背景：早在20世纪70年代，研究人员发现在一些淋巴组织增生的患者的肝细胞中可以检测到乙型肝炎病毒（Hepatitis B Virus，HBV）表面抗原，并提出淋巴组织增生与HBV感染可能存在一定关联。目前，HBV感染在我国传染病报告病例中高居第一位，是我国卫生健康工作所面临的极其严重的问题。恶性淋巴瘤在2017年全球十大癌症中排名第九位，每108名男性中有1名男性和162名女性中有1名女性患有恶性淋巴瘤。而一直以来，学者对于二者相关性的研究仍存在许多不足。

目的：分析HBV感染与恶性淋巴瘤及常见的恶性淋巴瘤亚型发病的关联。

方法：以2010年1月至2014年12月就诊于中国医学科学院肿瘤医院的恶性淋巴瘤患者为病例组，以同期就诊的原发肺癌患者为对照组，进行1:1个体匹配的病例对照研究。采用STATA 14.1软件进行统计分析，采用卡方检验比较病例组和对照组人口学特征及临床资料之间的差异；恶性淋巴瘤及常见亚型、性别、年龄采用条件Logistic回归分层分析；吸烟、饮酒采用非条件Logistic回归分层分析。

结果：1、HBV感染与恶性淋巴瘤发病无相关性（OR:1.24；95%CI：0.98-1.56）；HBV感染与霍奇金淋巴瘤（HL）无关（OR：0.83；95%CI：0.36-1.95），但与非霍奇金淋巴瘤（NHL）的发病存在相关性（OR：1.30；95%CI：1.02-1.67）。2、HBV感染与B细胞非霍奇金淋巴瘤（B-NHL）（OR：1.57；95%CI：1.18-2.10），特别是与弥漫性大B细胞淋巴瘤（OR：1.89；95%CI：1.28-2.79）的发病存在相关性，与T/NK细胞NHL的发病无关（OR：0.77；95%CI：0.47-1.27）。3、HBV感染与侵袭性淋巴瘤存在相关性（OR：1.34；95%CI：1.02-1.77），与惰性淋巴瘤无关。4.HBV感染与男性淋巴瘤患者的发病无关；与未感染HBV的女性相比，女性HBV感染者的恶性淋巴瘤发病风险有显著性的统计学意义（OR：1.50；95%CI：1.01-2.23）。年龄方面，45岁以下的恶性淋巴瘤患者的发病与HBV感染无关；45岁以上HBV感染者的恶性淋巴瘤发病风险增高（OR：1.38；95%CI：1.03-1.84）。5、吸烟者中，HBV感染和恶性淋巴瘤发病风险显著相关（OR：1.43；95%CI：1.02-2.00）；不饮酒者中，HBV感染和恶性淋巴瘤发病风险显著相关（OR：1.35；95%CI：1.04-1.77）。

结论：HBV感染与恶性淋巴瘤发病无相关性，但与NHL及侵袭性淋巴瘤的发病存在相关性，特别是与B-NHL中的弥漫大B细胞淋巴瘤密切相关；在女性、年龄大于45岁、吸烟、非饮酒等群体中，HBV感染者恶性淋巴瘤的发病风险增加。

Background: As early as the 1970s, researchers found that hepatitis B surface antigen could be detected in the hepatocytes of some patients with lymphoproliferation, and suggested that there might be a relationship between lymphoproliferation and HBV infection.At present, hepatitis B Virus (HBV) infection ranks first among the reported cases of infectious diseases in China, and it is an extremely serious problem facing our health work.Malignant lymphoma ranked ninth among the top 10 cancers worldwide in 2017, with 1 male per 108 men and 1 female per 162 women suffering from malignant lymphoma.However, scholars still have many deficiencies in the study of their correlation.

Objective: To analyze the association between HBV infection and the incidence of malignant lymphoma and common subtypes of malignant lymphoma.

Methods:A 1:1 matched case-control study was conducted between patients with malignant lymphoma who visited the Cancer Hospital of Chinese Academy of Medical Sciences from January 2010 to December 2014 and patients with primary lung cancer who visited the same period as the control group.STATA 14.1 software was used for statistical analysis, and chi-square test was used to compare the differences between case group and control group; conditional logistic regression stratified analysis was used for malignant lymphoma and common subtypes, gender and age; unconditional logistic regression stratified analysis was used for smoking and drinking.

Results:1. HBV infection was not associated with the incidence of malignant lymphoma (OR: 1.24; 95% CI: 0.98-1.56); HBV infection was not associated with Hodgkin lymphoma (HL) (OR: 0.83; 95% CI: 0.36-1.95), but was associated with the incidence of non-Hodgkin lymphoma (NHL) (OR: 1.30; 95% CI: 1.02-1.67).2. HBV infection was associated with the incidence of B-cell non-Hodgkin lymphoma (B-NHL) (OR: 1.57; 95% CI: 1.18-2.10), especially diffuse large B-cell lymphoma (OR: 1.89; 95% CI: 1.28-2.79), but not T/NK cell NHL (OR: 0.77; 95% CI: 0.47-1.27).3. There was a correlation between HBV infection and invasive lymphoma (OR: 1.34; 95% CI: 1.02-1.77), but not inert lymphoma.4. HBV infection was not associated with the incidence of male lymphoma patients; compared with women without HBV infection, the risk of malignant lymphoma in women with HBV infection was statistically significant (OR: 1.50; 95% CI: 1.01-2.23).In terms of age, the incidence of malignant lymphoma in patients younger than 45 years of age was not associated with HBV infection; the risk of malignant lymphoma in patients older than 45 years of age was increased (OR: 1.38; 95% CI: 1.03-1.84).5. There was a significant correlation between the risk of HBV infection and lymphoma among smokers (OR: 1.43; 95% CI: 1.02-2.00); among non-drinkers, there was a significant correlation between the risk of HBV infection and lymphoma (OR: 1.35; 95% CI: 1.04-1.77).

Conclusion: There is no correlation between HBV infection and the incidence of malignant lymphoma, but there is a correlation with the incidence of invasive lymphoma and NHL, especially with diffuse large B-cell lymphoma in B-NHL; in women, older than 45 years, smoking, non-drinking and other groups, the risk of malignant lymphoma is increased in HBV-infected patients.