原发性肝癌高危人群的研究

本文通过分析上海市肝癌发病情况和上海医科大学肝癌研究所的肝癌住院病人，显示上海市肝癌男性标化发病率为２９．６／１０万，女性为１０．０／１０万，男女合计为２０．１／１０万。男女发病率比约为３：１．男性肝癌发病率在３５岁前较低。以后逐渐上升，至４０岁接近男性全市平均水平，５０岁后发病率增幅较前要快，至８０岁达到高峰。女性肝癌发病率较男性低，年龄亦较晚，到５０岁才接近女性全市平均水平，发病年龄的高峰与男性相差１０年左右。肝癌患者中ＨＢｓＡｇ的阳性率显著高于自然人群，在有慢性肝炎史的肝癌患者中有近１／４的人ＨＢｓＡｇ阴性，提示有丙肝病毒感染的可能，肝癌患者的抗－ＨＣＶ阳性率为１１．１％，与ＨＢｓＡｇ的双重阳性率为５．８％，提示与ＨＢｓＡｇ独立，而在人群中抗ＨＣＶ的阳性率为２％左右，提示ＨＣＶ也是原发性肝癌的危险因素，所以肝癌的高危人群应包括抗ＨＣＶ阳性及一切有慢性病毒性肝炎史者。本文认为，在上海市，男性４５岁以上，女性５０岁以上，ＨＢｓＡｇ阳性或抗ＨＣＶ阳性或有慢性肝炎史的人群是肝癌的高危人群。

STUDY OF HIGH RISK POPULATION OF PRIMARY LIVER CANCER

The standardized incident rates of primary liver cancer (PLC) in Shanghai for whole population , men and women are 20/100, 000, 29. 6/100, 000 and 10. 0/100, 000 respectively ,the ratio of men to women is 3 :1. The incident rate in men below 35 years old is lower, it rises gradually and reaches mean of 30/100, 000 around 40 years old, after 50 it rises more rapidly and reaches apex in eighties , then decreases. Similar changes can be seen in women,but the incident rate is lower than that in men, it reaches mean of 10/100, 000 at about 50 years old. The proportion of positive HBsAg is more higher in patients with PLC than in natural population. There are about one .fourth patients of PLC with chronic viral hepatitis (CVH) have negative HBsAg, it implies that some of CVH are caused by hepatitis C virus (HCV). The proportion of positive anti-HCV is.11. 1 % in PLC patients and 2% in natural populaiton; the proportion of patients with positive anti-HCV and HBsAg is 5. 8% in PLC Patients. It suggests that HCV infection is probable a risk factor of PLC, So that high risk population of PLC should include people with positive anti-HCV or chronic hepatitis as well as people with positive HBsAg. The paper concludes that men over 45 or women over 55.with positive HBsAg or positive anti-HCV or chronic viral hepatitis are high risk population of PLC in Shanghai.