高级搜索

中山市小榄镇肝癌高发现场筛查评估及问题分析

俞霞, 季明芳, 程伟民, 吴标华

俞霞, 季明芳, 程伟民, 吴标华. 中山市小榄镇肝癌高发现场筛查评估及问题分析[J]. 肿瘤防治研究, 2016, 43(4): 287-290. DOI: 10.3971/j.issn.1000-8578.2016.04.010
引用本文: 俞霞, 季明芳, 程伟民, 吴标华. 中山市小榄镇肝癌高发现场筛查评估及问题分析[J]. 肿瘤防治研究, 2016, 43(4): 287-290. DOI: 10.3971/j.issn.1000-8578.2016.04.010
shu
YU Xia, JI Mingfang, CHENG Weimin, WU Biaohua. Situation and Problem on Screening of Liver Cancer in High-incidence Area of Xiaolan, Zhongshan City[J]. Cancer Research on Prevention and Treatment, 2016, 43(4): 287-290. DOI: 10.3971/j.issn.1000-8578.2016.04.010
Citation: YU Xia, JI Mingfang, CHENG Weimin, WU Biaohua. Situation and Problem on Screening of Liver Cancer in High-incidence Area of Xiaolan, Zhongshan City[J]. Cancer Research on Prevention and Treatment, 2016, 43(4): 287-290. DOI: 10.3971/j.issn.1000-8578.2016.04.010
shu

中山市小榄镇肝癌高发现场筛查评估及问题分析

  • 528400 中山，中山大学附属中山医院肿瘤研究所

基金项目: 中央补助地方公共卫生专项资金癌症早诊早治项目
详细信息
    作者简介:

    俞霞（1985-），女，硕士，住院医师，主要从事癌症早诊早治及肿瘤生物治疗

    通讯作者:

    季明芳，E-mail: jmftbh@sina.com

  • 中图分类号: R73-31

Situation and Problem on Screening of Liver Cancer in High-incidence Area of Xiaolan, Zhongshan City

  • Cancer Research Institution, Zhongshan Affiliated Hospital of Sun Yat-sen University, Zhongshan, Guangdong 528400, China

摘要

    摘要
  • 摘要: 目的 通过对高发区肝癌筛查现场的评估，了解筛查对象乙型肝炎表面抗原（hepatitis B surface antigen, HBsAg）阳性人群分布特征，并进一步分析筛查检出肝癌患者情况。方法 应用ELISA法检测血清HBsAg和甲胎蛋白（alpha-fetoprotein, AFP），B型超声进行腹部脏器检查。结果 （1）筛查人群HBsAg阳性率为15.7%（2 889/18 460），其中男性阳性率高于女性（P=0.000）。男女人群HBsAg阳性率均随年龄的增长呈降低趋势（P＜0.01）。（2）HBsAg阳性（肝癌高危）人群中初筛和随访分别检出肝癌11例和5例，早诊率分别为27.3%（3/11）和40%（2/5）。整个筛查队列两年共漏诊肝癌11例，其中4例源于高危人群自行退出随访，7例出自HBsAg阴性人群，漏诊的肝癌分别占相应人群总肝癌的20%（4/20）和25.9%（7/27）。（3）高危人群和一般人群组肝癌发病率分别为346.1/10万（20/5 778）和49.9/10万（37/74 084），前者发病率高于后者（P＜0.05）。高危人群组和一般人群组肝癌早诊率分别为30.0%（6/20）和8.1% （3/37），两者比较差异无统计学意义（P＞0.05）。高危人群组肝癌患者半年、1年和2年生存率分别高于一般人群组中肝癌患者（P＜0.05）。结论 在肝癌高发区进行筛查，了解人群HBsAg分布特征，筛选出高危人群，能及时发现肝癌患者，提高近期生存率。然而，HBsAg阴性人群和依从性差的高危人群中有一定的漏诊率，肝癌筛查的早诊率和生存率仍有待提高。

     

    Abstract: Objective To evaluate liver cancer screening in high-incidence area, so as to analyze the distribution characteristics of positive hepatitis B surface antigen (HBsAg) among the population and screen the liver cancer patients further. Methods ELISA was used to detect the serum levels of HBsAg and alphafetoprotein( AFP). Ultrasonography was used to examine the organ of belly. Results (1) The positive rate of HBsAg was 15.7%(2889/18460). The male had higher positive rate of HBsAg than the female(P>0.01). The positive rate of HBsAg was negatively associated with age(P<0.01); (2) In first screening and follow-up, we detected 11 and 5 liver cancer patients in HBsAg positive population(high-risk population of liver cancer), respectively. The rates of early detection were 27.3%(3/11) and 40%(2/5), respectively. There were 11 liver cancer patients who missed diagnosis in the whole screening population for two years, four of them were high-risk population of liver cancer and exited the following-up, and the other seven patients were detected from HBsAg negative population. The rates of missed diagnosis were 20%(4/20) in the high-risk population and 25.9%(7/27) in the whole screening population, respectively; (3) In general population and high-risk population, the incidence of liver cancer were 49.9/105(37/74 084) and 346.1/105(20/5778) respectively (P<0.05); the rates of early detection were 8.1% (3/37) and 30.0% (6/20), respectively(P>0.05). In general population, the survival rates of 0.5-, 1- and 2-year were lower than those in high-risk population(P<0.05). Conclusion Screening liver cancer in high-incidence area, we could understand the distribution of HBsAg, screen the high-risk population and detect liver cancer patients in time, so as to increase the recent survival rate of patients. However, the rates of missed diagnosis are high in HBsAg negative population and the highrisk population with poor compliance. The early detection and survival rates should be improved in liver cancer screening.

