479例肝细胞癌先证者家族聚集性分析

Familial aggregation in first-degree relatives of 479 probands with hepatocellular carcinoma

目的通过肝细胞癌(HCC)先证者一级亲属发病调查情况,探讨HCC病例分布的家族聚集性的特点。方法应用临床流行病学横断面研究方法,对2004～2008年广西医科大学附属肿瘤医院HCC先证者家系中一级亲属HCC发病情况进行调查,回顾性采用Poisson(泊松)分布模型拟合,并用频数分布拟合优度的χ2检验进行验证。对有家族史的HCC分布用二项分布(p+q)n模型拟合。HCC分离比采用Li-Mantel-Gart法估算。结果 HCC先证者479例,占住院人数16.91%(479/2832)。该家族中实际病例数分布超越了二项分布的概率范围(P=0.028)。HCC的分离比为0.04,分离比方差为0.00001509,标准误为0.003885,95%可信限区间:0.033784～0.046216。结论 HCC发病具有家族聚集现象,主要集中在一级亲属,HCC的遗传方式为多基因遗传,HCC先证者家系是HCC发病的危险因素之一。

Objective To investigate the prevalence of hepatocellular carcinoma（HCC ）among first-degree relatives and explore the familial aggregation of HCC. Methods A cross-sectional study was performed on first-degree relatives of HCC probands treated at the Affiliated Cancer Hospital of Guangxi Medical University from 2004 to 2008.The binomial distribution model was applied to test the goodness-of-fit of the frequency distribution.Resuhs There were 479 probands, accounting for 16.91% （479/2 832） of hospital admis- sions. Results of binominal distribution analysis showed that the number of HCC cases within proband families was significantly higher than the theoretical range（P=0.028）.The estimated separation ratio of HCC was 0.04,and the separation ratio variance was 0.000 015 09（SD=0.003 885,95%CI： 0.033 784-0.046 216）. Conclusion HCC shows significant familial aggregation in first-degree relatives of probands, and family history is one of the important risk factors for HCC.