文章目录

一项多中心前瞻性研究

原文发布日期：2023-09-04

英文摘要：

摘要翻译：

原文链接：

文章：

一项多中心前瞻性研究

a multicenter prospective study

原文发布日期：2023-09-04

英文摘要：

Current guidelines recommend hepatocellular carcinoma (HCC) surveillance for at-risk individuals, including individuals with hepatitis B virus infection. However, the performance and survival benefits of annual screening have not been evaluated through multicenter prospective studies in a Chinese population. Between 2017 and 2021, we included 14,426 participants with hepatitis B surface antigen seropositivity in an annual HCC screening study in China using a multicenter prospective design with ultrasonography and serum alpha-fetoprotein. After four rounds of screening and follow-up, the adjusted hazard ratios of death after correction for lead-time and length-time biases for screen-detected cancers at the prevalent and incident rounds were 0.74 (95% confidence interval = 0.60–0.91) and 0.52 (95% confidence interval = 0.40–0.68), respectively. A meta-analysis demonstrated that HCC screening was associated with improved survival after adjusting for lead-time bias. Our findings highlight the ‘real-world’ feasibility and effectiveness of annual HCC screening in community settings for the early detection of HCC and to improve survival.

摘要翻译：

目前的指南推荐对有风险的人群进行肝细胞癌（HCC）筛查，包括携带乙肝病毒（HBV）感染的人。然而，每年筛查的性能和生存益处在华人人群中尚未通过多中心前瞻性研究进行评估。2017年至2021年期间，我们纳入了14,426名携带肝表面抗原（HBSAg）阳性反应的参与者，使用基于超声波检查和血清α-FOEP检测的中国多中心 prospective研究设计在中国开展一项年度HCC筛查研究。经过四轮筛查和随访后，在既有多发现发癌症的调整后的风险比中（纠正了截断时间和随访时间偏倚），相应地降低了0.74（95%置信区间=0.60–0.91）和0.52（95%置信区间=0.40–0.68）。Meta分析显示，HCC筛查在调整截断时间偏倚后与生存率提高相关。我们的发现突出了在社区环境中进行年度HCC早期筛查的“真实世界”可行性和有效性，以提高肝癌的生存率。