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肝细胞癌发病年龄的家族相关性:一项基于人群的病例对照家族研究。

Familial correlations of onset age of hepatocellular carcinoma: a population-based case-control family study.

作者信息

Liu Li, Li Lixia, Zhou Shudong, Jiang Qingwu, Chen Sidong, Gao Yanhui, Chen Yue

机构信息

Department of Epidemiology and Biostatistics and Guangdong Key Lab of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.

Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.

出版信息

PLoS One. 2014 Sep 23;9(9):e108391. doi: 10.1371/journal.pone.0108391. eCollection 2014.

Abstract

BACKGROUND

There was lack of evidence for familial aggregation in onset age of hepatocellular carcinoma (HCC) in Chinese population. We conducted a population-based case-control family study to examine familial correlation of age of HCC onset in Taixing, China.

METHODS

A total of 202 cases and 202 matched controls as well as their relatives were included in the study. Lifetime cumulative risks of HCC were estimated using the Kaplan-Meier approach. Cross ratios (CRs) were obtained from stratified Cox proportional hazard models, to assess the familial correlation of onset age.

RESULTS

The mean age of HCC onset was decreased as increasing number of HCC cases in a family. The onset age was the earliest for first-degree relatives, intermediate for second-degree relatives, and latest for non-blood relatives (spouse) (log-rank test, P<0.01). The onset age was significantly correlated between probands and their relatives. In stratified Cox proportional hazard models, the CRs for the probands versus their fathers, mothers, siblings and uncles/aunts were 6.25 (95% confidence interval (CI): 1.84-21.25), 9.81 (95% CI: 1.24-77.56), 6.22 (95% CI: 1.37-28.36) and 3.24 (95% CI: 1.26-8.33), respectively. After adjustment for hepatitis B virus infection, the CRs remained significant.

CONCLUSION

This current study suggested a significant correlation of onset age for HCC among blood relatives. Familial HCC cases yielded earlier age of onset and their relatives have higher HCC risk in early age, highlighting intensive surveillance should be start at an earlier age for individuals with family history of HCC.

摘要

背景

在中国人群中,肝细胞癌(HCC)发病年龄存在家族聚集性的证据不足。我们开展了一项基于人群的病例对照家系研究,以探讨中国泰兴地区HCC发病年龄的家族相关性。

方法

本研究共纳入202例病例、202例匹配对照及其亲属。采用Kaplan-Meier法估计HCC的终生累积风险。通过分层Cox比例风险模型获得交叉比(CRs),以评估发病年龄的家族相关性。

结果

随着家族中HCC病例数的增加,HCC发病的平均年龄降低。一级亲属的发病年龄最早,二级亲属次之,非血亲亲属(配偶)最晚(对数秩检验,P<0.01)。先证者与其亲属的发病年龄显著相关。在分层Cox比例风险模型中,先证者与其父亲、母亲、兄弟姐妹及叔伯/姑姨的CRs分别为6.25(95%置信区间(CI):1.84-21.25)、9.81(95%CI:1.24-77.56)、6.22(95%CI:1.37-28.36)和3.24(95%CI:1.26-8.33)。调整乙型肝炎病毒感染因素后,CRs仍具有显著性。

结论

本研究提示血亲中HCC发病年龄存在显著相关性。家族性HCC病例发病年龄较早,其亲属在早年患HCC的风险较高,这突出表明对于有HCC家族史的个体应在更早年龄开始强化监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b51e/4172774/d8672107f864/pone.0108391.g001.jpg

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