论文部分内容阅读
目的 研究自然人群中HBsAg长期携带与肝癌发生的关系,为肝癌病因研究及采取预防措施提供进一步的证据。方法 1976年选择启东某社区15岁以上自然人群,用血清筛检确定HBsAg携带状态,建立11 534人前瞻队列数据库;1977年1月进入随访,截至于1998年12月,与人群癌症登记资料及居民病伤死因资料核实癌症发生的结局及出列人数。结果 队列观察总人年数为242 467。HBsAg携带者中发生肝癌125例,发生率为356.58/10万;HBsAg非携带者发生肝癌54例,发生率为26.04/10万,两组的相对危险度(RR)为13.69(95％ CI:9.95～18.85)。其中男性及女性HBsAg携带者的RR分别为11.98及17.06。各年龄组HBsAg携带者的肝癌发生率均高于非携带者。非条件Logistic回归模型分析显示性别、年龄、HBsAg、ALT为肝癌发生的显著的影响因素;而抗-HBs(+)为保护因素。HBsAg携带与食管、胃、肠、胰腺、肺、乳腺、宫颈各部位癌症及白血病等的发生未见有联系。结论 进一步证实了启东自然人群中HBsAg携带与肝癌发生的因果关系、联系的强度与联系的特异性。围绕HBV开展预防研究是现场肝癌防治的重点。
Objective To study the relationship between long-term HBsAg carrier and occurrence of hepatocellular carcinoma (HCC) in natural population and to provide further evidence for the study of the cause of HCC and preventive measures. Methods In 1976, a natural population over 15 years old in a certain community of Qidong was selected. Serum samples were screened to determine the carrier status of HBsAg, and 11 534 prospective cohort databases were established. In January 1977, follow-up was conducted. As of December 1998, Resident sickness and death data to verify the outcome of cancer and out of the number. The total number of cohorts observed in the cohort was 242 467. There were 125 cases of HCC in HBsAg carriers, with an incidence rate of 356.58 / 100 000. The incidence of HCC in non-carriers of HBsAg was 54 cases (26.04 / 100000), the relative risk (RR) was 13.69 (95% CI: 9.95 ~ 18.85). The RR of male and female HBsAg carriers were 11.98 and 17.06 respectively. The incidence of liver cancer among HBsAg carriers of all age groups was higher than that of non-carriers. Non-conditional logistic regression analysis showed that gender, age, HBsAg and ALT were the significant influencing factors of HCC. Anti-HBs (+) was the protective factor. HBsAg carriage and esophageal, stomach, intestine, pancreas, lung, breast, cervical cancer and other parts of the incidence of leukemia and so no contact. Conclusions further confirmed the causal relationship between the HBsAg carrier and the occurrence of HCC in the natural population of Qidong, the strength of the association and the specificity of the association. Preventive research around HBV is the focus of on-site prevention and treatment of liver cancer.