摘要
目的]评价上海市肝癌高危人群的监测方案。[方法]以35岁～55岁的乙肝抗原抗体阳性或有慢性肝炎史的18816名上海市民随机分为筛查组(9373人)与对照组(9443人)。筛查组每六个月作一次AFP与实时超声检查 ,检出的可疑病例即进入诊断程序 ,一旦确诊 ,且有手术指征者皆动员作手术切除 ;对照组不作任何主动检查 ,但发病的肝癌病人亦同样为之争取手术切除或其他积极的治疗 ,并随访其生存期。[结果]筛查组共筛查38444人年 ,检出肝癌86例。对照组共观察41077人年 ,发现肝癌67例。两组肝癌病例相比 ,筛查组Ⅰ期肝癌占60 5 % ,对照组为0(P<0 01)。筛查组小肝癌占45 3 % ,对照组为0(P<0 01)。筛查组能作手术切除的占46 5% ,而对照组7 5 % ,差异有统计学意义(P<0 01)。筛查组肝癌的1至5年生存率分别为65 9 %、59 9%、52 6 %、52 6 %和46 4% ,而对照组为31 2%、7 2 %、7 2 %、0和0。筛查组中肝癌死亡率为83 2/10万 ,对照组为131 5/10万 ,两组肝癌死亡率比为0 63。[结论]本研究结果说明筛查确能检出早期肝癌。通过积极治疗 ,筛查组肝癌病人的远期生存率显著高于对照组 。
To evaluate the effectiveness of surveillance for high risk population of primary liver cancer.Eighten thousand eight hundred and sixteen Shanghai urban residents aged 33～55 with serum evidence of HBV infection or chronic liver disease,regarded as high risk population of primary liver cancer,were randomly assigned to the screening group (9373) or the control group (9443).In screening group,participants were tested with serum AFP and real time ultrasound every 6 months,while in the control group,participants did not receive above examinations regularly.All the patients defined as primary liver cancer (PLC) in both groups underwent surgery and other active treatment,and followed up.PLC was detected of 86 cases in screening group with 38444 person-year screened,and 67 cases in control group with 41077 person-year (P<0 01).In screening group,60 5%(52/86) patients was with stage Ⅰ,and 45 3% (40/86) with small liver cancer.However,there was no patient with stage Ⅰ or with small liver cancer in the control group.The resection rates were 46 5% in the screening group,and 7 5% in the control group.The 1 to 5 year survival rates of PLC patients were 65 9%,59 9%,52 6%,52 6% and 46 4% for screening group and 31 2%,7 2%,7 2%,0 and 0 for control group,respectively.The mortalities of PLC were 83 2/10 5 in the screening group and 131 5/10 5 in the control group.The mortality rate ratio of the 2 groups that screening can detect PLC in early stage,improve the prognosis of PLC,and lead to a decrease in the mortality from PLC.
出处
《中国肿瘤》
CAS
2001年第4期199-201,共3页
China Cancer
关键词
高危人群
监测
二级预防
上海
肝癌
流行病学
liver neoplasms
high_risk population
surveillance
secondary prevention
Shanghai
