Quantitative Epidemiological Study on Risk of Hepatocellular Carcinoma

1988至1990年间，库鲁姆大学医院共收治了654名肝细胞癌患者。其中，191例符合原发性肝细胞癌或年龄在40岁至79岁之间的合格标准。1例年龄(5岁以内)、性别、居住地匹配的对照来自库鲁姆市两所大学附属综合医院的住院患者。受试者的生活方式信息由一名训练有素的面试者获得，作者审查了他们的医疗记录。截至1990年底，共完成病例对照133对(男110对，女23对)用于资料分析。男性以55~59岁年龄组为主，女性以60岁~年龄组为主。大约80%的病例被组织学诊断，约90%的病例患有肝硬变。在对照组中，入院时诊断为肝癌或消化性溃疡以外的癌症的患者在数量上占主导地位。HBs抗…抗体阳性率男性为10%，女性为17%，男性和女性分别为1%和4%。在访问前10年以上输血的比例，男性为19%，女性为26%，男性或女性为7%或4%。为了量化酒精消耗量，“一杯饮料”被定义为受试者饮用任何酒精相当于23毫升乙醇的酒精饮料，“饮酒年限”被定义为饮酒量乘以受试者饮酒习惯年份的持续时间。在男性中，74%的病例和60%的对照组在40岁之前饮酒1年以上，而在40岁之前饮酒超过60年的重度饮酒者在病例中更为普遍。大多数女性，无论是病例还是对照组，在40岁之前饮酒不足1年。用Logistic回归模型同时对这三个因素进行多因素分析，发现HBs抗原阳性、输血和大量饮酒可能是肝细胞癌的独立危险因素。男性的优势比分别为11.8、3.0和5.6(P&lt；0.05)，但女性的优势比均无统计学意义。在男性中，40岁之前饮酒量越多，患肝细胞癌的风险就越高，这一点在统计上也很重要。较少

A total of 654 hepatocellular caricinoma patients were admitted to the Kurume University Hospital during 1988 and 1990. Of them, 191 cases fulfilled the eligible criteria such as primary hepatocellular cancer or age between 40 and 79 years old. One age (within 5 year age group)-, sex-, and residence-matched control was obtained from the inpatients of the two university affiliated general hospitals in Kurume city. Life-style information with the subjects were obtained by a trained interviewer and their medical records were reviewed by the author. By the end of 1990, 133 case-control pairs (male 110 ; female 23) were completed for data analysis. The 55-59 age group among male and the 60-64 among female predominated in number. Approximately 80% of the cases were histologically diagnosed and about 90% suffered from liver cirrhosis. Among the controls, the patients whose dIagnosis at the time of admission was cancer other than liver or peptic ulcer were predominant in number. The HBs antige … More n positive rates were 10% among male cases, 17% among female cases and 1 or 4% among male or female controls, respectively. The proportion of the subjects who had blood trasfusion more than 10 years prior to the time of interview were 19% among male cases, 26% among female cases and 7 or 4% among male or female controls. In order to quantify the amount of ethanol consumed, "One drink" was defined as a drink when a subject consumed any alcoholic beverage containing alcohol equivalent to 23 ml of ethanol and "drink-years" was defined as the number of drinks times the duration in year of the subject's drinking habit. Among males, 74% of cases and 60% of controls consumed alcohol of more than 1 drink-years by age 40 and the heavy drinkers who consumed alcohol more than 60 drink-years by age 40 wwre more prevalent among cases. The majority of females, either cases or controls, consumed alcohol of less than 1 drink-years by age 40. Multivariate analysis applied to these three factors simultaneously based on a logistic regression model revealed that HBs antigen positive, blood transfusion, and heavy drinking might be the independent risk factors for hepatocellular carcinoma. The odds ratios for males were 11.8, 3.0 and 5.6, respectively (P<0.05) but for females none was statistically significant. It was also statistically significant among males that the more the alcohol amount consumed by age 40, the higher the risk of development of hepatocellular carcinoma. Less