启东肝癌的预防研究课件.ppt

启东肝癌的预防研究 　　 Jian-Guo CHEN Qidong Liver Cancer Institute 流行趋势  中国肝癌死亡率 癌症发病谱 ---启东 危险因素  HBsAg携带者的肝癌发病率和相对危险度 1977~2007, 启东 HBsAg 携带者和非携带者的肝癌年龄别发病率 预防 乙肝免疫接种, 1984-1990, 启东 化学预防 通过合成的或自然的物质来延迟、阻断或逆转致癌作用 (在癌变前) (例如，药物、食物、增补剂) 西 兰 花 苗 叉 生 试 验启 东, 2009 无症状者的早期诊断及高危人群的 筛查。 启东：30-69岁 HBsAg 阳性的男性为肝癌筛查的高危险人群。 筛 查 (A) 和 对 照 (B) 队 列 研究设计: 样本量和筛查时间 (X) .筛检组 (A: n = 240) 和对照组 (B: n = 108) 肝癌生存率  肝癌诊断及治疗情况汇总 评估 肝癌: 增加还是减少? 启 东 肝 癌 出 生 队 列 发 病 率 疫苗接种导致HBV 感染率的下降 肝 癌 流 行 黄曲霉毒素暴露的降低 但延迟作用仍在起作用 平 衡 老龄化导致高危人群的增加 谢 谢 国际抗癌联盟 世界抗癌大会 深圳 2010年8月21日 For the Strategies for Prevention of liver cancer, we have primary prevention and secondary prevention. Primary prevention includes HBV vaccination, aflatoxin comsumption reduction, and chemoprevention. Secondary prevention means early detection, diagnosis and treatment. A cancer registration system was set up since 1972. The cancer pattern for the past 4 decades showed that liver cancer is always the number one site of cancers, with a mortality rate of 60.69 per 100,000 on average. A trend analysis shows that the crude incidence rate of liver cancer, the red one, was increased in a APC rate of 1.51% during this period; While age-standarized rates by China population and by World population showed a decreased change of -0.95%, the blue one, and -0.70%, the green one, respectively. What can be attributed to the liver cancer prevalence in this area ? The major causal factor for liver cancer is HBV, the aflatoxin B1 could be the another one. This slide shows that about 83% of cases, died before 2003 from a 667 case cohort, contained double mutation at 1762T/and 1764A, based on the DNA recovered test from serum samples. Diamond graph modeling analysis shows that mutations are more common in the younger cases, and the frequency of mutation was higher in those survived shorter after screening. A controlled study of universal immunization of newborns has been conducted in Qidong since