PREVENTION OF PRIMARY HEPATOCELLULAR CARCINOMA--WOODCHUCK HEPATITIS VIRUS

摘要原发性肝细胞癌是最常见的癌症之一。 在世界上。临床确诊的肿瘤都是致命的。然而， 已经定义了PHC的高危人群，并将其作为血清标志物 已确认身份。处于高危状态的是慢性乙肝病毒携带者， 血清甲胎蛋白(AFP)水平的升高表明 PHC的这种肿瘤很小，很容易切除；患者有一种 预后良好。因此，PHC提供了一个独特的机会来开发 示范癌症控制研究计划。 本项目详细介绍了肝脏二级预防方案。 基于两步法的癌症：1)乙肝病毒的鉴定 2)监测乙肝病毒携带者甲胎蛋白水平。 AFP水平的特征性变化使PHC能够在 早期，体面的阶段。该计划的目标是 跟在后面。1)在东亚地区确定5000名乙肝病毒携带者 费城地区的人口。东亚人口的比例很高 因此，乙肝病毒携带率是筛查工作的重点。 2)在监测人群中每年检测10例可切除的肝癌。 3)比较切除患者的存活率与手术切除患者的存活率 新泽西州和宾夕法尼亚州肿瘤中列出的未切除患者 注册处。4)对AFP以外的PHC筛查试验进行评价； 具体地说，血清铁蛋白水平，抗肝癌的单抗 铁蛋白是一种糖基化/单糖化铁蛋白。 为了实施这一计划，一家肝癌预防中心(LCPC) 成立于福克斯·蔡斯癌症中心(Fccc)。乙肝病毒携带者将 通过费城卫生局的诊所，教堂 在LCPC进行筛查、私人医生转介和测试。承运商 将在LCPC每隔六个月监测一次AFP升高。 具有AFP特征性隆起的患者将接受扫描和 PHC的其他诊断程序。所有的治疗和随访都将是 在fccc进行的。

Primary hepatocellular carcinoma (PHC) is one of the most common cancers in the world. Clinically identified tumors are uniformly lethal. However, a high-risk population for PHC has been defined, and a serological marker identified. At high risk are chronic carriers of hepatitis B virus (HBV), and rises in the serum alpha fetoprotein (AFP) levels indicate early PHC's Such tumors are small and easily resectable; the patients have a good prognosis. Therefore, PHC presents a unique opportunity to develop a model cancer control research program. This project details a program for the secondary prevention of liver cancer based on a two-step approach: 1) identification of the HBV carriers; and 2) monitoring the AFP levels of HBV carriers. Characteristic changes in AFP levels allow PHC's to be detected at an early, respectable stage. The objectives of the program are the following. 1) To identify 5,000 HBV carriers within the east Asian populations of the Philadelphia area. East Asian Populations have high HBV carrier rates and are therefore, the focus of the screening effort. 2) To detect 10 resectable PHC's per year among the monitored population. 3) To compare the survival of the resected patients with the survival of non-resected patients listed in the New Jersey and Pennsylvania tumore registries. 4) To evaluate screening tests for PHC other than AFP; specifically, serum ferritin levels, monoclonal antibodies to PHC ferritin an glycosylated/monoglycosylated ferritin. To carry out this program, a Liver Cancer Prevention Center (LCPC) has been established at Fox Chase Cancer Center (FCCC). The HBV carriers will be identified through the Philadelphia Health Department clinics, church screenings, private physician referrals and testing at the LCPC. Carriers will be monitored at six-month intervals at the LCPC for AFP elevation. Persons with characteristic AFP elevations will undergo scanning and other diagnostic procedures for PHC. All treatment and follow-up will be carried out at the FCCC.