| Background: Primary liver carcinoma (PLC) is a malignant tumor that takesplace on liver cells or hepatic duct cells. It is called liver cancer for short below.PLC is one of the most common malignant tumors that morbidity is located in thesixth all over the world. PLC is the third lethal cancer in man of global, and it is thesecond cancer leading death in our country. The process of PLC is caused bymulti-stage and multiple factors, and it is the high malignant degree，processrapidly,easy to transfer, once found, more have been late period. So, earlydetection and diagnosis is the scientific method to improve the prognosis and the5-year survival rate of patients with PLC. Hepatitis B virus is the main factors thatlead to liver cancer, the HBsAg can be used as screening index of early PLC.Nasopharyngeal carcinoma (NPC) is one of high incidence malignant tumors in oursouth country, it mostly happens in pharyngeal recess that is a secret place, and itsincipient symptoms are not obvious. However, the patient’s5-year survival rate canreach95%if diagnosed early, or else, that rate just only about50%. At present, EB virus is the main factor of NPC, so for EB virus antibody detection helps to find theearly tumor. Through early detection and diagnosis PLC and NPC, can prolong thesurvival period, improve the prognosis of patient, in addition, Guangxi is a highincidence both PLC and NPC. Therefore, joint screening for both these two cancersthat not only provide a scientific basis for prevention and control, but alsoconforms to the cost-benefit principle of health economic.Objective:1.The joint screening was carry out in high occurrence area of PLCand NPC, in order to establish the risk group of PLC and NPC and the “doublepositive” group.2. Via the regular reexamination and tracing, we could analyze thetransformation rule of the risk group and find the cancer early.3. Explore thedifference between the “double positive” group and PLC or NPC.4. Explore theadvantage of joint screening and single screening.Method: The research started in November2010.The detection of HBsAg wascarried out in the community residents through cooperated with a communityhospitals. Then built the risk group of PLC who HBsAg positive. Two pairs ofsemi-hepatitis, liver function (AST and ALT), the qualitative analysis of alpha fetalprotein (AFP) and B-ultrasound of liver was done at fixed period in the group. Ifthe results implied the patients were possibly diagnosed with cancer, the qualitativeanalysis of AFP and CT were needed to future done. In November2010, the secondreexamination of the risk group of PLC was carried out, and the subjects get thetest of VCA-IgA at the same time. And built the risk group of NPC who EBVpositive. If VCA-IgA remained positive, we performed the nasopharyngoscopy andtissue biopsy. Sometimes both HBsAg and VCA-IgA were positive for patients andthey were called the “double positive”. So, established the “double positive” group and explore them between the risk group of PLC and NPC. If the PLC and NPCpatients were found, we would understand their pathological staging and registeredit. One screening and four reexaminations has been done in the risk group of PLCby November2013, while the risk group of NPC and the “double positive” grouphas get one screening and two reexaminations.Results:1. Establish the risk group of PLC in November2010:12703people joined inthe screening laboratory,9344men and3359women.946people were classified asthe risk group of PLC and positive rate was7.45%.The queue of age mainlydistributed from20to49and man to female ratio is about3:1.2. First reexamination of the risk group of PLC in May2011:487peoplejoined in the reexamination and negative conversion of HBsAg was not found inthe risk group.51.48%patients were followed-up.8patients of AFP were positive,and198patients of ALT,99patients of AST and110patients of B-ultrasonic wavewere abnormal.3. In November2011①the second reexamination of the risk group of PLC:717patients of the risk group come back to reexamination and the rate was75.79%,663cases were still the risk group. There are321people take part in the tworeviews, and the rate was33.93%. The negative conversion of HBsAg had54casesand the rate was7.53%.12087people joined in the physical examination, and983patients who HBsAg were positive, while320cases were new.②Establish the riskgroup of NPC: the test of VCA-IgA was performed in12087subjects.639patientsbelonged to the risk group of NPC and the positive rate was5.29%. There wasstatistically significant difference on the age (P<0.05).③Establish the group of “double positive”:70patients with HBsAg and VCA-IgA were found and the ratewas0.579%. The group of “double positive” accounted for7.12%and10.95%ofthe one of PLC and NPC, respectively. Through analyzing, in this group theinfection rate of EBV was higher than HBV (P<0.05).4. In June2012①the third reexamination of the risk group of PLC:620peopleparticipated in first screening and the rate was65.54%. There are271people takepart in the three reviews, and the rate was28.65%.1054cases of HBsAg werepositive in this examination, queue increased264people.3patients were diagnosedwith cancer, one early-stage and two terminal cancers.②The first reexamination ofthe risk group of NPC:578people joined in this examination and the rate ofreexamination was90.45%.504cases were the risk group of NPC,74cases turnednegative and the rate was13.83%. One cancer patient was found③The firstreexamination of the group of “double positive”:49people join and the rate ofreexamination was70%. The number of “double positive” kept on43.6patientswere that HBsAg turned negative and VCA-IgA did not change and the negativeconversion ratio was12.24%. In the group, there was no change of VCA-IgA. Inthis analysis, the negative conversion ratio of VCA-IgA was lower than HBsAg（P<0.05）.5. In June2013①the first reexamination of the risk group of PLC:524peopleparticipated in first screening and the rate was55.39%.217people took part in allof the inspection, the rate was22.04%. The queue included1530people in total,875people joined this examination.②The second reexamination of the risk groupof NPC:394people joined this examination and the rate of reexamination was61.66%.368cases were the risk group of NPC,26cases turned negative and the rate was6.95%.③The second reexamination of the group of “double positive”:40people joined and the rate of reexamination was57.14%. The number of “doublepositive” kept on20.18patients were that HBsAg turned negative and VCA-IgAdid not change and the negative conversion ratio was12.24%. In the group,2patients of both VCA-IgA and HBsAg turded negative. The negative conversionratio of VCA-IgA and HBsAg were50%and5%. Analytically, the negativeconversion ratio of HBsAg was lower than VCA-IgA（P<0.05）. The new cancerpatients were not found.Conclusions:1.The infection rate of HBV was steady in the community. Withincreasing age group， the infection rate of EBV has increased. Thosecharacteristics and rule provided the direction for the prevention of PLC and NPCin other community.2. After three risk-groups were established, via analysis, therewas some interactions between HBV and EBV since the patients infected twoviruses.3. The group of “double positive” had some own characteristics, itsprevention and treatment should be different form PLC or NPC.4. Firstly jointscreened the PLC and NPC, conforms the principle of health economic. |
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