原发性肝癌二级预防价值的研究

A Study of the Second Prevention Value of Primary Hepatic Cancer

目的：研究肝癌二级预防的价值。方法：1993年1月至1997年12月，将18816名肝癌高危对象随机分为筛查组与对照组。筛查组每6个月作一次AFP与实时超声检查，5年中共检出86例肝癌，对照组不作主动检查，5年中共发生51例肝癌。结果：筛查组检出之肝癌中Ⅰ期肝癌占60．5％，能作手术切除者占46．5％，5年生存率达52．7％，对照组则分别为0、7．8％与0，差异十分显著（P＜0.01）。筛查检出之病例作手术切除者术后1～5年生存率为89．7％、89.7％、84．9％、84．9％及84．9％，而非手术治疗者治疗后分别为39．8％、30.2％、19．2％、19.2％及19,2％。两者差异十分显著（P＜0．01）。与对照组相比前者差异显著，后者差异不显著。结论：筛查检出之病例应尽可能争取作手术切除才能体现肝癌二级预防之价值。

Objective: In order to evaluate the effectiveness of second prevention of primary liver cancer (PLC). Methods:During the Januay 1993 to the December 1997, 18, 816 persons were divided randomly to allocated screening group and control group. In the screening group every individual was checked up by serum AFP test and ultrasound every 6 months. In the control group they were unchecked. 86 patients with PLC in the screening group were detected while 51 patients with PLC occurin the control group. Results: In patients from the screening group, 60. 5 % were in first stage, 46. 5 % of them were treated by surgical resection, 5 years survival rate of 52. 7 %. However, in the control group were 0, 7. 8 % and 0 respectively. In the screening group, 40 patients were treated by surgical resection. After resection 1 -5 years survival reat were 89. 7 %, 89. 7 %,84. 9 %, 84. 9 % and 84. 9 %. 44 patients werre treated by unresection. Their 1-5 years survival rate were 39. 8 %, 30. 2 %,19. 2 %, 19. 2 % and 19. 2 %. Conclusion: It is suggest effective of second prevention of PLC was embodied only the patients who were early detected by screening were treated by surgical resection.