding the pathobiology of HP-related gastric lymphoproliferation are still ill-defined, such as the definition of additional pathogenetic events implicated in the malignant transformation (nearly all the HP-infected individuals do not develop a gastric lymphoma), the possible lack of regression of HPassociated gastric lymphoproliferation after HP eradication, [8][9][10][11] and the evidence of gastric low-grade B-cell NHLs, which appear HP-negative ab initio. 8,9,12,13 Autoimmunity may contribute to gastric chronic inflammation and lymphoproliferation. 11,[14][15][16][17][18][19] In particular, studies on SS-related chronic gastritis and gastric low-grade B-cell NHL showed intragastric B-cell clonal expansion also in the absence of HP infection. 11,18,19 Furthermore, recent clinical and experimental results have linked the HCV to SS-like manifestations and acquisition of MALT. 2,[20][21][22] We herein report the gastric mucosa as a possible extrahepatic localization of HCV. Viral antigens and RNA were detected within a HP-positive low-grade B-cell NHL lesion, in an HCV-infected patient with clinical and pathological findings consistent with SS. This gastric low-grade B-cell NHL did not regress, despite successful HP eradication. Molecular analyses of the immunoglobulin heavy chain (IgH) genes used by the neoplastic clone indicated an antigen-driven

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Oligoclonal non-neoplastic B cell expansion is the key feature of type II mixed cryoglobulinemia: Clinical and molecular findings do not support a bone marrow pathologic diagnosis of indolent B cell lymphoma

Vita

Gasparotto

et al. 2000

Arthritis & Rheumatism

105

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Based on the present results, as well as on evidence from previous studies of liver lesions, oligoclonal non-neoplastic B cell proliferation in the course of chronic infection-related inflammation appears to be the key feature of type II MC. Of note, molecular evidence from target tissues supports the clinical findings both at the time of type II MC diagnosis and in cases of OBCL complication. Bone marrow pathologic findings resembling those of IBCL should thus be considered in the light of clinical and molecular evidence.

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Hepatitis C virus, non-Hodgkin's lymphomas and hepatocellular carcinoma

Cited by 65 publications

References 26 publications

Smoking and non‐Hodgkin lymphoma: Case‐control study in Italy

Smoking and non‐Hodgkin lymphoma: Case‐control study in Italy

Gastric mucosa as an additional extrahepatic localization of hepatitis C virus: Viral detection in gastric low-grade lymphoma associated with autoimmune disease and in chronic gastritis

Oligoclonal non-neoplastic B cell expansion is the key feature of type II mixed cryoglobulinemia: Clinical and molecular findings do not support a bone marrow pathologic diagnosis of indolent B cell lymphoma

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