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开发一种用于预测中年日本人 10 年内肝细胞癌风险的模型:日本基于公共卫生中心的前瞻性研究队列 II。

Development of a prediction model for 10-year risk of hepatocellular carcinoma in middle-aged Japanese: the Japan Public Health Center-based Prospective Study Cohort II.

机构信息

Environmental Epidemiology Section, Center for Environmental Health Sciences, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.

出版信息

Prev Med. 2012 Aug;55(2):137-43. doi: 10.1016/j.ypmed.2012.05.017. Epub 2012 Jun 4.

Abstract

OBJECTIVE

The purpose of the present study was to develop a risk estimation model for the 10-year risk of hepatocellular carcinoma (HCC) that could be easily used in a general population to aid in the prevention of HCC.

METHODS

Our prediction model was derived from data obtained on 17,654 Japanese aged 40 to 69 years who participated in health checkups (follow-up: 1993-2006). Cox proportional hazards regression was applied to obtain coefficients for each predictor.

RESULTS

During follow-up, a total of 104 cases of HCC were newly diagnosed. After checking the model fit, we incorporated age, sex, alcohol consumption, body mass index, diabetes, coffee consumption, and hepatitis B and C virus infection into the prediction model. The model showed satisfactory discrimination (Harrell's c-index=0.94) and was well calibrated (the overall observed/expected ratio=1.03, 95% confidence interval=0.83-1.29). We also developed a simple risk scoring system. Those subjects with total scores of 17 or more under this system (score range: -1 to 19) had an estimated 10-year HCC risk of over 90%; those with 4 points or less had an estimated risk of less than 0.1%.

CONCLUSION

We developed a simple 10-year risk prediction model for HCC in the Japanese general population as a public education tool.

摘要

目的

本研究旨在开发一种适用于一般人群的肝癌(HCC)10 年风险评估模型,以帮助预防 HCC。

方法

我们的预测模型源自参加健康检查的 17654 名 40 至 69 岁日本人群的数据(随访:1993-2006 年)。应用 Cox 比例风险回归获得每个预测因子的系数。

结果

在随访期间,共新诊断出 104 例 HCC。在检查模型拟合度后,我们将年龄、性别、饮酒、体重指数、糖尿病、咖啡摄入以及乙型和丙型肝炎病毒感染纳入预测模型。该模型显示出令人满意的区分度(Harrell's c 指数=0.94)和良好的校准度(总体观察/预期比值=1.03,95%置信区间=0.83-1.29)。我们还开发了一种简单的风险评分系统。根据该系统,总分为 17 分或以上的受试者(得分范围:-1 至 19)预计 10 年内 HCC 风险超过 90%;总分为 4 分或以下的受试者预计风险小于 0.1%。

结论

我们为日本一般人群开发了一种简单的 HCC 10 年风险预测模型,作为公众教育工具。

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