Study Of Cancer Epidemic And Screening And Primary Hepatic Carcinoma Molecular Epidemiology In Urumqi Xinjiang

Objective:To investigate the epidemic features of cancer incidence and mortality in Urumqi in 2014,so as to provide a scientific evidence for cancer prevention and control.To investigate cancer high-risk rate,screening rate,detection rate in 2014 Urumqi city urban area and to provide the further evidence for cancer screening,early detection and treatment programs.To investigate the relationships between the AKT1,MDM2,STAT3,PTEN gene polymorphism and primary hepatic carcinoma.To establish and evaluate a quantitative method to analyze genomie DNA methylation level for ealy clinical diagnosis of hepatocellular carcinoma and discover the p16,SLIT2,SCARA5 and Runx3genes methylative level difference in blood of primary hepatic carcinoma.Methods:1)To investigate the malignant tumor incidence and mortality data based on medical institutions for cancer registration in 2014 Urumqi,to descript analysis include of incidence and morbidity stratified by gender,age group and cancer site.Combined with the data of Urumqi's population in 2014,The indexes including the crude incidence and mortality,age-specific incidence and mortality,age-standard incidence by Chinese population and by world population were calculated respectively.2)Epidemiological investigation and cancer risk evaluation were launched among 40⁶9 years old residents four districts in Urumqi city.People who were at high risk of lung cancer,liver cancer,upper digestive tract cancer,female breast cancer and colorectal cancer screening accordance with the principle of informed consent voluntarily.Cancer high risk rate,screening rate and the clinical detection rates were calculated.3)In case-control study,collected 101 cases primary hepatic carcinoma patients as case group,selected from primary hepatic carcinoma high-risk groups 81 cases as intra-control group,at the same time,collected 102 cases of healthy people as extra-control group.Through the self-made questionnaire of hepatic carcinoma epidemiological investigation to collect the medical records based on the questionnaire of urban cancer early detection cancer treated early project risk assessment and the questionnaire of adult chronic non-communicable disease and risk factors in China.SNaPshot was used to detect the gene polymorphism of STAT3rs193922716,rs193922717,rs193922721,rs113994138,rs113994139,rs587777647,rs587777648 and PTEN rs121909221,rs121909239,rs121909240.PCR-RFLP was used to detect the gene polymorphism of AKT1 rs1130214,rs3730358 and MDM2rs227974.4)In case-control study,collected 25 cases primary hepatic carcinoma patients as case group,selected from primary hepatic carcinoma high-risk groups 25 cases as intra-control group,at the same time,collected 25 cases of healthy people as extra-control group.Through the gene polymorphism questionnaire of hepatic carcinoma epidemiological investigation to collect the medical records.Pyrosequencing was used to detect the p16,SLIT2,SCARA5 and Runx3 gene methylation status.Results:1)2014 Urumqi tumor registration investigation of 729212 people,1651 new diagnosed cancer cases and 673death cases were investigated cases,The crude incidence of cancer in urumqi city was226.41/10⁵ in 2014,and the age-standard incidence by Chinese population and by world population were 150.55/10⁵ and 145.20/10⁵ respectively.In addition,the mortality of cancer was 92.29/10⁵ and the age-standard mortality by Chinese population and by world population were 54.58/10⁵ and 53.77/10⁵ respectively.Male cancer overall mortality rate was higher than female?x²=19.06,P=0.00?,the overall incidence rate was lower than female?x²=1.26,P=1.26?.Male lung cancer?including the trachea,bronchi?,the incidence of gastric cancer,liver cancer were higher than female,differences were statistically significant?P=0.00?.The most common cancers were lung cancer?including the trachea,bronchi?,thyroid cancer,breast cancer,prostate cancer,colorectal cancer,gastric cancer,cervical cancer,liver,kidney and urinary tract cancer,brain and nervous system cancer,which accounted for 72.44%of all cancer cases.Lung cancer?including the trachea,bronchi?,liver cancer,gastric cancer,colorectal cancer,gallbladder,prostate cancer,pancreatic cancer,leukemia,breast cancer,esophageal cancer accounted for75.49%of all cancer deaths.lung?including trachea,bronchi?and liver cancer mortality in male than women,the