Tanaka Hideo, Imai Yasuharu, Hiramatsu Naoki, Ito Yuri, Imanaka Kazuho, Oshita Masahide, Hijioka Taizo, Katayama Kazuhiro, Yabuuchi Iwao, Yoshihara Harumasa, Inoue Atsuo, Kato Michio, Takehara Tetsuo, Tamura Shinji, Kasahara Akinori, Hayashi Norio, Tsukuma Hideaki
Osaka Medical Center for Cancer and Cardiovascular Diseases, Ikeda Municipal Hospital, Osaka University Graduate School of Medicine, Osaka Police Hospital, Osaka, Japan.
Ann Intern Med. 2008 Jun 3;148(11):820-6. doi: 10.7326/0003-4819-148-11-200806030-00004.
Japan has the highest incidence rate of primary liver cancer attributed to chronic hepatitis C virus (HCV) infection among developed countries. Molecular clock analysis of HCV sequences revealed that the spread of HCV took place earlier in Japan than in other countries. This might influence recent temporal trends in hepatocellular carcinoma (HCC) incidence.
To characterize the contribution of HCV-related hepatocellular carcinoma (HCC) to recent changes in HCC incidence in Osaka, Japan.
Population-based survey.
Osaka Cancer Registry and 10 hospitals in Osaka.
63,862 patients with HCC that was diagnosed between 1981 and 2003 in Osaka Prefecture, including 5253 HCV-seropositive patients with HCC that was diagnosed between 1990 and 2003 at 10 hospitals.
Incidence of HCC and estimated incidence rate of HCV-related HCC, measured by multiplying the prevalence of anti-HCV by the corresponding HCC incidence rate.
Between 1981 and 2003, peak incidence of HCC among men age 50 to 59 years, 60 to 69 years, and 70 to 79 years occurred in 1986, 1995, and 2000, respectively, with marked downward trends thereafter (average annual change, -7.9, -22.3, and -12.4 per 100,000 persons, respectively). Similar trends were observed in women. Estimated sex- and age-specific incidence of HCV-related HCC (per 100,000 persons) decreased from 255 to 92 cases at the maximum in men age 60 to 69 years and from 61 to 34 cases in women age 60 to 69 years, whereas estimated incidence of non-HCV-related HCC did not change between 1990 and 2003.
Infection was determined only by HCV seropositivity.
The incidence of HCC in Osaka started to decrease by 2000, mainly because of decreased HCV-related HCC.
在发达国家中，日本因慢性丙型肝炎病毒（HCV）感染导致的原发性肝癌发病率最高。对HCV序列的分子钟分析显示，HCV在日本的传播早于其他国家。这可能会影响肝细胞癌（HCC）发病率近期的时间趋势。
明确HCV相关肝细胞癌（HCC）对日本大阪HCC发病率近期变化的影响。
基于人群的调查。
大阪癌症登记处及大阪的10家医院。
1981年至2003年在大阪府诊断出的63862例HCC患者，包括1990年至2003年在10家医院诊断出的5253例HCV血清学阳性的HCC患者。
HCC发病率以及HCV相关HCC的估计发病率，通过将抗-HCV患病率乘以相应的HCC发病率来计算。
1981年至2003年期间，50至59岁、60至69岁和70至79岁男性的HCC发病率峰值分别出现在1986年、1995年和2000年，此后呈明显下降趋势（每10万人的年均变化分别为-7.9、-22.3和-12.4）。女性也观察到类似趋势。60至69岁男性中HCV相关HCC的估计性别和年龄特异性发病率（每10万人）从最高的255例降至92例，60至69岁女性从61例降至34例，而1990年至2003年期间非HCV相关HCC的估计发病率没有变化。
感染仅通过HCV血清学阳性来确定。
大阪的HCC发病率在2000年开始下降，主要是因为HCV相关HCC减少。
