慢性HBV感染对原发性肝细胞癌年龄别死亡率高峰影响的队列研究

A prospective cohort study on the effect of chronic HBV infection on peak age of age-specific mortality of primary hepatocellular carcinoma

目的:探讨慢性HBV感染对原发性肝细胞癌(HCC)年龄别死亡率高峰的影响。方法:1992年在江苏省海门市建立了一支90234人群的HCC研究队列,以HBsAg(+)作为HBV感染的指标,凡半年内连续2次HB-sAg(+)者判定为慢性HBV感染。HBsAg(+)组14338人,HBsAg(-)组75896人。1993年起每年随访一次队列成员的生命状况,至2007年终止,计算两组人群HCC年龄别死亡率。以HBsAg(+)组死亡密度(787.27/10万人年)和HBsAg(-)组死亡密度(48.81/10万人年)分别作为两组人群进入HCC死亡率高峰的界点,比较进入死亡率高峰的年龄差别。结果:HBsAg(+)组报告HCC1352例,对照组479例,差异有统计学意义(χ2=5027.00,P<0.01),相对危险度(RR)为16.13(95%可信区间14.64～18.04)。HBsAg(+)组比对照组进入HCC年龄别死亡率高峰的年龄提前5～6年。结论:慢性HBV感染可促使HCC发病提前。

Objective： To evaluate the effect of chronic hepatitis B virus （HBV） infection on peak age of age-specific mortality of primary hepatoceUular carcinoma（HCC）. Methods： A cohort of 90234 subjects was assembled in Haimen City, Jiangsu in 1992. At cohort entry, HBsAg （＋） was an indicator of HBV infection, and those tested HBsAg （＋） twice within 6 months were identified as chronic HBV infection. There were 14338 HBsAg （＋） and 75896 HBsAg （-） subjects in the cohort respectively. The vital status of each cohort member was followed from 1993 until 2007. Age-specific HCC mortality was calculated for each group and the peak age of age-specific mortality was compared. Results： There were 1352 and 479 HCC deaths in HBsAg（＋） and HBsAg（-） groups respectively. HCC mortality was significantly different between the two groups （X2=5027.00, P〈0.01） with a relative risk （RR） of 16.13,95%CI 16.64- 18.04. The age-specific mortality peaked 5-6 years earlier in HBsAg （＋） group than in HBsAg （-） group. Conclusions： Chronic HBV infection can result in HCC occurrence at an earlier age.