[A 22-year-follow-up cohort study on primary liver cancer in Haimen city of Jiangsu province]

Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Oct 10;38(10):1376-1379. doi: 10.3760/cma.j.issn.0254-6450.2017.10.016.
[Article in Chinese]

Abstract

Objective: A prospective cohort study was carried out to assess the mortality and potential risk factors for primary liver cancer (PLC) in Haimen city of Jiangsu province. Methods: The cohort involved 89 789 adult residents aged 25-69 years. Upon the entry of this project, each subject was asked to complete a questionnaire and to provide a blood sample of 10 ml. Surface antigen of hepatitis B virus (HBsAg) was tested by radioimmunoassay. All the subjects were followed-up every year for vital statistics and death certificate information until 2014. Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95% confidence interval (95%CI) for PLC mortality associated with HBsAg status and other risk factors. Results: During the 1 299 611 person-years of follow-up, a total of 2 583 PLC cases were identified, including 2 149 men and 434 women. Mortality of the PLC for men and women were 247.80/100 000 person-years and 100.38/100 000 person-years, respectively. Among those who died of PLC, 73.87% had been tested HBsAg positive. HBV infection seemed the predominant risk factor for PLC and the HRs were 15.97 for men (95%CI: 14.29-17.85) and 21.63 for women (95%CI: 16.16-28.96) respectively. Ageing, cigarette smoking, previous history of hepatitis, and family history of HCC were factors associated with the increased risk for PLC. Conclusion: People living in Haimen city had a high risk on PLC. HBV infection appeared the most important risk factor for HCC mortality in this area.

目的: 分析海门原发性肝癌队列(海门队列)中死亡情况及其危险因素。 方法: 海门队列自1992年建立,共纳入25~69岁健康人群89 789人。对入组研究对象进行基线调查并采集外周静脉血10 ml,检测HBsAg,并对生存状况及肝癌死亡情况每年进行1次随访。计算肝癌死亡率,采用Cox比例风险模型进行多因素分析。 结果: 截至2014年12月31日,海门队列共随访1 299 611人年,其中2 583(男性2 149,女性434)例死于肝癌。肝癌死亡病例中HBsAg阳性者占73.87%。男女性肝癌死亡率分别为247.80/10万人年和100.38/10万人年。多因素分析显示,HBsAg阳性是海门队列男女性原发性肝癌最为主要的危险因素(男性:HR=15.97,95%CI:14.29~17.85;女性:HR=21.63,95%CI:16.16~28.96)。年龄、吸烟史、既往肝炎史以及肝癌家族史均与原发性肝癌发病风险有关。 结论: 海门地区成年人原发性肝癌死亡率处于较高水平,HBV感染仍为该地区最主要的危险因素。.

Keywords: Cohort study; Primary liver cancer; Risk factors; Surface antigen of hepatitis B virus.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular / ethnology
  • Carcinoma, Hepatocellular / mortality*
  • China / epidemiology
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hepatitis B
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B virus
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / epidemiology
  • Humans
  • Liver Neoplasms / ethnology
  • Liver Neoplasms / mortality*
  • Liver Neoplasms / pathology
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Smoking / adverse effects
  • Smoking / epidemiology

Substances

  • Hepatitis B Surface Antigens