Retrospective observation of dynamic levels of serum Golgi protein 73 in patients prior to the onset of liver cancer / 中华预防医学杂志

<p><b>OBJECTIVE</b>To observe the dynamic levels of serum Golgi protein 73(GP73) in patients prior to and after the onset of liver cancer, and to explore the related factors.</p><p><b>METHODS</b>From 2007 to 2012, a periodical screening program was carried out in a group of high risk population with positive Hepatitis B surface antigens (HBsAg) , twice a year. Their serum specimens from every screening time point were kept in Qidong Biobank until liver cancer was diagnosed. Thirty-nine patients with liver cancer were recruited for the study, each of them at least had three times of specimens collected as well as B ultrasound scan (BUS) exam results at onset of disease and within 30 months before diagnosed, amongst 6 time points. In total, there were 162 specimens collected to test GP73 by double-antibody sandwich enzyme-linked immuno-sorbent assay (ELISA). Statistical analyses of time series and differences among groups were performed by stata software 10.</p><p><b>RESULTS</b>The average value of 39 patient's GP73 at the time point of liver cancer onset was (126.77 ± 73.73) µg/L, while the values at the other five time points prior to the onset were (128.32 ± 81.18) , (129.97 ± 83.62) , (127.38 ± 80.10) , (135.52 ± 97.88) and (138.24 ± 93.58) µg/L, respectively, with no significant difference (F = 0.07, P = 0.997). No obvious changing trends of GP73 were observed among the 39 liver cancer cases at the 6 time points. All 162 samples were divided into two groups: without hepatic cirrhosis (63 samples) and with cirrhosis (99 samples) according to findings of B-ultrasonic wave; whose average GP73 values were separately (97.16 ± 51.39) and (151.20 ± 91.68) µg/L. The difference showed statistical significance (F = 18.22, P < 0.01). Furthermore, if we grouped the samples by the average value of GP73 at 130.19 µg/L, then there were only 1/14 of the subjects without hepatic cirrhosis having higher GP73 values, but 12 of the 25 subjects with hepatic cirrhosis having higher GP73 values. The difference showed statistical significance (P = 0.013). The results of Linear regression model also showed that there was no correlation between GP73 and time series (t = 0.75, P = 0.455), but significant correlation between GP73 and hepatic cirrhosis (t = 4.30, P < 0.01).</p><p><b>CONCLUSION</b>No significant changes of the dynamic levels of GP73 could be found among the liver cancer patients within 30 months prior to the onset of disease. GP73 values of the patients with liver cancer may depend on their background of hepatic diseases; and hepatic cirrhosis might be one of the main influencing factors or confounding factors.</p>

Trends in the mortality of liver cancer in Qidong, China: an analysis of fifty years / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To describe and analyze the charecteristics and trends of liver cancer mortality during the past fifty years in Qidong, China.</p><p><b>METHODS</b>Retrospective mortality survey was conducted to get the data on liver cancer death in the period of 1958-1971, and the data from 1972 to 2007 were obtained from the records of cancer registration in Qidong. The crude mortality rate (CR) of liver cancer, and age-standardized rate by Chinese population (CASR) and by world population (WASR) were calculated and analyzed. The total percent changes (PC) and annual percent changes (APC) were used for evaluating the increasing trends of the mortality. The sex-specific rate, age-specific rate, truncated rate of the age group 35 - 64, cumulative rate of the age group 0-74, cumulative risk, period-rate, and the rate for age-birth cohort were compared.</p><p><b>RESULTS</b>The natural death rate in Qidong residents for the past five-decade period experienced a wave interval of 8.62‰ in 1958 down to 5.37‰ in 1979, and up to 7.75‰ in 2007. The mortality rate for all-site cancers was increased from 56.69 per 100, 000 to 234.97 per 100, 000. The mortality rate of liver cancer, being 20.45 per 100, 100 in 1958 was increased to 49.04 per 100, 000 in 1972, and up to 69.29 per 100, 000 in 2007. According to the registration data of 1972 - 2007, the death from liver cancer was accounted for 34.88% of all deaths due to cancers, with a CR of 58.86 per 100, 000, CASR of 38.36 per 100, 000, and WASR, 49.37 Per 100, 000 in Qidong. The truncated rate for the age group 35 - 64 was 117.08 per 100, 000, and the cumulative rate for the age group 0-74 and the cumulative risk were 5.15% and 5.02%, respectively. The CRs for males was 90.52 per 100, 000 and for females was 27.93 per 100, 000, with a sex ratio of 3.24:1. For the period of 1972 - 2007, the PC for CR was 49.71%, and APC was +1.41%, showing an increasing variation tendency. The APCs for CASR and WASR, however, were decreasing, with a percentage of -1.11%, and -0.84%, respectively. The age-specific mortality rates by period showed a decreasing trend for those under age of 44. Moreover, age-birth cohort analysis showed a more rapid lowering mortality in the age groups 35-, 30-, 25-, and 15-, that is, those born after 1950's.</p><p><b>CONCLUSIONS</b>Liver cancer remains the leading death cause due to cancers in Qidong, with a continuing higher crude mortality rate. Yet the age-standardized mortality rate has presented a declining posture. The liver cancer mortality in young people in Qidong demonstrates a continuously falling trend. The campaign for the control of liver cancer in Qidong has achieved initial success.</p>