     

    • HTML全文
    • 参考文献(13)
  • [1] Ferlay J, Soerjomataram I, Ervik M, et al. Globocan 2012 v1.0, Cancer incidence and mortality worldwide: IARC cancer base No.11[DB/OL]. Lyon:International Agency for Research on Cancer, 2013. http://globocan.iarc.fr, 2013-12-12/2014-01-18.
    [2] Committee of Cancer Early Diagnosis and Treatment.Scheme of cancer early diagnosis and treatment(Edition 2011)[M]. Beijing: The People's Health Publishing House, 2011: 110-43. [癌症早 诊早治项目专家委员会. 癌症早诊早治项目技术方案(2011年 版)[M] 北京: 人民卫生出版社, 2011: 110-43.]
    [3] Wei KR, Yu YL, Yang YY, et al. Analysis of geographic distribution of malignant tumor in Zhongshan city in 2000-2004[M]. Guangzhou: Guangdong People's Publishing House, 2012: 688-9. [魏矿荣, 余元龙, 杨有业, 等. 中山市恶性肿瘤发病地域分布研 究（2000-2004）年[M]. 广州: 广东人民出版社, 2012: 688-9.]
    [4] He SZ, Su CH, Shen LT, et al. Occult hepatitis B virus infection in normal population, Xiamen[J]. Zhonghua Yu Fang Yi Xue Za Zhi, 20 15, 49(2): 132-6. [何水珍, 苏成豪, 沈理通, 等. 厦门市自然人 群中乙型肝炎病毒隐匿性感染状况调查[J]. 中华预防医学杂 志, 2015, 49(2): 132-6.]
    [5] Cheng JQ, Ma HW, Xie X, et al. Sero-epidemiological investigation on hepatitis B among permanenets in Shenzhen area[J]. Zhonghua Liu Xing Bing Xue Za Zhi, 2013, 34(12): 1179-82. [程锦泉, 马汉 武, 谢旭, 等. 深圳市常住人口乙型肝炎血清流行病学调查[J]. 中华流行病学杂志, 2013, 34(12): 1179-82.]
    [6] Zhang CY, Huang TR, Zhang ZQ, et al. Study on HBV infection of the cancer prevention screening population in the primary liver cancer high incidence area of Guangxi[J]. Guangxi Yi Xue, 2006, 28 (12): 1857-9. [张春燕, 黄天壬, 张振权, 等. 广西肝癌高发区 成年居民乙型肝炎病毒感染的现况研究[J]. 广西医学，2006, 28 (7): 1857-9.]
    [7] Chen JG, Lu JH, Zhu YR, et al. A thirty-one year prospective follow-up program on the HBsAg carries state and primary liver cancer in qidong, China[J]. Zhonghua Liu Xing Bing Xue Za Zhi, 20 10, 31(7): 721-6. [陈建国, 陆建华, 朱源荣, 等. 乙型肝炎病毒 感染与肝癌发生的31年随访研究[J]. 中华流行病学杂志, 2010, 31 (7): 721-6.]
    [8] Zhang BH, Yang BH, Tang ZY, et al. Randomized controlled trial of screening for hepatocellular carcinoma[J]. J Cancer Res Clin Oncol, 2004, 130(7): 417-22.
    [9] Rosa I, Denis J, Renard P, et al. A french multicentric longitudinal descriptive study of hepatocellular carcinoma management,(the changh cohort):preliminary results[J]. J Hepatol, 2010, 52 (Suppl1): S231-2.
    [10] Trinchet JC, Chaffaut C, Bourcier V, et al. Ultrasonographic surveillance of hepatocellular carcinoma in cirrhosis: a randomized trial comparing 3- and 6-month periodicities[J]. Hepatology, 2011, 54(6): 1987-97.
    [11] Altekruse SF, McGlynn KA, Dickie LA, et al. Hepatocellular carcinoma confirmation,treatment,and survival in surveillance, epidemiology, and end results registries, 1992-2008[J]. Hepatology, 2012, 55(2): 476-82.
    [12] Trevisani F, De Notariis S, Rapaccini G, et al. Semiannual and annual surveillance of cirrhotic patients for hepatocellular carcinoma: effects on cancer stage and patient survival (Italian experience) [J]. Am J Gastroenterol, 2002, 97(3): 734-44.
    [13] Mourad A, Deuffic-Burban S, Ganne-Carrie N, et al. Hepatocellular carcinoma screening in patients with compensated Hepatitis C virus(HCV)-rlated cirrhosis aware of their HCV status improves survival:a modeling approach[J]. Hepatology, 2014, 59(4): 14 71-81.
    • 相关文章
    • 施引文献
    • 资源附件(0)
计量
  • 文章访问数:  1095
  • HTML全文浏览量:  388
  • PDF下载量:  340
  • 被引次数: 0
出版历程
  • 收稿日期:  2015-06-24
  • 修回日期:  2015-08-11
  • 刊出日期:  2016-04-24

目录

摘要
HTML全文
    参考文献(13)
    相关文章
    施引文献
    资源附件(0)

    /

    返回文章
    返回

    下载中心

    友情链接

    联系我们

    地址：武汉市洪山区卓刀泉南路116号（430079）

    电话：027－87670126

    Email：zlfzyjzz@vip.163.com

    This work is licensed under a Creative Commons Attribution 3.0 License.

    邮件订阅 RSS
    总访问量：11728504 今日访问：27683

    版权所有 © 《肿瘤防治研究》编辑部 鄂公网安备 42011102005013号 鄂ICP备2022015867号

    本系统由北京仁和汇智信息技术有限公司开发  百度统计

    x 关闭 永久关闭