| 蔡雷琦,姜 帆,边学峰,等.2014—2019年山东省济南市肝癌流行趋势及生存分析[J].中国肿瘤,2025,34(12):938-945. |
| 2014—2019年山东省济南市肝癌流行趋势及生存分析 |
| Epidemic Trends and Survival Analysis of Liver Cancer in Jinan City of Shandong Province from 2014 to 2019 |
| 投稿时间：2025-09-28 |
| DOI：10.11735/j.issn.1004-0242.2025.12.A005 |
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| 中文关键词: 肝癌 流行 趋势 生存分析 山东 |
| 英文关键词:liver cancer epidemic trend survival analysis Shandong |
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| 中文摘要: |
| 摘 要：［目的］ 分析 2014—2019年山东省济南市肝癌发病与死亡的流行特征、变化趋势及生存状况。［方法］ 整理2014—2019年肿瘤登记报告的济南市户籍居民的肝癌数据，计算肝癌的粗发病（死亡）率、中标发病（死亡）率、世标发病（死亡）率、0~74岁累积率等，用Joinpoint模型计算发病及死亡的平均年度变化百分比（average annual percentage change，AAPC），用Kaplan-Meier法计算生存时间，用Cox比例风险回归模型评估死亡风险，计算风险比（hazard ratio，HR）。［结果］2014—2019年济南市肝癌粗发病率为30.16/10万，中标发病率为17.12/10万，世标发病率为18.79/10万，0~74岁累积发病率为2.00%；肝癌粗死亡率为24.37/10万，中标死亡率为13.52/10万，世标死亡率为15.01/10万，0~74岁累积死亡率为1.58%。分性别看，男性中标发病率（26.73/10万）、中标死亡率（20.97/10万）均为女性（7.96/10万、6.46/10万）的3倍以上；分城乡看，农村地区中标发病率（17.54/10万）、中标死亡率（14.57/10万）均高于城市地区（16.85/10万、12.84/10万）。2014—2019年肝癌中标发病率与死亡率均呈显著下降趋势（P均<0.05），中标发病率年均下降4.72%，中标死亡率年均下降2.83%。发病中位年龄63岁，年龄别发病、死亡率均随年龄增长而上升，80~84岁组达峰。全人群1、3、5年生存率分别为42.61%、22.52%和17.29%，中位生存0.70年。城市地区5年生存率（19.70%）显著高于农村地区（13.51%）（P<0.001）。济南市肝癌病例的5年生存率逐年提高，由2014年的15.52%升至2019年的22.49%。多因素Cox模型显示，与2014年相比，2016年及以后诊断的肝癌患者死亡风险显著降低。［结论］ 2014—2019年济南市肝癌发病率、死亡率呈持续下降趋势，但生存率仍处于较低水平。男性、中老年及农村居民为肝癌防控重点人群，需强化乙肝疫苗接种、高危人群早筛及规范诊疗，进一步降低疾病负担、提升患者生存水平。 |
| 英文摘要: |
| Abstract： ［Purpose］ To analyze the epidemiological characteristics， change trends and survival status of liver cancer incidence and mortality in Jinan City of Shandong Province from 2014 to 2019. ［Methods］ The data of liver cancer in Jinan from 2014 to 2019 were sorted out. The crude rates of incidence /mortality， age-standardized incidence rate by Chinese (ASIRC) and world standard population (ASIRW)， age-standardized mortality rate by Chinese (ASMRC) and world standard population (ASMRW)， cumulative rate of 0~74 years old， etc. of liver cancer were calculated. The average annual percentage change (AAPC) of incidence and mortality was calculated with the Joinpoint model. The survival time was calculated by Kaplan-Meier. Cox proportional hazards regression model was used to evaluate mortality risk， and hazard ratio (HR) was calculated. ［Results］ From 2014 to 2019， the crude incidence rate， ASIRC， ASIRW and cumulative rate (0~74 years old) of liver cancer in Jinan were 30.16/105， 17.12/105， 18.79/105 and 2.00%， respectively； the crude mortality rate， ASMRC， ASMRW and cumulative rate (0~74 years old) were 24.37/105， 13.52/105， 15.01/105 and 1.58%， respectively. By gender， the ASIRC (26.73/105) and ASMRC (20.97/105) of male were three times more than those of female (7.96/105 for ASIRC， 6.46/105 for ASMRC). By urban-rural classification， the ASIRC (17.54/105) and ASMRC (14.57/105) in rural areas were higher than those in urban areas (16.85/105 for ASIRC， 12.84/105 for ASMRC). From 2014 to 2019， both the ASIRC and ASMRC of liver cancer showed a significant downward trend (both P<0.05)， with an average annual decrease of 4.72% for ASIRC and 2.83% for ASMRC. The median age at diagnosis was 63 years old； the age-specific incidence rate and age-specific mortality rate increased with age， peaking in the age group of 80~84 years old. The 1-year， 3-year and 5-year survival rates of the total population were 42.61%， 22.52% and 17.29%， respectively， with a median survival time of 0.70 years. The 5-year survival rate in urban areas (19.70%) was significantly higher than that in rural areas (13.51%， P<0.001). The 5-year survival rate of liver cancer cases in Jinan increased steadily year by year， rising from 15.52% in 2014 to 22.49% in 2019. The multivariate Cox model showed that compared with 2014， the mortality risk decreased significantly from 2016 to 2019. ［Conclusion］ Although the incidence and mortality of liver cancer in Jinan showed a continuous downward trend from 2014 to 2019， the survival rate remains at a low level. Men， middle-aged and elderly people， and rural residents are the key populations for liver cancer prevention and control. It is necessary to strengthen hepatitis B vaccination， targeted screening of high-risk groups and standardized diagnosis and treatment to further reduce the disease burden and improve the survival level of patients. |
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