农村地区肝癌高危人群肝病流行病学特征分析

Epidemiological Characteristics of Common Hepatopathy Among High-risk Population of Liver Cancer in Rural Areas of China

[目的]探讨常见肝病在肝癌高危人群中的流行特点和分布特征。[方法]选取2008-2011年间,男性年龄在35~64岁,女性在45~64岁且参加安徽省、江苏省、河南省以及山东省肝癌早诊早治项目的常住居民为研究对象,并对其进行现场流行病学调查、血液生化指标检测和肝脏B超检查。[结果]本研究共纳入31571人,男性和女性分别占52.88%和47.12%。当B超联合甲胎蛋白进行筛查时,共检出肝癌104例,检出率为0.33%。研究共发现肝脏异常6376例,脂肪肝是最常见的肝脏病变,在男性和女性中分别占总体病变的55.09%和61.28%。在全人群和HBsAg阳性人群中,肝癌、肝大、肝硬化、肝占位在男性人群中占比均高于女性。且在HBsAg阳性人群中,这四种病变的占比均高于HBsAg阴性人群。[结论]脂肪肝、肝囊肿、肝血管瘤、肝硬化以及肝占位是研究地区较常见的肝脏病变,男性和HBsAg阳性者为常见肝病的高危人群。

[Purpose]To analyze the epidemiological characteristics of common hepatopathy among the high-risk population of liver cancer in rural areas of China.[Methods]Males aged 35~64 years and females aged 45~64 years who were participated in the liver cancer early detection and treatment program in rural areas of Anhui,Jiangsu,Henan and Shandong Provinces were selected as the target population for liver cancer screening.The screening procedures included epidemiologic investigation,blood biochemistry tests and ultrasonography examination.[Results]A total of 31571 individuals completed all tests;males and females accounted for 52.88%and 47.12%,respectively.With the ultrasound and alpha-fetoprotein for screening,104 cases of liver cancer were detected with a detection rate of 0.33%.There were 6376 cases of hepatopathies,among which the fatty liver was the most common one;the detection rate of hepatopathy was 55.09%for males and 61.28%for females,respectively.The proportions of liver cancer,hepatomegaly,cirrhosis and focal liver lesions were higher in males than that in females in all populations and individuals with positive HBsAg.The proportions of these four kinds of hepatopathies were much higher among the population with positive HBsAg than those with negative HBsAg.[Conclusions]Fatty liver,liver cyst,liver hemangioma,cirrhosis and focal liver lesions are the common hepatopathies in the target study areas,and males and individuals with positive HBsAg are regarded as the high-risk population of hepatopathy.