Early Detection and Prognosis of Patients with Hepatocellular Carcinoma

描述(由申请人提供)： 肝细胞癌是全球第五大常见肿瘤和第三大常见癌症死亡原因。在美国，它是过去10年中发病率增加最多的肿瘤。发病率和死亡率相似，表明总体上肝细胞癌的存活率较低。因此，改进早期发现和识别最高风险人群的战略至关重要。对于K23奖，我表示我将进行两项研究：一项是以肝细胞癌和肝硬变患者为对照的病例对照研究，另一项是前瞻性的肝硬变队列研究。其目的是评估新的肿瘤标志物用于检测早期肝细胞癌，并确定发生肝细胞癌的危险因素。多中心病例对照研究已接近完成，前瞻性研究的预期效果良好。在这项提案中，将有两个目标：1)评估肝细胞癌发生的危险因素和早期发现肝细胞癌的新生物标志物；2)对肝细胞癌患者的预后进行前瞻性评估。我们最近发表了一项比较肝癌分期系统的最大规模的试验，发现巴塞罗那分期系统在确定肝癌患者预后方面是最好的，因为它考虑了肝功能、肿瘤负担和表现状况。在R03的其余部分，我计划继续对每6-12个月进行一次常规医疗护理的肝硬变患者进行前瞻性队列研究，这是基于国家指南的。我还计划在肝癌患者确诊后每隔指定的时间间隔(最初为6周，之后每2个月追踪一次)来研究肝癌患者的预后因素，并前瞻性地验证巴塞罗那的分期系统。在K23和R03结束时，我将有R01提交的初步数据，更重要的是，我将成为一名独立调查员。 肝癌是全球第五大常见肿瘤，也是全球第三大常见癌症死亡原因。在过去的10年里，与所有其他癌症相比，肝癌在新肿瘤中的增长幅度最大。因此，识别肿瘤的危险因素，寻找新的早期发现和判断预后的方法是极其重要的。

DESCRIPTION (provided by applicant): Hepatocellular carcinoma (HCC) is the 5th most common tumor and the 3rd most common cause of cancer death worldwide. In the U.S.A., it is the tumor with the largest increase in incidence over the last 10 years. The incidence and death rates are similar indicating the overall poor survival of HCC. Therefore, strategies to improve the early detection and to identify those at the highest risk are of paramount importance. For the K23 award I indicated I would do 2 studies: a case-control study of patients with HCC and cirrhosis as controls, and a prospective cirrhotic cohort study. The aims were to evaluate new tumor markers for the detection of early HCC and to identify risk factors for the development of HCC. The multicenter case-control is nearing completion, and accrual for the prospective study is well. In this proposal, there will be 2 aims: 1) is the evaluation of risk factors for the development of HCC and novel biomarkers for the early detection of HCC, and 2) the prospective evaluation of the prognosis of patients with HCC. We recently published the largest trial comparing the staging systems of HCC, and found that the Barcelona Staging systems was the best at determining prognosis of patients with HCC because it takes into account liver function, tumor burden and performance status. For the remainder of the R03, I plan to continue the prospective cohort study of patients with cirrhosis when they are seen for their routine medical care every 6 -12 months, which is based on national guidelines. I also plan to follow patients with HCC after their diagnosis at designated intervals (6weeks initially then every 2 months thereafter) to study the prognostic factors of patients with HCC and to prospectively validate the Barcelona Staging system. At the end of the K23 and R03, I will have the preliminary data for an R01 submission and more importantly, I will be on my way to being an independent investigator. Liver cancer is the 5th most common tumor and the 3rd most common cause of cancer death worldwide. Over the last 10 years, liver cancer has the largest increase in new tumors compared to all other cancers. Therefore, identifying the risk factors, identifying new methods for early detection and determining prognosis for this tumor is of extreme importance.