第25卷第9期.PDFVIP

第25 9 化  学  进  展 Vol. 25 No.9 卷　第 期 2013 9 Sep., 2013 年 月 PROGRESS IN CHEMISTRY Prevention of Liver Cancer in Qidong, China: Lessons from Aflatoxin Biomarker Studies Patricia A. Egner 1 Jin-Bing Wang 2 Yuan-Rong Zhu 2 Lisa P. Jacobson 1 Derek Ng 1 Alvaro Muñoz 1 Jed W. Fahey 1 Jian-Guo Chen 2 Tao-Yang Chen 2 Geng-Sun Qian 2 John D. Groopman 1 Thomas W. Kensler 1,3* (1. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; 2. Qidong Liver Cancer Institute, Qidong 226200, China; 3. School of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA) Abstract Primary liver cancer has been the leading cause of cancer death in Qidong, China, with about 800 deaths annually in this region of 1.1 million residents. Epidemiological studies have highlighted the importance of infection with hepatitis B virus (HBV) and dietary exposure to hepatocarcinogenic aflatoxins as key, interactive determinants of risk in Qidong and other endemic areas. Identification of these risk factors was enabled through the development of biomarkers allowing for measures of their prevalence in case-control and other study cohorts. Vaccination against HBV began in pilot studies in the 1980s in Qidong but did not become universal for newborns until earlier this decade. Despite minimal impact on cancer mortality to date, vaccination programs are poised to blunt the development of liver diseases including cancer in this region over the next generations. Strategies for reducing aflatoxin exposure are also required, especially for those already i