A Survey on the Prevalence of Hepatocellular Carcinoma and Hepatitis B Virus Infection in Peng-Hu, Taiwan

澎湖地區肝細胞癌及B型肝炎之盛行率調查

黃冠棠(Guan-Tarn Huang) ； 許金川(Jin-Chuan Sheu) ； 楊培銘(Pei-Ming Yang) ； 林肇堂(Jaw-Town Lin) ； 賴明陽(Ming-Yang Lai) ； 陳定信(Ding-Shinn Chen) ； 王德宏(Teh-Hong Wang) ； 宋瑞樓(Juei-Low Sung)

《中華民國消化系醫學會雜誌》 5卷2期 (1988/06) Pp. 57-63

https://doi.org/10.6557/GJTa.198806_5(2).0002

摘要

從民國74年8月26日至9月2日在澎湖有1,265位（男性610 位，女性655位）無症狀受檢者接受腹部超音波、胎兒蛋白及B 型肝炎標誌檢查。B型肝炎表面抗原陽性率20.4%，有9.0%之受檢者為B型肝炎表面抗原、表面抗原、核心抗體均陰性，且這陰性率隨著年紀增加而降低。分析40歲以上之受檢者，表面抗原陽性率為18.4%，其中男性爲22.4%，女性爲14.5彩。男女之問的差異在統計學上是有意義的。
有五位受檢者被發現胎兒蛋白值升高，二位診斷爲肝細胞癌，一位失代償肝硬化。另有六位受檢者胎兒蛋白正常，但超音波檢查發現有佔位性病灶，但均非肝細胞癌。總共這次調查發現二位肝細胞癌患者，其中胎兒蛋白值高於400 ng/ml 有一位，另一位只稍微上升。其中B型肝炎表面抗原陽性的有一位。
澎湖B型肝炎感染盛行率和臺灣其他地區類似。但發現肝細胞癌之兩例患者中，一例為B型肝炎表面抗原陽性。雖然本研究受檢者仍不夠多，但我們以為腹部超音波配合胎兒蛋白檢查在肝細胞癌篩檢上雖然是一較好的方式，且腹部超音波可以找出腫瘤位置，但胎兒蛋白檢查較簡便且具經濟效益。

關鍵字

肝細胞癌 ； B型肝炎 ； 盛行率調查

並列摘要

Totally 1265 (610 males, 655 females) asymptomatic subjects received abdominal ultrasonography (US) and determination of α-fetoprotein (AFP), and hepatitis B markers at Peng-Hu islands between August 26 and September 2, 1985. The positive rate of hepatitis B surface antigen (HBsAg) was 20.4%, and 9.0% of the population studied were negative for HBsAg, hepatitis B surface antibody (anti-HBs), and hepatitis B core antibody (anti-HBc). The seronegative rate decreased as the age increased. Analyzing the subjects over 40 years old only, the HBsAg Positive rate was 18.4% with 22.4% in males and 14.5% in females. The difference of HBsAg positive rate by sex is statistically significant.
Five subjects with elevated AFP were found. Two were diagnosed as hepatocellular carcinoma (HCC), and 1 decompensated liver cirrhosis. Another six subjects were found to have space occupying lesion by US, none of them was diagnosed as HCC. In total, HCC were found in 2 cases during this survey, AFP increased over 400 ng/ml in 1, increased slightly in 1 and HBsAg was positive in 1 case.
The prevalence of HBV infection in Peng-Hu islands is similar to that in other areas of Taiwan. But in the subjects with HCC detected in this survey, the HBsAg-positive rate seemed lower than those of our previous study. Although the present series is small, we conclude that although combination of abdominal US and AFP is better, AFP is convenient and economic.

並列關鍵字

hepatocellular carcinoma ； hepatitis B ； prevalence by mass survey