RESUMO
Current guidelines recommend hepatocellular carcinoma (HCC) surveillance for at-risk individuals, including individuals with hepatitis B virus infection. However, the performance and survival benefits of annual screening have not been evaluated through multicenter prospective studies in a Chinese population. Between 2017 and 2021, we included 14,426 participants with hepatitis B surface antigen seropositivity in an annual HCC screening study in China using a multicenter prospective design with ultrasonography and serum alpha-fetoprotein. After four rounds of screening and follow-up, the adjusted hazard ratios of death after correction for lead-time and length-time biases for screen-detected cancers at the prevalent and incident rounds were 0.74 (95% confidence interval = 0.60-0.91) and 0.52 (95% confidence interval = 0.40-0.68), respectively. A meta-analysis demonstrated that HCC screening was associated with improved survival after adjusting for lead-time bias. Our findings highlight the 'real-world' feasibility and effectiveness of annual HCC screening in community settings for the early detection of HCC and to improve survival.
Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/diagnóstico , China/epidemiologia , Antígenos de Superfície da Hepatite B , Neoplasias Hepáticas/diagnóstico , Estudos ProspectivosRESUMO
Gene-environment interactions may increase gastric cancer (GC) risk. Seven susceptibility loci identified by genome-wide association studies (GWASs) suggest that genetic factors play a role in gastric carcinogenesis. Meanwhile, Helicobacter pylori (H. pylori) infection, smoking, and alcohol drinking are also important environmental factors for gastric cancer. However, studies to explore the role of gene-environment interactions in gastric carcinogenesis, and particularly the relationship between the seven susceptibility loci and their potential interactions with H. pylori infection, smoking, and alcohol drinking in risk of GC, and severe intestinal metaplasia (IM)/dysplasia, have been inconclusive. A total of 1273 subjects in a Chinese population were recruited, and genotyping was carried out using the competitive allele-specific PCR (KASP) method. Unconditional logistic regression was applied to model the associations between genetic polymorphisms and the disease risk. Effect modifications by H. pylori infection, smoking and alcohol drinking were evaluated. PSCA rs2294008/rs2976392 showed a significant, multiplicative interaction with H. pylori infection in risk of GC. Meanwhile, PRKAA1 rs13361707 had an additive interaction with H. pylori infection. SLC52A3 rs13042395 showed an interaction with alcohol drinking in risk of GC. Moreover, three SNPs, MUC1 rs4072037, ZBTB20 rs9841504 and PRKAA1 rs13361707, were associated with precancerous gastric lesions (severe IM/dysplasia). Our data suggest that genetic predisposition factors identified by GWAS may interact with environmental risk factors, Particularly for H. pylori infection and alcohol consumption, to increase the risk of GC.
Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Povo Asiático/genética , Predisposição Genética para Doença , Infecções por Helicobacter/complicações , Fumar/efeitos adversos , Neoplasias Gástricas/genética , Proteínas Quinases Ativadas por AMP/genética , Consumo de Bebidas Alcoólicas/genética , Antígenos de Neoplasias/genética , China , Feminino , Proteínas Ligadas por GPI/genética , Estudo de Associação Genômica Ampla , Infecções por Helicobacter/genética , Humanos , Modelos Logísticos , Masculino , Proteínas de Membrana Transportadoras/genética , Mucina-1/genética , Proteínas de Neoplasias/genética , Proteínas do Tecido Nervoso/genética , Fatores de Risco , Fumar/genética , Neoplasias Gástricas/etiologia , Fatores de Transcrição/genéticaRESUMO
In this paper, we analyze the transformer of X-ray high-voltage high-frequency generators and, have designed and implemented a high-voltage insulation testing system for its oil tank using full-bridge series resonant soft switching PFM DC-DC converter.
