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

(1)白细胞介素-10基因启动子多态性与日本慢性丙型肝炎患者肝纤维化的进展我们检测了52名健康受试者和114名输血后丙型肝炎患者IL-10基因启动子中3个双等位基因多态性的遗传情况，分别位于转录起始位点的-1082、-819和-592位点，产生3种不同的单倍型。根据肝活检标本的纤维化程度，将患者分为缓慢或无进展组（34例）、中间进展组（33例）和快速进展组（47例）：缓慢进展组比中间和快速进展组更常具有推定的高IL-10产生GCC单倍型（p<0.01）。GCC单倍型个体比ATA或ACC单倍型个体更可能具有较少的肝纤维化（优势比0.1，95%置信区间0.01-0.9）。这些结果表明，在慢性肝炎， ...更多信息 C，推定的高IL-10产生单倍型GCC与肝纤维化进展的抑制相关。（2）脱-γ-羧基凝血酶原（DCP）指数是一个新的肝细胞癌预后指标。背景：已有研究表明，脱-γ-羧基凝血酶原（DCP）是影响肝细胞癌（HCC）患者预后的重要因素。最近，一种单克隆抗体，19 B7，它识别的Gla结构域的。DCP已被识别。19 B7抗体识别与MU-3识别的表位不同的表位，MU-3是另一种针对DCP的抗体。在这项研究中，作者调查了DCP的测量使用的抗体MU-3和19 B7，分别作为一个预后因素，肝癌患者谁有孤立的，小肿瘤和或儿童阶段AHCC.Methods：104例肝癌患者谁有孤立的，小肿瘤或儿童阶段A肿瘤在1991年和2001年之间的研究。所有患者均接受治疗，平均随访3.2年。作者分析了DCP指数（MU-3测量的DCP和19 B7测量的DCP）与患者预后的相关性。根据DCP指数将患者分为3组：1）DCP阴性（DCP<40毫任意单位（mAU）/mL）），2）低DCP指数（DCP>或= 40 mAU/mL ; MU-3：19 B7比率，<3.0，和-3）高DCP指数（DCP>或40 mAU/mL ; MU-3：19 B7比率，>或= 3.0）。高DCP指数组患者的生存率低于DCP指数组患者的生存率。阴性组的生存率显著低于低DCP指数组。在单因素考克斯比例风险模型中，高DCP指数和低DCP指数为阳性因素。使用多变量考克斯比例风险模型分析的阳性预测因素包括年龄（风险比，3.27; P=0.006），DCP指数低（风险比，2.87; P=0.012）和高DCP指数（风险比，12.3，P<0.0001）。DCP指数评分高的患者的预后比DCP指数评分低的患者和DCP阴性的患者差。作者得出结论，DP指数是HCC患者的预后指标。版权所有2003年美国癌症协会。（3）日本西南部的人类T淋巴细胞病毒I型感染、生存率和癌症风险：一项前瞻性队列研究目的：本研究前瞻性评估HTLV I感染与生存率和癌症发病率的关系。方法：研究基地包括4个，297名成人（1993年，40-69岁），曾在日本长崎A医院门诊就诊或接受年度健康检查，在1985年和1992年之间（HTLV I血清阳性=24.7%）。在随访期间1993-1999或2000年共发生恶性肿瘤261例，死亡10例，成人T细胞白血病/淋巴瘤（ATL）6例。校正性别、年龄和其他协变量后，HTLV-I血清阳性与除ATL外的所有原因的死亡率增加相关（率比[RR] 1.3，95%置信区间[CI] 1.0-1.7），所有非肿瘤性疾病（RR 1.6，95% CI 1.1-2.3）和心脏病。未发现HTLV I感染与发生除ATL以外的全部癌症的风险增加相关（RR 0.97，95% CI 0.73-1.3），结直肠癌，肝癌或肺癌，但与胃癌风险降低相关，结论：HTLV I感染与除ATL和所有非肿瘤性疾病外的所有原因的死亡率增加相关。HTLV I携带者可能不会增加一般癌症风险，但胃癌风险降低。少

(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