上海地区肝癌流行病学特征与诊疗模式演变:基于2016—2023年数据分析  

Epidemiological characteristics and evolution of diagnosis and treatment modalities for liver cancer in Shanghai:an analysis of data from 2016 to 2023

作　　者：向雪琳 丁飞 冯浩 夏强[1,3] XIANG Xue-lin;DING Fei;FENG Hao(Department of Liver Surgery,Instiute of Molecular Medicine,Renji Hospital,Shanghai Jiao Tong Unirersity School of Medicine,Punan Branch,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai Research Center of Transplantation,Shanghai 200127,China;不详)

机构地区：[1]上海交通大学医学院附属仁济医院肝脏外科,上海200127 [2]上海交通大学医学院附属仁济医院浦南分院,上海200127 [3]上海器官移植研究中心,上海200127

出　　处：《中国实用外科杂志》2024年第9期1062-1067,共6页Chinese Journal of Practical Surgery

基　　金：上海市2023年度“科技创新行动计划”优秀学术带头人(青年)项目(No.23XD1423100)。

摘　　要：目的通过上海交通大学医学院附属仁济医院及上海市登记性数据分析,由点及面地研究上海市肝癌流行特点及诊疗模式转变。方法根据申康医联信息系统的统计数据及上海交通大学医学院附属仁济医院临床数据存储库登记数据,对上海2016—2023年肝癌的流行病学特征及诊疗情况进行分析。结果以上海市级医院为参照系,2016—2021年上海共收治肝癌病人98960例,其中首次手术病人占肝癌病人43.3%,3年、5年生存率逐年上升。以上海交通大学医学院附属仁济医院为样本,课题组发现2019—2023年肝癌诊疗人数总体上升,年龄分布以45~74岁中老年为主,年轻病人占比逐年上升;组织病理学分型以肝细胞癌为主(约占93.1%),肝胆混合型肿瘤(cHCC-CCA)占比上升;微创手术及接受系统治疗病人比例明显增加,参加多学科综合治疗协作组(MDT)模式的病人逐年增加,且MDT方案执行率达98.9%。结论上海市肝癌发病呈年轻化趋势,cHCC-CCA增多,微创手术及系统治疗开展逐年增长,MDT诊疗参与度显著提升。To comprehensively investigate the epidemiological characteristics of liver cancer and the transformation of diagnosis and treatment modalities in Shanghai,based on analysis of registered data from Renji Hospital,Shanghai Jiao Tong University School of Medicine and Shanghai Municipality.Methods Epidemiological characteristics and diagnosis and treatment landscapes of liver cancer in Shanghai from 2019 to 2023 were analyzed based on statistical data from the Shengkang Medical Union Information System and registered clinical data repository of a tertiary hospital in Shanghai.Results With reference to municipal hospitals in Shanghai,a total of 98960 liver cancer cases were managed from 2016 to 2021,43.3%of which were first-time surgery patients with annually increasing 3-year and 5-year survival rates.Taking Renji Hospital,Shanghai Jiao Tong University School of Medicine as sample,the study found that liver cancer cases increased overall from 2019 to 2023,with a majority of 45-to 74-year-old and rising proportion of younger patients.Hepatocellular carcinoma(HCC)is identified as the predominant histological subtype(93.1%),with combined hepatocellular-cholangiocarcinoma(cHCC-CCA)increased.Patients receiving minimally invasive surgeries and systemic treatment increased significantly.Participation in multidisciplinary team(MDT)consultations increased annually,with a high implementation rate of 98.9%.Conclusion The incidence of liver cancer in Shanghai is showing a trend towards younger ages,with an increasing prevalence of cHCC-CCA.There has been a significant expansion in minimally invasive surgical procedures and systemic treatments,accompanied by a notable enhancement in the involvement of multidisciplinary teams(MDT)in patient care.

关 键 词：肝细胞肝癌 肝内胆管癌 流行病学 诊疗模式 

分 类 号：R6[医药卫生—外科学]