Kamsa-ard Supot, Wiangnon Surapon, Suwanrungruang Krittika, Promthet Supannee, Khuntikeo Narong, Kamsa-ard Siriporn, Mahaweerawat Suwannee
Cancer Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Asian Pac J Cancer Prev. 2011;12(9):2209-13.
The Khon Kaen Cancer Registry (KKCR), having both hospital and population-based registration, was established in 1984 at the Faculty of Medicine, Khon Kaen University. Liver cancer is the most frequent malignancy among Thais from northeastern Thailand, but there has hitherto been no assessment of trends over time.
To perform a statistical assessment of the incidence trends between 1985 and 2009 of liver cancer, specifically focusing on cholangiocarcinoma (CHCA).
Cases of CHCA, registered between 1985 and 2009, were retrieved from the KKCR and all those with a specific ICD-O-3rd diagnosis with a coding of C22.1, C24.0, C24.8 and C24.9 were selected. Incidence trends were calculated using the generalized linear model method (GLM), which generates incidence rate based logarithms. Jointpoint analysis was used to identify the best fitting model.
Of the 18,589 cases of liver cancer 42% (7,859) were hepatocellular carcinoma and 58% (10,731) were CHCA. Among persons with CHCA, males were affected two times more frequently than females. Three-quarters of the cases were between 55 and 69 years of age. Morphology verified through a cytological or histological examination of tissue from the primary site (%MV) was only 10.8 % (1,141). The respective overall Age Standardized Rate (ASR) for CHCA from 1985 to 2009 was 16.8 to 62.0 per 100,000 among males and 4.8 to 25.6 per 100,000 among females. The respective, overall, ASR of CHCA among males vs. females was 44.3 per 100,000 (95% CI: 38.9 to 49.7) vs. 17.6 (95% CI: 14.5 to 20.7). Among males vs. females, the respective incidence from 1990 to 2009 has been significantly decreasing by -0.7% per year (Annual Percent Change, APC: -0.7%, 95%CI: -2.1% to +0.8%) vs. -0.4% per year (APC: -0.4%, 95% CI: -2.1% to +1.4%).
The rate increase in the first 5 to 6 years may be due to improved completeness of the registry, since in the subsequent 10 to 12 years there is a rather stable rate. It may be, however, that the recent decline in incidence represents a real fall in risk.
孔敬癌症登记处（KKCR）于1984年在孔敬大学医学院成立，兼具医院登记和人群登记。肝癌是泰国东北部地区泰国人最常见的恶性肿瘤，但迄今为止尚未对其随时间的趋势进行评估。
对1985年至2009年肝癌的发病率趋势进行统计评估，特别关注胆管癌（CHCA）。
从KKCR检索1985年至2009年登记的CHCA病例，选取所有具有特定ICD-O-第三版诊断编码为C22.1、C24.0、C24.8和C24.9的病例。使用广义线性模型方法（GLM）计算发病率趋势，该方法基于对数生成发病率。采用联合点分析确定最佳拟合模型。
在18589例肝癌病例中，42%（7859例）为肝细胞癌，58%（10731例）为CHCA。在CHCA患者中，男性受影响的频率是女性的两倍。四分之三的病例年龄在55至69岁之间。通过对原发部位组织进行细胞学或组织学检查验证的形态学（%MV）仅为10.8%（1141例）。1985年至2009年CHCA的总体年龄标准化率（ASR）在男性中为每10万人16.8至62.0例，在女性中为每10万人4.8至25.6例。男性与女性CHCA的总体ASR分别为每10万人44.3例（95%CI：38.9至49.7）和每10万人17.6例（95%CI：14.5至20.7）。在男性与女性中，1990年至2009年的发病率分别以每年-0.7%（年度百分比变化，APC：-0.7%，95%CI：-2.1%至+0.8%）和每年-0.4%（APC：-0.4%，95%CI：-2.1%至+1.4%）的速度显著下降。
最初5至六年的发病率上升可能是由于登记的完整性提高，因为在随后的10至12年中发病率相当稳定。然而，近期发病率的下降可能代表着实际风险的降低。