difference was statistically significant?P=0.00?.The digestive and respiratory organs were the main system of incidence and death tumor.New cases of children cancer 0⁴ years old young group was a high incidence of cancer of age children in Urumqi city.2)A total of 49574 residents finished valid questionnaires and risk assessment.Cancer high risk rate of lung cancer,liver cancer,upper digestive tract cancer,female breast cancer and colorectal cancer were 13.25%,12.03%,20.38%,18.36%,14.21%respectively.Five highest risk rate of upper digestive tract cancer,cancer of various differences between cancer risk had a statistical meaning?x²=1785,P=0.00?.The rates of people who encountered Single,couple,three,four and five types of cancer high risk were 26.86%,9.68%,4.50%,9.68%and 4.50%respectively.Screening rate for the five types of cancer were 37.36%for lung cancer,41.27%for liver cancer,19.82%for upper digestive tract cancer,45.53%for foremale breast cancer,16.61%for colorectal cancer.Lung cancer or suspected lung cancer detection rate was0.49%,the suspected liver cancer detection rate was 0.12%,the upper digestive tract cancer detection rate was 0.15%,breast screening BI-RADS Grade 4⁵ detection rate of female breast cancer was 2.27%.Colorectal cancer detection rate was 0.17%.3)There were no significant differences of gender,nationality,age distribution.Cultural degree,marital status,occupational exposure history,per capita income,ever suffered from second liver,fatty liver,presence of liver cancer and liver cirrhosis,diabetes and family history of primary hepatic carcinoma had exist differences in gene polymorphism three groups.STAT3 and PTEN each genotype and allele distribution difference between three groups were no statistically significant difference.The difference was statistically significant in rs1130214,rs3730358,rs2279744 each genotype and allele distribution difference between three groups respectively?P<0.05?.By gene mutation as dependent variable,Logistic regression showed that the person who was primary hepatic carcinoma and primary hepatic carcinoma high-risk groups were more likely to mutate in rs1130214of AKT1 gene?OR=1.91,95%CI:1.25².91?,the same with male?OR=2.70,95%CI:1.66⁵.00??OR=2.70,95%CI:1.66⁵.00?.4)There were no significant differences of gender,nationality,age distribution.Occupational exposure history,percapita income,AFP?+?,HBsAg?+?,presence of liver cancer and liver cirrhosis,family history of primary hepatic carcinoma and meat,bean products,smoked fried food intake frequency,taste preference had exist differences in three groups,the differences were statistically significant.The 7 CpG loci of p16 gene methylation level was low,there was no statistically significant difference?P>0.05?.The CpG3 and CpG4 of SLIT2 gene loci methylation level case group was higher than in the intra-control group and extra-control group,but there was no statistically significant difference?P>0.05?.The CpG2 loci of SCARA5 gene methylation rate in three groups were 14.00�1.51%,11.35�1.92%,12.13�2.17%,difference was statistically significant?x²=11.962,P=0.00?.The CpG1,CpG2,CpG3,CpG4,CpG5 and CpG8 of Runx3 gene loci,methylation rate were 97.20�1.58%,96.00�1.89%,96.24�1.23?x²=3.975,P=0.023?;96.96�2.34%,97.20�2.45%,94.00�2.21%?x²=14.189,P=0.000?;90.76�1.16%,89.20�2.69%,88.28�1.54%?x²=10.733,P=0.000?;91.80�1.35%,90.52�2.55%,90.02�1.22%?x²=5.462,P=0.006?;82.56�1.53%,79.12�3.09%,80.02�1.12%?x²=17.697,P=0.000?;90.44�1.26%,88.68�2.84%,89.04�1.21%?x²=5.838,P=0.004?respectively.There was no statistically significant difference between CpG island methylation of Runx3 and SCARA5 gene with age,sex,hepatitis b,liver cirrhosis,AFP,HBsAg and other clinical data.Conclusion:The incidence and mortality of cancer in Urumqi near approached to national and global level.Some comprehensive measures should be strengthened to prevent and control for cancer in Urumqi.Technical soluation and program management should be improved to enhance the effect of cancer screening early detection and early treatment programs.Rs1130214 of AKT1 gene polymorphism had a certain relationship with the occurrence of primary hepatic carcinoma;Male,liver cancer and liver cancer patients with high-risk groups were the influence factors of rs1130214 AKT1 gene locus mutation.SCARA5 and Runx3 gene in hepatocellular carcinoma patients with abnormal methylation express degree,could be used as molecular markers of early auxiliary diagnosis of liver cancer.