Survey of the serum hepatocellular carcinoma marker Golgi glycoprotein (GP73) among Qidong residents and correlation analysis to outcome at two-year follow-up / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To survey the levels of Golgi glycoprotein (GP73), a hepatocellular carcinoma (HCC) marker, in residents of Qidong and determine the correlation of detected GP73 concentration ranges with outcome at two-year follow-up.</p><p><b>METHODS</b>A total of 12,378 individuals (age range: 35-69 years old) from Qidong were enrolled in the study. All participants were tested for hepatitis B virus (HBV) by detecting hepatitis B surface antigen (HBsAg) in serum. One-tenth of the participants were assigned to a stratified-random sample group (those with identification numbers ending with "0") to represent a "subgroup of the natural population" (HBsAgPop, n = 1227). All HBsAg carriers were stratified as a "subgroup of positivity" (HBsAgPve, n = 1025). One-tenth of all HBsAg-negative individuals were assigned to a stratified-random sample group to represent a "subgroup of negativity" (HBsAgNve, n = 1132). Enzyme-linked immunoassay was used to measure the serum GP73 and alpha-fetoprotein (AFP) levels; the distribution, medians (50th percentile), and 95th percentiles of GP73 were determined for the three subgroups. A two-year follow-up was carried out to observe the differential incidence of HCC between the HBsAgPve and HBsAgNve subgroups.</p><p><b>RESULTS</b>A positively skewed distribution of the GP73 values was observed for all three subgroups. The medians for HBsAgPve, HBsAgNve, and HBsAgPop were 67 mug/L, 54 mug/L, and 55 mug/L; the 95th percentiles were 174 mug/L, 108 mug/L, and 114 mug/L, respectively. The AFP positivity rates were 7.23% (37/512) for carriers whose GP73 values were above the median level and 0.78% (4/513) for carriers with GP73 values below the median level, with a highly significant difference between the two (P less than 0.01). A the two-year follow-up, 23 (4.49%) of the 512 carriers with GP73 more than or equal to 67 mug/L had developed HCC, while only one patient (0.19%) of the 513 carriers with GP73 less than 67 mug/L developed HCC, which yielded a relative risk value of 23.6. In the non-carriers, no HCC cases had occurred, regardless of serum GP73 level.</p><p><b>CONCLUSION</b>Serum GP73 has a higher potential as a diagnostic/prognostic marker of HCC in individuals with HBsAg positivity. In follow-up of HBsAg carriers, GP73 may help in the early detection of liver cancer.</p>

A thirty-one year prospective follow-up program on the HBsAg carrier state and primary liver cancer in Qidong, China / 中华流行病学杂志

