Quantitative Epidemiological Study on Risk of Hepatocellular Carcinoma

1988年和1990年期间，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 - 79岁之间的合格标准。从库鲁梅市两所大学附属综合医院的住院患者中获得年龄（5岁年龄组内）、性别和居住匹配的对照。研究对象的生活方式信息由训练有素的采访者获得，提交人审查了他们的医疗记录。到1990年底，共完成133对病例对照（男110对，女23对）进行数据分析。男性以55 ~ 59岁、女性以60 ~ 64岁为主。约80%的病例经组织学诊断，约90%为肝硬化。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占多数。HBs抗体阳性率男性为10%，女性为17%，男性对照组和女性对照组分别为1%和4%。受访前输血10年以上的男性占19%，女性占26%，男性对照组和女性对照组分别占7%和4%。为了量化乙醇的消耗量，“一杯”定义为受试者饮用任何酒精含量相当于23毫升乙醇的酒精饮料时的一次饮酒，“饮酒年”定义为饮酒次数乘以受试者饮酒习惯的年持续时间。在男性中，74%的病例和60%的对照组到40岁时饮酒超过1杯，到40岁时饮酒超过60杯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，到40岁时饮酒少于1杯。通过logistic回归模型对这三个因素同时进行多因素分析，发现HBs抗原阳性、输血和酗酒可能是肝细胞癌的独立危险因素。男性的比值比分别为11.8、3.0和5.6 (P<0.05)，女性的比值比无统计学意义。在男性中，40岁时饮酒量越多，患肝细胞癌的风险就越高，这在统计上也很重要。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