A COHORT STUDY ON THE CANCER INCIDENCE IN AN AREA WHERE HTLV I, HCV AND HBV ARE ENDEMIC

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(1) Interleukin-10 promoter polymorphism and liver fibrosis progression in patients with chronic hepatitis C in Japan.We examined the inheritance of three biallelic polymorphisms in the IL-10 gene promoter, at positions -1082, -819, and -592 from the transcription start site, which produce three different haplotypes, in 52 healthy subjects and 114 patients with post-transfusion hepatitis C. Patients were classified into slow or no-progression group (34 patients), intermediate progression group (33 patients) and rapid progression group (47 patients), based on the degree of fibrosis of liver biopsy specimens : The slow progression group had the putative high IL-10 producing GCC haplotype more often than, the intermediate and rapid progression groups (p<0.01). Individuals with the GCC haplotype were more likely to have less hepatic fibrosis than individuals with the ATA or ACC haplotypes (odds ratio 0.1, 95% confidence interval 0.01-0.9). These results indicate that, in chronic hepatitis … More C, the putative high IL-10 production haplotype GCC is associated with inhibition of the progression of liver fibrosis.(2)The des-gamma-carboxy prothrombin index is a new prognostic indicator for hepatocellular carcinoma.Background : Des-gamma-carboxy prothrombin (DCP) has been reported to be an important prognostic factor in patients with hepatocellular carcinoma (HCC). Recently, a monoclonal antibody, 19B7, which recognizes the Gla domain of. DCP, has been identified. The 19B7 antibody recognizes an epitope different from that recognized by MU-3, which is another antibody against DCP. In this study, the authors investigated the measurement of DCP using the antibodies MU-3 and 19B7, respectively, as a prognostic factor for patients with HCC who had solitary, small tumors and or Child Stage AHCC.Methods : One hundred four patients with HCC who had solitary, small tumors or Child Stage A tumors were enrolled in the study between 1991 and 2001. All patients were treated and were followed for a mean of 3.2 years. The authors analyzed the correlation between the DCP Index (DCP measured by MU-3 and DCP measured by 19B7) and patient prognosis. The patients were classified into 3 groups based on their DCP Index :1) DCP negative (DCP<40 milli arbitrary unit (mAU)/mL)), 2)low DCP Index (DCP> or = 40mAU/mL ; MU-3:19B7 ratio, <3.0, and-3) high DCP Index (DCP> or 40mAU/mL ; MU-3:19B7 ratio, > or= 3.0).Results : The survival rate for patients in the high DCP Index group was lower compared with the survival rate for patients in the DCP-negative group and was significantly lower compared with the survival rate for patients in the low DCP Index group. In a univariate Cox proportional hazards model, the positive factors were high DCP Index and low DCP Index. Among the positive predictive factors that were analyzed using a multivariate Cox proportional hazards model were age (hazard ratio, 3.27; P=0.006), low DCP Index (hazard ratio, 2.87; P=0.012), and high DCP Index (hazard ratio, 12.3, P<0.0001).Conclusions : The prognosis of patients who had a high DCP Index score was poorer compared with patients who had a low DCP Index score and patients who were classified as DCP negative. The authors concluded that the DP Index is a prognostic indicator for patients with HCC. Copyright 2003 American Cancer Society.(3)Human T lymphotropic virus type-I infection, survival and cancer risk in southwestern Japan : A prospective cohort study.Objectives : This study prospectively evaluated the associations of HTLV I infection with survival and cancer incidence.Methods : The study base comprised 4,297 adults (aged 40-69 years in 1993) who had either visited the outpatient clinic or who had received annual health check-ups at the A Hospital, Nagasaki, Japan, between 1985 and 1992 (HTLV I seropositivity=24.7%). During the follow-up period (1993-1999 or 2000), 290 deaths and 261 cases of malignant neoplasms occurred, including 10 deaths and six incident cases of adult T -cell leukemia/lymphoma (ATL).Results : After adjustment for gender, age and other covariates, HTLV-I seropositivity was associatedd with an increased mortality from all-causes excluding ATL (rate ratio [RR] 1.3, 95% confidence interval [CI] 1.0-1.7), all non-neoplastic diseases (RR 1.6, 95% CI 1.1-2.3) and heart diseases. HTLV I infection was not found to be associated with an increased risk of developing total cancers other than ATL (RR 0.97, 95% CI 0.73-1.3), colorectal cancers, liver cancer or lung cancer, but was associated with a reduced risk of gastric cancer, (RR=0.42, 95% CI 0.18-0.99).Conclusions : HTLV I infection is associated with increased mortality from all-causes excluding ATL and all non-neoplastic diseases. HTLV I carriers may not be at increased general cancer risk, but at reduced risk of gastric cancer. Less