摘要
[目的]评估沈阳城市地区肝癌筛查效果,为肝癌疾病防治提供依据和建议。[方法]收集2016-2018年沈阳城市24个社区40~74岁常住人口的基本情况,通过防癌风险评估问卷进行初筛,临床筛查方案为甲胎蛋白(AFP)检测联合腹部超声检查。对进行高危评估的人群进行随访,随访截止时间为2019年10月30日,分析肝癌筛查参与情况、肝癌筛查技术诊断效果及不同人群肝癌患者生存情况。[结果] 2016-2018年评估出肝癌高危人群19 606人,其中7052人进行临床筛查,参与率为35.97%。女性高于男性(P<0.05),50~59岁年龄组高于其他年龄组(P<0.05)。HBsAg阳性率、肝硬化、肝占位性病变检出率男性均高于女性(5.95%vs 4.44%,P<0.01;1.19%vs 0.20%,P<0.01;0.75%vs 0.38%,P<0.05)。且肝硬化检出率随着年龄的增加而升高。肝癌高危评估模型的敏感性为25.00%,特异性为81.00%,AFP联合超声检查的敏感性为33.33%,特异性为98.84%。肝癌高危风险组和一般风险组肝癌生存率差异无统计学意义(χ^(2)=0.03,P=0.87),临床筛查组和未筛查组发生肝癌生存率差异无统计学意义(χ^(2)=0.37,P=0.55)。[结论]肝癌高危评估模型、临床早筛技术的敏感性有待提高,应加快早期标志物的研发与应用。
[Purpose] To evaluate the effectiveness of hepatocellular carcinoma(HCC) screening in Shenyang City. [Methods] The primary screening of HCC was carried out with cancer risk assessment questionnaire among resident aged 40~74 years in 24 communities in Shenyang from 2016 to2018. The identified high risk population of HCC were recommended for clinical screening with Alpha-fetoprotein(AFP) detection combined with abdominal ultrasound examination. All the participants were followed up until October 30,2019. [Results] From 2016 to 2018,19 606 subjects were identified as high risk of HCC by primary screening,of which 7052 were screened clinically with a participation rate of 35.97%,among whom females were more than males(P<0.05) and the people in age group 50~59 were more than people in other age groups(P<0.05). The detection rates of positive HBsAg,cirrhosis and liver occupying lesions in males were higher than those in females(5.95% vs 4.44%,P<0.01;1.19% vs 0.20%,P<0.01;0.75% vs 0.38%,P<0.05). The detection rate of cirrhosis and liver occupying lesions increased with age. The sensitivity and specificity of the high risk assessment model of HCC were 25.00% and 81.00%,respectively,and those of AFP combined with ultrasound were 33.33% and 98.84%,respectively. There was no significant difference in the survival rate of HCC between the high risk group and the general risk group(χ^(2)=0.03,P=0.87),and between the clinical screening group and the non-screening group(χ^(2)=0.37,P=0.55).[Conclusion] The result suggests that the value of high risk assessment and clinical screening with AFP and abdominal ultrasound is limited for screening of hepatocellular carcinoma,more sensitive serologic markers are required for the screening.
作者
于慧会
左婷婷
吴颖
董首兰
王丹波
于连政
刘运泳
YU Hui-hui;ZUO Ting-ting;WU Ying;DONG Shou-lan;WANG Dan-bo;YU Lian-zheng;LIU Yun-yong(Cancer Hospital of China Medical University,Liaoning Cancer Hospital&Institute,Shenyang 110042,China;Dadong District Center for Disease Control and Prevention,Shenyang 110042,China;Heping District Center for Disease Control and Prevention,Shenyang 110000,China;Liaoning Provincial Center for Disease Control and Prevention,Shenyang 110001,China)
出处
《中国肿瘤》
CAS
CSCD
北大核心
2021年第4期286-291,共6页
China Cancer
基金
2019年度辽宁省重点研发计划(2019JH2/10300013)。
关键词
肝癌
筛查
高危评估
生存率
辽宁
hepatocellular carcinoma
screening
high-risk population
survival
Liaoning
