MOLECULAR EPIDEMIOLOGY OF PRIMARY HEPATOCELLULAR CARCINOMA IN CHINA

原发性肝细胞癌（PHC）是美国第三大最常见的癌症。 中国和广西沿海省份最常见的癌症， 广东、福建、浙江、江苏、上海。 因为生存 率是如此令人沮丧（低于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 (and全中国）与慢性B型肝炎感染有关 病毒（HBV），但PHC发病率分布不均， 这些高风险省份与以下疾病的患病率仅弱相关： HBV慢性携带者。 其他独立作用的因素，或 协同作用，HBV必须参与，但知之甚少。 该项目的总体目标是在一个 海门市46,350例男性5年前瞻性巢式病例对照研究 中国江苏省泗县因素（除HBV感染外） 导致肝癌的高风险。 大约255例原发性肝癌是 预计5年内在该人群中发生。 的方法 实现这一目标是测试特定的关联假设， 通过收集生物样本和暴露， 调查问卷的信息，在研究开始时， 实验室测量的具体人接触这些生物 每个PHC病例的样本和两个对照在发生时， 每个案件。 具体目标包括测试以下变量 作为PHC的风险因素：a）暴露于黄曲霉毒素B1; B）慢性 丙型肝炎病毒感染; c）硒的体内储存减少; d）增加身体铁储存; e）烟草使用。 这些关系 相互之间、慢性HBV感染和PHC风险的变量将 被评价。 关于饮酒、水源、饮食的信息 食用十字花科蔬菜、玉米、大米、花生和绿色茶 将通过问卷调查获得，并与PHC的风险相关， 与其他变量的相互作用。 中国每年约有12.5万人死于PHC。 疫苗接种 抗HBV可能最终将死亡率降低80%，但这是 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 导致采取相对简单的措施，降低PHC死亡率， 中国，而且在美国和其他发达国家。

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.