Early Detection and Prognosis of Patients with Hepatocellular Carcinoma

描述（由申请人提供）： 肝细胞癌（HCC）是世界范围内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年中发病率增长最快的肿瘤。两者的发病率和死亡率相似，表明HCC的总体生存率较差。因此，改善早期发现和查明高危人群的战略至关重要。对于K23奖，我表示我将做2项研究：一项以HCC和肝硬化患者为对照的病例对照研究，以及一项前瞻性队列研究。目的是评估新的肿瘤标志物用于早期HCC的检测，并确定HCC发展的危险因素。多中心病例对照研究已接近完成，前瞻性研究的累积情况良好。在该提案中，将有2个目标：1）是评估HCC发展的风险因素和早期检测HCC的新生物标志物，以及2）HCC患者预后的前瞻性评估。我们最近发表了比较HCC分期系统的最大规模试验，发现巴塞罗那分期系统在确定HCC患者预后方面最好，因为它考虑了肝功能，肿瘤负荷和性能状态。在R 03的剩余时间里，我计划继续对肝硬化患者进行前瞻性队列研究，根据国家指南，每6 - 12个月进行一次常规医疗护理。我还计划在诊断后的指定时间间隔（最初6周，然后每2个月一次）随访HCC患者，以研究HCC患者的预后因素，并前瞻性地验证巴塞罗那分期系统。在K23和R 03结束时，我将获得R 01提交的初步数据，更重要的是，我将成为一名独立研究者。 肝癌是全球第五大常见肿瘤，也是第三大癌症死亡原因。在过去的10年中，与所有其他癌症相比，肝癌的新肿瘤增加最多。因此，确定危险因素，确定早期检测和确定这种肿瘤预后的新方法是极其重要的。

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.