PREVENTION OF PRIMARY HEPATOCELLULAR CARCINOMA--WOODCHUCK HEPATITIS VIRUS

原发性肝细胞癌是最常见的恶性肿瘤之一 世界上临床上鉴定的肿瘤都是致命的。然而，在这方面， 已经确定了PHC的高危人群， 鉴定高风险的是B型肝炎病毒（HBV）的慢性携带者， 血清甲胎蛋白（AFP）水平的升高表明早期 原发性肝癌这种肿瘤很小，很容易切除，病人有一个 预后良好。因此，初级保健提供了一个独特的机会， 模范癌症控制研究计划。 该项目详细介绍了肝脏二级预防方案 基于两步方法的癌症：1）识别HBV 监测HBV携带者AFP水平。 甲胎蛋白水平的特征性变化使PHC的检测， 早期的，体面的阶段该方案的目标是 以下. 1)在东亚地区确定5，000名HBV携带者 费城地区的人口。东亚人口比例高 HBV携带率，因此，筛查工作的重点。 2)在监测人群中每年检测10例可切除的PHC。 3)比较手术切除患者的生存率和 新泽西和宾夕法尼亚肿瘤中未切除的患者 登记处。4)评价除AFP外的PHC筛查试验; 特别是血清铁蛋白水平、抗PHC单克隆抗体 铁蛋白是糖基化/单糖基化的铁蛋白。 为了实施这一计划，肝癌预防中心（LCPC） Fox Chase Cancer Center（FCCC）HBV携带者将 通过费城卫生部诊所，教堂 LCPC的筛查、私人医生转诊和检测。载体 将在LCPC每六个月监测一次AFP升高。 具有特征性AFP升高的人将接受扫描， PHC的其他诊断程序。所有治疗和随访将 这是在FCCC。

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.