目的 为评价人群患肝癌的风险,用Meta分析方法计算肝癌主要危险因素--乙肝病史、饮酒、饮用不洁水和经常食用黄曲霉毒素污染食物的综合危险度,并建立综合风险评价模型.方法 在PubMed和CBMDisc电子数据库中检索并通过电子检索和手工查阅的方式获得符合纳入标准的文章共34篇,计算各因素的合并效应综合危险度.结果 以社区人群为对照的文献显示乙肝对肝癌发生的综合危险度为6.66[95%可信区间(5.57,7.97)];而以医院人群为对照文献的综合危险度高达25.09[95%可信区间(18.59,33.86)];饮酒、饮用不洁水和经常食用黄曲霉毒素污染食物的综合危险度分别为2.14[95%可信区间(1.97,2.34)]、1.39[95%可信区间(1.17,1.65)]和1.36[95%可信区间(1.13,1.64)].结论 综合风险评价模型可以根据社区个体的生活习惯和疾病史等情况评价个人患肝癌风险的大小,据此可给予其个性化的筛查方案,这将大大提高肝癌筛查的效率和成本效果.%Objective To evaluate the risk of liver cancer, meta-analysis was used to estimate synthetical OR (odds ratio) of main risk factors of liver cancer, including hepatitis B, alcohol drinking, rude water drinking and regularly taking aflatexin contaminated food. A synthetical hazard evaluation model was built up. Methods By electronic search of databases included PubMed and CBMDisc as well as manual search in the campus library, a total of 34 papers met the including criteria. The pooled estimation of OR was calculated for each risk factor. Results OR of hepatitis B infection was respectively 6.66 (95%CI 5.57～7.97) and 25.09 (95%CI 18.59～33.86) for studies using community control and hospital control. ORes of alcohol drinking, rude water drinking and regularly taking aflatoxin contaminated food were 2.14 (95%CI 1.97～2.34), 1.39 (95%CI 1.17～1.65), and 1.36(95%CI 1.13～1.64) respectively. An integrated risk evaluation model was built up. Conclusion The integrated model can be used to assess individual hazard of liver cancer according to one's disease history and living habits. The findings contribute to the design of individualized screening protocol, hence to improve the efficiency and cost-effectiveness of screening for liver cancer.
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