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5581名HBsAg阳性的男性随机分入周期性筛检组(A组,3712人)及对照组(B组,1869人)。A组(19155.4人年)共发生肝癌257例,B组(9785.5人年)为117例,两组的肝癌发生率分别为1342/10万与1196/10万;两组肝癌死亡分别为218与109例,肝癌死亡率分别为1138/10万与1114/10万。两组中Ⅰ期肝癌病例分别为29.6％与6.0％,差异有非常显著性意义。1、3、5年相对生存率A组为23.7％、7.0％、4.0％,B组为9.7％、4.0％、4.1％。用Poisson回归模型拟合显示,在调正年龄、初筛AFP及入列年份后,筛检对于肝癌的相对危险度为0.83,95％CI为0.68～1.03,有较弱的“保护”作用,Cox回归模型拟合结果显示当临床分期未引入模型时,筛检对于肝癌有显著的“保护”作用:危险率为0.6617,95％CI为0.5234～0.8365;而模型经调整后,危险率即接近“1”,95％CI为0.74～1.26。
5,581 HBsAg-positive men were randomly assigned to a periodic screening group (group A, 3712) and a control group (group B, 1869). There were 257 cases of liver cancer in group A (19155.4 person-years) and 117 cases in group B (9785.5 person-years). The incidence of hepatocellular carcinoma in the two groups was 1342/100,000 and 1196/100,000 respectively; the deaths of liver cancer in the two groups were 218 and 218 respectively. In 109 cases, the mortality of liver cancer was 1138/100,000 and 1114/100,000 respectively. The incidence of stage I liver cancer in the two groups was 29.6% and 6.0%, respectively, and the difference was very significant. The relative survival rates for the 1, 3, and 5 years in group A were 23.7%, 7.0%, and 4.0%, and those in group B were 9.7%, 4.0%, and 4.1%. Fitting with the Poisson regression model showed that the relative risk of screening for liver cancer was 0.83, 95% CI was 0.68 to 1.03, and there was a weak “protection” effect after adjustment for age, initial screening AFP, and year of enrollment. Cox regression model fitting results showed that when the clinical stage was not introduced into the model, screening had a significant “protection” effect on liver cancer: the risk rate was 0.6617, 95% CI was 0.5234 to 0.8365; and after the model was adjusted, the risk rate was close to “1”, 95% CI 0.74 to 1.26.