上海市人群2002-2006年肝癌生存率分析

Survival analysis of liver cancer between 2002 and 2006 in Shanghai

背景与目的：我国是肝癌高发地区。上海市最新监测数据显示,肝癌发病率居恶性肿瘤发病前列,疾病负担仍很大。该研究旨在分析上海地区肝癌患者生存率情况,为肝癌的防治提供基础数据。方法：根据上海市肿瘤登记处收集的2002—2006年肝癌登记和生存随访报告资料,采用寿命表法和EdererⅡ法对肝癌患者的观察生存率（observed survival,OS）和相对生存率（relative survival,RS）及其相关人口学和疾病状况特征资料进行分析。结果：纳入分析的上海市2002—2006年诊断的肝癌病例20 702例,1~5年OS分别为32.03%、21.63%、16.51%、13.66%和11.72%,1~5年RS分别为34.21%、23.93%、19.18%、16.84%和15.45%。男性OS较女性OS高,0~34岁年龄段患者OS高于其他年龄组,肝细胞癌的OS高于其他类型,Ⅰ期患者的OS明显高于Ⅲ期和Ⅳ期,市区和郊区居住肝癌患者生存情况差异无统计学意义（P〈0.05）。过去30多年来,上海市肝癌患者5年OS和RS改善明显。结论：上海市肝癌患者的生存水平上升明显,但与其他常见恶性肿瘤相比,生存率仍较低,因此,进一步加强危险因素和高危人群的控制和干预是今后肝癌防治工作的重点。

Background and purpose： China is a high incidence area of liver cancer. The latest monitoring data in Shanghai show that liver cancer is one of the most common cancers with very high disease hurden. This study aimed to describe and analyze the population-based survival rates of patients with liver cancer in Shanghai. Methods： Data of liver cancer cases diagnosed between 2002 and 2006, including follow-up information and death report, were collected from Shanghai Cancer Registry. Life table and Ederer I[ were used to calculate observed survival （OS） and relative survival （RS）. The related demographic characteristics and status were also analyzed to reflect the survival situations of the liver cancer survivors in major areas of Shanghai. Results： In this study, 20 702 liver cancer cases were included in analysis. Five-year OS rate for liver cancer was 11.72%, whereas RS rate was 15.45%. The OS of male liver cancer patients was higher than that of female patients. Patients whose age ranged from 0-34 years had the highest survival rates than patients from other age groups. The survival of patients with hepatocellular carcinoma was higher than that of patients with other histologic types of liver cancer. Significant difference in survival had also been found among patients with various stages of liver cancer. The survival rate of patients with stage [ liver cancer was much higher than that of patients with stage ]]] and 1V liver cancers. There was no significant difference in the survival of liver cancer patients between urban and rural residents. Over the past 3 decades, the 5-year OS increased dramatically in Shanghak Conclusion： The survival of patients with liver cancer in Shanghai is improved significantly. The prognosis is poor compared with other common malignant tumors. It is necessary to strengthen the risk factors and high-risk population control and intervention in the future.