2017—2019年广东省深圳市城市居民肝癌风险评估及筛查结果分析

Analysis of Liver Cancer Risk Assessment and Screening Results Among Urban Residents in Shenzhen,2017—2019

[目的]分析2017—2019年广东省深圳市城市癌症早诊早治项目中肝癌高危评估与筛查情况。[方法]按照深圳市城市癌症早诊早治中肝癌筛查流程,选定社区年龄40~74岁的当地居民,问卷调查之后采用国家统一评估模型评估出高危人群,进一步通过肝脏B超+甲胎蛋白(alpha fetoprotein,AFP)检测,发现早期肝脏病变。[结果]2017—2019年度,深圳市城市癌症早诊早治项目共计36457人完成危险因素问卷调查,评估出肝癌高危人群7038人,高风险率为19.30%(7038/36457)。男性肝癌高风险率(21.62%,3269/15117)显著高于女性(17.66%,3769/21340)(χ2=89.209,P<0.001)。3762人完成临床筛查,筛查率为53.45%(3762/7038)。经肝脏B超+AFP检测,共检出AFP阳性9例(检出率为0.24%,9/3762),肝硬化31例(检出率为0.82%,31/3762),肝占位33例(检出率为0.88%,33/3762),可疑肝癌2例(检出率为0.05%,2/3762)。[结论]通过问卷调查评估出高危人群后,采用肝脏B超结合AFP检测的筛查手段能够有效检出肝癌及癌前病变。

[Purpose]To analyze the results of liver cancer risk assessment and screening among urban residents in Shenzhen from 2017 to 2019.[Methods]According to the liver cancer screening protocol in urban Shenzhen,the local residents aged 40~74 years from the selected communities were enrolled in the study.The high-risk populations were identified by evaluation with the national unified questionnaires.The high-risk individuals underwent liver ultrasonography and AFP tests for detection of early liver disease.[Results]During 2017—2019,a total of 36457 residents completed questionnaire risk assessment,and 7038 subjects(19.30%)were identified to have high risk of liver cancer with a high-risk rate of liver cancer of 21.62%(3269/15117)in males and17.66%(3769/21340)in females(χ2=89.209,P<0.001).A total of 3762 subjects participated in clinical screening with a compliance rate of 53.45%(3762/7038).There were 9 cases of AFP positive(0.24%,9/3762),31 cases of cirrhosis(0.82%,31/3762),33 cases of occupying lesions in the liver(0.88%,33/3762),and 2 cases of suspected liver cancer(0.05%,2/3762).[Conclusion]The protocol of liver cancer screening by questionnaire risk assessment combined with liver ultrasound and AFP detection is feasible and effective for detection of liver cancer and other liver lesions.