肝细胞癌高危人群标准的探讨

Discussion of the criteria of the high-risk population of hepatocellular carcinoma

目的 从肝细胞癌患者中确立高危因素 ,探讨肝细胞癌高危人群的确立 ,并由此推算高危人群普查及其定期自我体检的重要意义。方法 对 172 5例行肝细胞癌切除术的患者进行回顾性随访 ,将随访资料完整的 14 5 7例进行临床分期及其与肝内无瘤生存的相关分析 ,根据频数表划分肝细胞癌发病高危人群段。结果 肝细胞癌患者年龄分布呈相对正态分布 ,取 90 %可信区间 ,高危人群年龄段为 31～ 6 5岁。亚临床期肝细胞癌患者术后无瘤生存状况明显好于临床期者。结论 可将血清抗 HBc阳性或 /及HBsAg阳性 ,尤其有乙型肝炎病史 ,年龄 31～ 6 5岁者作为国内肝细胞癌的高危人群。加强对此人群普查 ,增强其定期体检意识 ,可使大部份肝细胞癌患者得以在亚临床期早发现早治疗 ,在现有的医疗技术条件下将肝细胞癌的治疗提高到一个新水平。

Objective To explore the establishment of high risk population of hepatocellular carcinoma (HCC) and the significance of HCC survey in the population and regular physical check ups themselves through studying high risk factors in HCC patients. Methods 1 725 patients having hepatectomy for HCC were followed up retrospectively. It was analyzed the correlation between clinical stages and local regional disease free survival in 1 457 cases with follow up data. The age range of HCC high risk population was calculated with the frequent table.Results The ages of HCC patients was of relatively normal distribution. The disease free survival after hepatectomy of patients in subclinical stage was better than that of patients in clinical and advanced stages.Conclusion People can regarded as HCC high risk population, who are anti HBc and/or HBsAg positive and especially have hepatitis B record, and who are of thirty one to sixty five years old. Most HCC patients can be found and get effective treatment early in subclinical stage by carrying out HCC survey in the population and strengthening their consciousness of regular physical check ups. The treatment of HCC will be improved by present medical techniques.