江苏省海门市原发性肝癌队列随访结果分析  

A 22-year-follow-up cohort study on primary liver cancer in Haimen city of Jiangsu province

作　　者：黄培新[1] 王娜[2] 钱俊华 江峰[2] 杨艳蕾[1] 林文尧[1] 赵琦[2] 赵根明[2] 姜庆五 

机构地区：[1]海门市疾病预防控制中心慢病科,226121 [2]复旦大学公共卫生学院流行病学教研室教育部公共卫生安全重点实验室,上海200032

出　　处：《中华流行病学杂志》2017年第10期1376-1379,共4页Chinese Journal of Epidemiology

摘　　要：目的分析海门原发性肝癌队列（海门队列）中死亡情况及其危险因素。方法海门队列自1992年建立，共纳入25～69岁健康人群89789人。对人组研究对象进行基线调查并采集外周静脉血10ml，检测HBsAg，并对生存状况及肝癌死亡情况每年进行1次随访。计算肝癌死亡率，采用Cox比例风险模型进行多因素分析。结果截至2014年12月31日，海门队列共随访1299611人年，其中2583（男性2149，女性434）例死于肝癌。肝癌死亡病例中HBsAg阳性者占73．87％。男女性肝癌死亡率分别为247．80／10万人年和100．38／10万人年。多因素分析显示，HBsAg阳性是海门队列男女性原发性肝癌最为主要的危险因素（男性：HR=15．97，95％CI：14．29—17．85；女性：HR=21．63，95％CI：16．16—28．96）。年龄、吸烟史、既往肝炎史以及肝癌家族史均与原发性肝癌发病风险有关。结论海门地区成年人原发性肝癌死亡率处于较高水平，HBV感染仍为该地区最主要的危险因素。Objective A prospective cohort study was carried out to assess the mortality and potential risk factors for primary liver cancer （PLC） in Haimen city of Jiangsu province. Methods The cohort involved 89 789 adult residents aged 25-69 years. Upon the entry of this project, each subject was asked to complete a questionnaire and to provide a blood sample of 10 ml. Surface antigen of hepatitis B virus （HBsAg） was tested by radioimmtmoassay. All the subjects were followed-up every year for vital statistics and death certificate information until 2014. Cox proportional hazard model was used to estimate the hazard ratio （HR） and 95% confidence interval （95% C/） for PLC mortality associated with HBsAg status and other risk factors. Results During the 1 299 611 person-years of follow-up, a total of 2 583 PLC cases were identified, including 2 149 men and 434 women, Mortality of the PLC for men and women were 247.80/100 000 person-years and 100.38/100 000 person-years, respectively. Among those who died of PLC, 73.87% had been tested HBsAg positive. HBV infection seemed the predominant risk factor for PLC and the HRs were 15.97 for men （95%CI： 14.29-17.85） and 21.63 for women （95%CI： 16.16-28.96） respectively. Ageing, cigarette smoking, previous history of hepatitis, and family history of HCC were factors associated with the increased risk for PLC. Conclusion People living in Haimen city had a high risk on PLC. HBV infection appeared the most important risk factor for HCC mortality in this area.

关 键 词：原发性肝癌 危险因素 乙型肝炎病毒表面抗原 队列研究 

分 类 号：R181.3[医药卫生—流行病学] R735.7[医药卫生—公共卫生与预防医学]