Objective To study the relationship between hepatitis B virus (HBV) and primary liver cancer (PLC), and to assess the outcome of PLC in the carriers of HBsAg. Methods General population over age of 15 from a community in Qidong was screened for HBsAg, anti-HBs,and alanine transaminase (ALT) in 1976, and followed-up thenceforth. From January 1, 1977 through December 31, 2007, 12 351 people were enrolled in the cohort, and their occurrence, outcome of PLC and other cancers, together with all the withdrawals due to death were linked to and checked with database from Qidong Cancer Registry and Qidong Vital Registry programs. Results The total observed person-years (PYs) were 355 305.0. One hundred and seventy-three PLC cases were identified among the HBsAg carriers, with an incidence of 361.55 per 100 000 PYs, while PLC cases were only 95 for the non-carriers, with an incidence of 30.90 per 100 000 PYs. The overall relative risk (RR)was 11.70(95%CI: 9.06-15.19) ,with RR 12.30 for men and 10.46 for women. HBsAg carriers had high incidence at each age group,compared with the non-carriers for both men and women. Data from cross-over analysis showed that the incidence rates of PLC for the sub-cohorts of female non-carriers,male non-carriers, female carriers, and male carriers were 1.00,3.07, 10.46, and 37.76, respectively.The cumulative rates of PLC in the 4 groups were 0.86%, 2.73%, 10.22%, and 34.19%, respectively.Results from aon-conditional logistic regression model showed that the gender (male), age, HBsAg ( + ), and ALT( + ) were risk factors for the development of PLC while anti-HBs( + ) demonstrated a protective effect. No relationship was found among carriers and non-carriers for cancer sites such as lung, stomach, esophagus, intestine, pancreas, breast, cervix, bladder, and lymphoma, brain tumor, or leukemia. Conclusion Causation and its strength, together with specificity and persistency of the association were confirmed from this HBsAg-related cohort study in the general population in Qidong.Intervention measures on HBV should be highlighted for the control of PLC among the HBV infected individuals.

The patterns of cancer incidence during 1972-2005 in Qidong, China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the patterns of cancer incidence from 1972 to 2005 in Qidong, Jiangsu province.</p><p><b>METHODS</b>A population-based cancer registration system was established in Qidong region with 1.1 millions residents to collect data of cancer incident cases. 70,646 cases were registered during the years from 1972 to 2005, and ICD-10 was administrated for classification and coding, and crude rate (CR) and age-standardized rate (ASR), percent change (PC), annual percent change (APC) were calculated using annual data on population size. Changes within age-groups for different periods of incidence, and for different years of birth (birth cohort) for the leading sites of cancers were analyzed.</p><p><b>RESULTS</b>The average annual incidence for cancers during the years of 1972-2005 was 184.77 per 100,000 (ASR: 109.32 per 100,000), of which, the incidence for male was 239.22 (ASR: 136.08), and 131.58 (ASR: 79.26) per 100,000 for female. The cumulative risk of cancer occurrence was 16.31% (21.62% in males, and 11.11% in females). The most common leading sites in rank in this area were liver (CR: 60.69 per 100,000), stomach (32.97), lung (27.59), oesophagus (9.34), rectum (8.06), breast (6.48), pancreas (5.97), leukaemia (3.84), bran and CNS (3.43), and colon (2.93). Female breast cancer (12.59) and cervix cancer (4.62) were the forth and the eighth in rank among all sites for women. Liver cancer accounted for almost one third (32.84) of the malignancies. Furthermore, the cancers from digestive organs accounted for 65.85% of all sites. CR rates were rising overall, at 87.19% for PC, and at 1.85% for APC. The ASR, however, reduced by 12.14% for PC, and by 0.51% for APC. The rising trends were also observed for the ASR from cancers in lung, female breast, and colon-rectum, while the decreasing trends were observed for stomach and oesophagus cancer. Birth cohort analysis showed that there was a decline in ages under 35 for the incidence of liver cancer, in ages over 40 for stomach cancer, and in those aged over 45 for bladder cancer and over 50 for oesophagus cancer. Rising trends existed for incidence rates from lung cancer in the aged over 30, pancreas cancer in aged 45-59, and female breast cancer in those aged 40 and above.</p><p><b>CONCLUSION</b>Monitoring of cancer incidence rates through population-based cancer registration in 34 years did help to show the burden and patterns of main cancer sites and time trends, which provides some references to future aetiological study, and policy making on cancer control in Qidong.</p>