【摘要】 目的 了解2013—2018年安徽省淮河流域肝癌早诊早治项目高危人群肝癌检出率及相关因素。方法 于2013—2018年，在安徽省淮河流域6个区(县)采用整群抽样的方法选取当地乡或村中35～64岁常住居民，通过健康因素调查问卷和乙肝表面抗原检测评估出肝癌高危人群。其中34 957名居民参与了后续腹部B超检查和血清甲胎蛋白检测联合筛查。采用χ~2检验和logistic回归模型分析肝癌检出率的相关因素。结果 在34 957名肝癌筛查参与者中，共检出肝癌182例，检出率为0.52%。多因素回归模型显示：女性(OR=0.435,95%CI:0.307～0.616)、35～40岁组(OR=0.135,95%CI:0.032～0.561)、41～50岁组(OR=0.618,95%CI:0.413～0.925)、超重(OR=0.712,95%CI:0.522～0.973)和肥胖(OR=0.390,95%CI:0.207～0.735)的人群肝癌检出率更低；与未患肝硬化和HBsAg检测阴性组相比，仅有肝硬化(OR=7.250,95%CI:5.142～10.221)、仅HBsAg检测阳性(OR=14.781,95%CI:5.199～42.026)、患肝硬化同时HBsAg检测阳性(OR=59.408,95%CI:37.620～93.814)居民肝癌检出率显著增高；与无消化道相关症状者相比，具有3种以上消化道相关症状者(OR=2.189,95%CI:1.474～3.251)人群肝癌检出率高。结论 安徽省淮河流域肝癌早诊早治项目中肝癌检出率低于全国水平。男性、高龄、正常或低体重、HBsAg检测阳性、患肝硬化以及具有3种以上消化道相关症状人群肝癌检出率更高，其中患肝硬化并且HBsAg检测阳性者的肝癌检出率远远高于其他人群。更多还原

【Abstract】 Objective To investigate the detection rate of liver cancer and its associated factors among high-risk population participating in liver cancer screening program in the Huai River Basin, Anhui Province from 2013 to 2018. Methods A cluster sampling method was used to select permanent residents aged 35-64 years from villages of six districts(counties) in the Huai River Basin, Anhui Province from 2013 to 2018. The population at high risk for liver cancer was assessed using health factor questionnaire and testing of hepatitis B virus surface antigen(HBsAg), of which 34,957 residents with high risk for liver cancer participated in further clinical screenings for liver cancer, including abdominal B-ultrasound examination and serum alpha-fetoprotein detection. Chi-square test and logistic regression model were used to explore the factors related to the detection rate of liver cancer. Results Among 34,957 participants undergoing clinical screenings, a total of 182 cases of liver cancer were detected, with the detection rate of was 0.52%. Multivariate regression model showed that females(OR=0.435, 95%CI:0.307-0.616), the younger group((compared with the age group of 61-64 years), the age group of 35-40 years(OR=0.135, 95%CI:0.032-0.561, the age group of 41-50 years(OR=0.618, 95%CI:0.413-0.925)), participants with overweight(OR=0.712,95%CI: 0.522-0.973) and participants with obesity( OR = 0.390,95%CI: 0.207-0.735) had lower detection rates of liver cancer. Compared with participants without cirrhosis and HBsA g positive,the detection rates of liver cancer in those with liver cirrhosis alone( OR = 7.250,95%CI: 5.142-10.221),with HBsA g positivity alone( OR = 14.781,95%CI: 5.199-42.026),and with both HBsA g positivity and cirrhosis( OR = 59.408,95% CI: 37.620-93.814) were significantly higher. The detection rate of liver cancer was higher in participants with more than three digestive tract symptoms( OR = 2. 189,95% CI: 1. 474-3. 251)compared with those without any digestive tract symptom. Conclusion The detection rate of liver cancer among the population participating in liver cancer screening program in the Huai River Basin,Anhui Province was lower than the national level.Participants who are male,old and have normal or low weight,HBsA g positivity,liver cirrhosis and more than 3 digestive tract symptoms have a higher detection rate of liver cancer,of which the detection rate of liver cancer in participants with liver cirrhosis and HBsA g positivity is far higher than that in other participants.更多还原