乙型肝炎病毒感染与肝癌关系的26年前瞻性定群观察  

Analysis of relationship between hepatitis B virus infection and primary liver cancer by a 26-year prospective cohort study in Qidong of Jiangsu Province

作　　者：沈小雷 王海捷 施启生 张启南[2] 王金兵[2] 孙燕[2] 吴燕[2] 陆培新[2] 

机构地区：[1]江苏省启东市近海镇社区卫生服务中心,南通226200 [2]江苏省启东肝癌防治研究所,南通226200

出　　处：《江苏预防医学》2015年第5期11-13,共3页Jiangsu Journal of Preventive Medicine

摘　　要：目的观察乙型肝炎病毒(HBV)感染与原发性肝癌(肝癌)发生的关系及临床意义。方法在肝癌高发地区对携带乙型肝炎表面抗原(HBsAg)的220例患者和作为对照的非携带者228人进行前瞻性定群观察,历时26年。结果 HBsAg(+)组肝癌发生率为962.97/10万人年,HBsAg(-)组为72.42/10万人年,HBsAg(+)组发生肝癌的风险是HBsAg(-)组的13.30倍,差异有统计学意义(χ2=42.05,P<0.001)。HBsAg(+)人群中的肝癌发病归因于HBsAg(+)的部分占全部发病的92.48%。肝癌患者中,发现感染HBV到诊断肝硬化的平均时间为20.26年,中位时间9年;生存时间最短31d,最长12年2个月仍生存,平均2年6个月,中位生存期为9个月。结论 HBV感染是当地肝癌高发的主要病因,防治乙型肝炎、定期观察肝癌高危人群是切实可行的肝癌防治方案。Objective To study the relationship between hepatitis B virus（HBV） infection and primary liver cancer（PHC） ; to evaluate its clinical significance. Methods A prospective cohort study was condu.cted in districts with high primary liver cancer incidence. A total of 220 patients who were positive for HBsAg and 228 healthy Control subjects were recruited, who were subjected to a 26-year follow-up study. Results The incidence of PHC for HBsAg （＋） patient group （962.97/10s per year） was significantly higher than that of control group （72.42/10^5 per year） ,the incidence of PHC for HBsAg （＋） patient group was 13.30 times than that of control group with statistical difference（χ2 =42.05, P〈0. 001）. The factor of HBsAg （＋） contributed for 92.48 % of all causes of PHC among HBsAg （＋） patients. The average duration between the onset of HBV infection and the diagnosis of Cirrhosis was 20.26 years with a median of 9 years among PHC patients. The survival time was from 31 d to 12 years and 2 months, with average of 2 years and 6 months and median of 9 months. Conclusion HBV infection was main cause of local high incidence of PHC. The prevention and treatment of hepatitis B, together with regular observation of high risk population were practical scheme of prevention and cure for PHC.

关 键 词：原发性肝癌 乙型病毒性肝炎 前瞻性观察 

分 类 号：R512.62[医药卫生—内科学]