中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2010年
7期
721-726
,共6页
陈建国%陆建华%朱源荣%朱健%张永辉
陳建國%陸建華%硃源榮%硃健%張永輝
진건국%륙건화%주원영%주건%장영휘
乙型肝炎病毒%肝肿瘤%相对危险度%前瞻研究
乙型肝炎病毒%肝腫瘤%相對危險度%前瞻研究
을형간염병독%간종류%상대위험도%전첨연구
Hepatitis B virus%Liver neoplasm%Relative risk%Prospective study
目的 研究乙型肝炎病毒(HBV)与肝癌发生的关系,评价HBsAg长期携带者发生肝癌的结局.方法 利用1976年建立的启东某社区15岁以上自然人群队列[血清筛检确定HBsAg、抗-HBs及丙氨酸转氨酶(ALT),并进行前瞻随访],该数据库与人群癌症登记资料、居民病伤死因资料链接核实,分析1977年1月至2007年12月12351名人群中肝癌等肿瘤的发生情况.结果 队列观察总人年数为355 305.0.HBsAg携带者中发生肝癌173例,发生率为361.55/10万;HBsAg非携带者发生肝癌95例,发生率为30.90/10万,两组比较RR=11.70(95%CI:9.06～15.19);其中男性和女性HBsAg携带者的RR值分别为12.30和10.46.两性各年龄组HBsAg携带者的肝癌发生率均高于非携带者.若以女性非携带者肝癌的发生率为1,则男性非携带者、女性携带者、男性携带者的RR值分别为3.07、10.46和37.76;该四组人群在31年中肝癌发生的累积率分别为0.86%、2.73%、10.22%和34.19%.非条件logistic回归模型分析显示性别(男性)、年龄、HBsAg、ALT为肝癌发生的显著影响因素,抗-HBs为保护因素.HBsAg携带与其他部位癌的发生未见有联系.结论 证实启东自然人群中HBsAg携带与肝癌发生的因果联系;针对HBV感染而采取干预措施是现场肝癌防治的重点.
目的 研究乙型肝炎病毒(HBV)與肝癌髮生的關繫,評價HBsAg長期攜帶者髮生肝癌的結跼.方法 利用1976年建立的啟東某社區15歲以上自然人群隊列[血清篩檢確定HBsAg、抗-HBs及丙氨痠轉氨酶(ALT),併進行前瞻隨訪],該數據庫與人群癌癥登記資料、居民病傷死因資料鏈接覈實,分析1977年1月至2007年12月12351名人群中肝癌等腫瘤的髮生情況.結果 隊列觀察總人年數為355 305.0.HBsAg攜帶者中髮生肝癌173例,髮生率為361.55/10萬;HBsAg非攜帶者髮生肝癌95例,髮生率為30.90/10萬,兩組比較RR=11.70(95%CI:9.06～15.19);其中男性和女性HBsAg攜帶者的RR值分彆為12.30和10.46.兩性各年齡組HBsAg攜帶者的肝癌髮生率均高于非攜帶者.若以女性非攜帶者肝癌的髮生率為1,則男性非攜帶者、女性攜帶者、男性攜帶者的RR值分彆為3.07、10.46和37.76;該四組人群在31年中肝癌髮生的纍積率分彆為0.86%、2.73%、10.22%和34.19%.非條件logistic迴歸模型分析顯示性彆(男性)、年齡、HBsAg、ALT為肝癌髮生的顯著影響因素,抗-HBs為保護因素.HBsAg攜帶與其他部位癌的髮生未見有聯繫.結論 證實啟東自然人群中HBsAg攜帶與肝癌髮生的因果聯繫;針對HBV感染而採取榦預措施是現場肝癌防治的重點.
목적 연구을형간염병독(HBV)여간암발생적관계,평개HBsAg장기휴대자발생간암적결국.방법 이용1976년건립적계동모사구15세이상자연인군대렬[혈청사검학정HBsAg、항-HBs급병안산전안매(ALT),병진행전첨수방],해수거고여인군암증등기자료、거민병상사인자료련접핵실,분석1977년1월지2007년12월12351명인군중간암등종류적발생정황.결과 대렬관찰총인년수위355 305.0.HBsAg휴대자중발생간암173례,발생솔위361.55/10만;HBsAg비휴대자발생간암95례,발생솔위30.90/10만,량조비교RR=11.70(95%CI:9.06～15.19);기중남성화녀성HBsAg휴대자적RR치분별위12.30화10.46.량성각년령조HBsAg휴대자적간암발생솔균고우비휴대자.약이녀성비휴대자간암적발생솔위1,칙남성비휴대자、녀성휴대자、남성휴대자적RR치분별위3.07、10.46화37.76;해사조인군재31년중간암발생적루적솔분별위0.86%、2.73%、10.22%화34.19%.비조건logistic회귀모형분석현시성별(남성)、년령、HBsAg、ALT위간암발생적현저영향인소,항-HBs위보호인소.HBsAg휴대여기타부위암적발생미견유련계.결론 증실계동자연인군중HBsAg휴대여간암발생적인과련계;침대HBV감염이채취간예조시시현장간암방치적중점.
Objective To study the relationship between hepatitis B virus (HBV) and primary liver cancer (PLC), and to assess the outcome of PLC in the carriers of HBsAg. Methods General population over age of 15 from a community in Qidong was screened for HBsAg, anti-HBs,and alanine transaminase (ALT) in 1976, and followed-up thenceforth. From January 1, 1977 through December 31, 2007, 12 351 people were enrolled in the cohort, and their occurrence, outcome of PLC and other cancers, together with all the withdrawals due to death were linked to and checked with database from Qidong Cancer Registry and Qidong Vital Registry programs. Results The total observed person-years (PYs) were 355 305.0. One hundred and seventy-three PLC cases were identified among the HBsAg carriers, with an incidence of 361.55 per 100 000 PYs, while PLC cases were only 95 for the non-carriers, with an incidence of 30.90 per 100 000 PYs. The overall relative risk (RR)was 11.70(95%CI: 9.06-15.19) ,with RR 12.30 for men and 10.46 for women. HBsAg carriers had high incidence at each age group,compared with the non-carriers for both men and women. Data from cross-over analysis showed that the incidence rates of PLC for the sub-cohorts of female non-carriers,male non-carriers, female carriers, and male carriers were 1.00,3.07, 10.46, and 37.76, respectively.The cumulative rates of PLC in the 4 groups were 0.86%, 2.73%, 10.22%, and 34.19%, respectively.Results from aon-conditional logistic regression model showed that the gender (male), age, HBsAg ( + ), and ALT( + ) were risk factors for the development of PLC while anti-HBs( + ) demonstrated a protective effect. No relationship was found among carriers and non-carriers for cancer sites such as lung, stomach, esophagus, intestine, pancreas, breast, cervix, bladder, and lymphoma, brain tumor, or leukemia. Conclusion Causation and its strength, together with specificity and persistency of the association were confirmed from this HBsAg-related cohort study in the general population in Qidong.Intervention measures on HBV should be highlighted for the control of PLC among the HBV infected individuals.
