MOLECULAR EPIDEMIOLOGY OF PRIMARY HEPATOCELLULAR CARCINOMA IN CHINA

原发性肝细胞癌(PHC)是世界上第三大常见癌症 中国和沿海省份广西最常见的癌症， 广东、福建、浙江、江苏和上海。因为幸存下来 比率如此惨淡(不到5%)，PHC也是最常见的原因 这些地区的癌症死亡人数。这些省份约80%的初级保健中心 (和所有中国)都与慢性乙肝感染有关 病毒(乙肝)，但肝癌发病率分布不均 这些高风险省份与艾滋病的流行只有微弱的相关性。 慢性乙肝病毒携带者。其他独立作用的因素，或 协同作用，乙肝病毒必须参与其中，但人们对此知之甚少。 该项目的总体目标是在 海门市46350名男性5年前瞻性嵌套病例对照研究 江苏省中国，因素(除乙肝病毒感染外) 这导致了PHC的高风险。大约255例原发性肝癌是 预计在5年内在这一人群中发生。本发明公开了一种用于 实现这一目标的目的是检验特定关联的假设 通过收集生物样本和暴露于有PHC风险的变量 在研究开始时通过问卷提供信息，并制定 人体特定暴露在这些生物中的实验室测量 发生时来自每个PHC病例和两个对照的样本 每一箱都是。具体目标包括测试以下变量 作为PHC的危险因素：a)接触黄曲霉毒素B1；b)慢性 感染丙型肝炎病毒；c)体内储存的硒减少； D)增加体内铁储存；e)烟草使用。它们之间的关系 变量之间、慢性乙肝病毒感染和肝癌风险之间的关系 被评估。关于酒精使用、水源、饮食的信息 食用十字花科蔬菜、玉米、大米、花生和绿茶 将通过问卷调查获得，并与PHC的风险和 与其他变量的相互作用。 中国每年约有125,000人死于肝癌。接种疫苗 抗乙肝病毒可能最终将死亡率降低80%，但这是 这在几十年内都不太可能发生。与此同时，理解 影响这种风险的各种环境和遗传因素可能 导致相对简单的措施来降低肝癌死亡率，不仅是在 中国，也在美国等发达国家。

Primary hepatocellular carcinoma (PHC) is the third most common cancer in China and the most common cancer in the coastal provinces of Guangxi, Guangdong, Fujian, Zhejian, Jiangsu, and Shanghai. Because the survival rate is so dismal (less than 5%), PHC is also the most common cause of cancer deaths in these areas. About 80% of the PHCs in these provinces (and all of China) are associated with chronic infection with hepatitis B virus (HBV), but the unequal distribution of PHC incidence rates within these high risk provinces correlates only weakly with the prevalences of chronic carriers of HBV. Other factors that act independently of, or synergistically with, HBV must be involved, but are poorly understood. The overall goal of this project is to identify, within the context of a 5 year prospective, nested case-control study of 46,350 men in Haimen County, Jiangsu Province, China, factors (in addition to HBV infection) that contribute to the high risk of PHC. About 255 cases of PHC are expected to occur in this population in 5 years. The method for accomplishing this goal is to test hypotheses of association of specific variables with risk of PHC, by collecting biological samples and exposure information by questionnaire, at the beginning of the study, and making laboratory measures of person-specific exposures in these biological samples from each PHC case and two controls at the time of occurrence of each case. The Specific Aims consist of testing the following variables as risk factors for PHC: a) Exposure to aflatoxin B1; b) Chronic infection with hepatitis C virus; c) Decreased body stores of selenium; d) Increased body iron stores; e) Tobacco use. The relationship of these variables to each other, to chronic HBV infection, and to PHC risk will be evaluated. Information on alcohol use, water source, dietary consumption of cruciferous vegetables, corn, rice, peanuts, and green tea will be obtained by questionnaire and related to risk of PHC and to interactions with the other variables. About 125,000 people die each year from PHC in China. Vaccination against HBV may eventually reduce this mortality by 80%, but that is unlikely to happen for several decades. In the meantime, understanding the various environmental and genetic factors that affect this risk could lead to relatively simple measures for reducing PHC mortality not only in China, but also in the United States and other developed countries.