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[目的]探讨HBsAg无症状携带者的肝癌发病风险,为促进HBV感染人群进行肝癌早诊早治和预防研究提供科学依据。[方法]对1659名无症状HBsAg携带者进行10年(1997～2006)随访。[结果]研究人群肝癌世界标化发病率为513.87/10万,是1972～2000年20～64岁男性自然人群的5.63倍,标准化发病比(SIR)为4.99。1997～2000年ALT水平在100U以下的ALT异常患者占87.47%,AFP浓度在1∶10++～1∶100++的AFP阳性患者占47.53%;AFP阳性率随ALT异常升高呈显著上升趋势(χ2=35.14,P=0.000)。[结论]对肝癌高危人群HBsAg携带者,尤其ALT低水平异常患者和AFP低浓度阳性患者,持久加强开展早诊早治和预防研究,对减缓肝癌的危害具有重要临床价值。
[Objective] To investigate the risk of hepatocellular carcinoma in HBsAg asymptomatic carriers and provide a scientific basis for promoting early diagnosis, early diagnosis and prevention of hepatocellular carcinoma in HBV infected population. [Methods] A total of 1659 asymptomatic HBsAg carriers were followed up for 10 years (1997-2006). [Results] The standardized incidence rate of liver cancer in the study population was 513.87 / 100000, 5.63 times of the natural population aged 20-64 years old in 1972 ~ 2000, the standardized incidence ratio (SIR) was 4.99. The ALT level between 1997 and 2000 was about 100U The percentage of patients with ALT abnormalities accounted for 87.47%, and AFP positive patients with AFP concentrations between 1:10 ++ and 1: 100 ++ accounted for 47.53%. The positive rate of AFP was significantly increased with the abnormality of ALT (χ2 = 35.14, P = 0.000). [Conclusion] It is of great clinical value to persistently strengthen the research on early diagnosis, early diagnosis and prevention of HBsAg carriers, especially those with low level of ALT and low level of AFP in patients with liver cancer at high risk.