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目的探讨HBsAg阳性者原发性肝癌(简称肝癌)发病情况和二级预防作用,为促进HBV感染者进行肝癌早诊早治提供科学依据。方法以分层抽样方法对广西隆安县12个乡镇30～55岁农村居民抽样,采静脉血用(ELISA法检测HBsAg及HBsAg阳性者甲胎蛋白(AFP),选取3007名HBsAg阳性、AFP阴性者进入研究队列,每半年对研究对象进行HBV血清学标志物、谷丙转氨酶(ALT)、AFP检测和肝脏B超检查及肝癌随访,连续三年。结果共随访8826.0人年,肝癌平均发病率为691.14/10万人年,男性高于女性并且随年龄增大而升高。AFP平均阳性率为2.18%,ALT平均异常率为22.80%,其中ALT>100U占20.95%。B超平均异常率为34.67%,以肝内光点增粗为主,占异常人次的35.78%。AFP阳性率及B超异常率随ALT水平升高而增加。AFP和/或B超体检初步诊断肝癌的符合率为88.46%。结论肝癌高危人群HBsAg阳性者,特别是ALT、B超异常且AFP阳性者,加强肝癌的预防及早诊早治,对防治肝癌有重要意义。
Objective To investigate the incidence and secondary prevention of primary hepatocellular carcinoma (HBeAg) positive in HBsAg-positive patients and provide a scientific basis for promoting the early diagnosis and treatment of HCC. Methods A stratified sampling method was used to sample rural residents aged 30-55 in 12 townships and townships in Long’an County, Guangxi. Blood samples were collected for the detection of HBsAg and AFP by ELISA. 3007 HBsAg positive and AFP negative Enrolled in the study cohort, HBV serology markers, alanine aminotransferase (ALT), AFP test and liver B ultrasound examination and liver cancer were followed up every three years for three consecutive years.Results A total of 8826.0 person-years were followed up.The average incidence of liver cancer was 691.14 / 100000 person-years, the male was higher than the female and increased with age.The average positive rate of AFP was 2.18%, the average ALT rate was 22.80%, ALT> 100U accounted for 20.95% .The B-average abnormal rate was 34.67%, mainly in intrahepatic spot enlargement, accounting for 35.78% of the abnormal population.The positive rate of AFP and abnormal B rate increased with the increase of ALT.The coincidence rate of AFP and / or B- 88.46% .Conclusion HBsAg-positive patients with high-risk liver cancer, especially ALT, B-ultrasound and AFP-positive, to strengthen the prevention of liver cancer and early diagnosis and treatment of hepatocellular carcinoma is of great significance.