工厂开展原发性肝癌二级预防的初步研究

PRELIMINARY RESULT OF SECONDARY PREVENTION FOR PRIMARY LIVER CANCER CARRIED OUT AT FACTORIES

目的采取肝癌高危人群定期监测的二级预防，以期发现早期原发性肝癌，降低死亡率。方法年龄３５～５９岁男、女性，（１）有乙型肝炎病毒感染标志（指“二对半”）者；（２）有慢性迁延性肝炎或肝硬化史５年以上者；（３）有肝癌家族史（指父母、兄弟、姐妹等）者；（４）甲胎蛋白（ＡＦＰ）低持阳性者。建立监测随访记录表（一人一表），检查内容为甲胎蛋白（ＡＦＰ）和肝脏Ｂ超，半年复查一次。结果三年半监测检出６例肝癌，检出率１．２４％，其中５例是小肝癌，早期发现率８３．３％。结论肝癌高危人群监测的二级预防是一项投入少，效果显著的有效方法，可望提高肝癌的生存率。ＡＦＰ＋肝脏Ｂ超可以起到互补作用。

Objective:Periodic screening in high risk population might detect early primary liver cancer patients and thus lower the mortality.Methods:A medical record was prepared for each subject to note down the results of alphafetoprotein(AFP)and ultrasound performed once per six months,The high risk population included those 35～59 years old males and females with positive hepatitis B infection, with chronic persisting hepatitis or liver cirrhosis more than 5 years,with liver cancer family history,or with consistent low positive level of AFP.Results:After three and a half years ,there were six liver cancer patients detected,the rate was 124%.Five of them were small liver cancer.Conclusions:Screening in high risk population for primary liver cancer is a costeffective way to improve the longterm prognosis.AFP and ultrasound may be mutually complementary.