Newsletter No. 355

No. 355, 4.4.2010 NEWS & EVENTS 嶄新指數評估乙肝病者患癌風險 Score to Predict Future Risk of Liver Cancer • 腫 瘤學系與內科及藥物治療學系耗時十年，共同設 計了一套運算簡易的肝癌風險指數，評估慢性乙型 肝炎病者的患癌風險，以便優先為高風險病人治療。 全港約有五十萬慢性乙型肝炎患者，當中近四分一會因肝 癌或肝硬化等併發症而病故。醫學界建議患者每六至十二 個月進行一次肝癌普查。如有需要，醫生可利用持續抗病 毒藥物抑制乙肝病毒，減低患癌風險。由於大部分患者須 接受長期抗病毒藥物治療及定期肝癌普查，為本港醫療界 及病人帶來沉重的經濟負擔。 有見及此，腫瘤學系與內科及藥物治療學系決意研發一 套簡單廉宜的評估方法，其研究始於1997年，共招募了兩 組人士。第一組為一千零五名慢性乙肝患者，研究人員跟 進他們的病情，發現了五項最重要的肝癌因素，分別為年 齡、白蛋白數量、膽紅素數量、乙肝病毒數量及肝臟有否 硬化。研究人員利用這五項因素，設計出肝癌風險指數， 分成高中低三個風險組別。 研究人員其後運用以上指數，為第二組共四百二十四名慢 性乙肝患者評估風險，再觀察不同風險組別的患癌比例， 以測試該指數的準確性。經計算後，第二組有70%患者屬 低風險，而中及高風險的則各有15%。經過十年的觀察，中 及高風險的患者分別有29%及32.3%患上肝癌，而低風險 組別的則只有2.9%，可見中及高風險患者的患癌機會明顯 較高。 因此，中大建議利用肝癌風險指數為所有慢性乙肝患者評 估，以便選擇合適療法。低風險患者則可先觀察病情，並 於一至兩年後再以指數計算風險級別。 T he Department of Clinical Oncology and Department of Medicine and Therapeutics have jointly developed and validated a simple score to predict the risk of liver cancer in patients with chronic Hepatitis B by conducting a 10-year study. This new score can identify and prioritize high risk patients for regular liver cancer surveillance and anti-viral treatment. Around 500,000 people in Hong Kong suffer from chronic Hepatitis B, and 25% eventually die of liver cancer or cirrhotic complications. Testing every six to 12 months is recommended for early detection. Anti-viral treatment that suppresses the Hepatitis B virus can reduce the risk of liver cancer. However, most patients require long-term anti-viral treatment. The large number of patients in the community has imposed a heavy burden on resources for cancer screening and Hepatitis treatment. With the aim of developing a tool for the accurate assessment of cancer risk, the two departments initiated a study in 1997. Two cohorts were recruited. In the first cohort, risk factors of liver cancer were evaluated in 1,005 patients. Age, albumin, bilirubin, Hepatitis B viral load and cirrhosis status were found to be the most important factors associated with future liver cancer development. The accuracy of the prediction score was subsequently validated in the second cohort of 424 patients. The risk score of each patient was calculated and the proportion of patients in each risk group who developed liver cancer was studied. Seventy per cent of the patients were classified in the low risk group and 15% each in the medium and high risk groups. After a 10-year observation, 29% and 32.3% of patients in the medium and high risk groups developed liver cancer, compared to only 2.9% in the low risk group. The results clearly demonstrated high liver cancer risk in patients with medium and high risk. According to the results, if the risk level of a patient is known, he/she may select the most appropriate treatment plan earlier. Patients with low cancer risk can be observed with monitoring of the prediction score every one to two years. （左起）腫瘤學系陳林教授及莫樹錦教授與內科及藥物治療學系陳力元教授和黃煒燊教授 (From left) Prof. Chan Lam Stephen and Prof. Mok Shu-kam Tony of the Department of Clinical Oncology, and Prof. Chan Lik-yuen Henry and Prof. Wong Wai-sun Vincent of the Department of Medicine and Therapeutics 濟世為懷的羅德學人 Fresh Rhodes Specializes in Curing and Caring • 去 年畢業的聯合書院醫科生鄭華哲，在來自本地院 校四十多名精英中脫穎而出，獲選本屆港區羅德學 人。他是香港自有羅德獎學金二十多年以來，第十三位中大 培育的羅德學人，也是本港首位醫科生膺此榮譽。 鄭華哲的父親是傳道人，母親是護士，在他們的薰陶下， 加上信仰基督教的影響，自小矢志行醫助人。他表示：「只 要見到病人的病情有所改善，我便覺得一切努力和艱辛都 是值得的。」 華哲不但學業成績傑出，獲多項校內獎譽，亦把握每一機 會，服務社會。在學時他曾擔任威爾斯親王醫院兒童服務 小組的隊長，先後往內蒙古自治區的中學義教英語，參加 雲南的援助工程，以及往肯亞裂谷一所小型醫院照顧病 人。華哲坦言這些經驗「讓我體會人的能力有限，然而，當 看見有那麼多人活在困苦中，又怎能視而不見，不加以援 手？那管是小小的幫助，只要令他們的生活有所改善，也 應去做。」 醫學以外，他探索的世界廣闊無邊。乘着到美國威廉士大 學當交換生的機會，他便選修了英國文學、政治學、藝術 和雕刻，又加入划艇隊，不斷多方嘗試，開拓潛能。這樣下 來，不但擴展了視野，更留意到不同文化的特質，也鍛練了 強健的體魄。 現時在醫院實習的華哲將於10月啟程，負笈牛津大學修讀 全日制研究生課程，參與癌症研究工作。他計劃學成後， 回港行醫。 M r. Timothy Cheng, a 2009 medical graduate of United College, has beaten some 40 outstanding students from local universities to become this year’s Hong Kong Rhodes Scholar. He is the 13th Rhodes Scholar from CUHK since the scholarship was introduced to Hong Kong more than two decades ago, and the first medical student in Hong Kong to be given this honour. Born of a missionary father and a mother who was a nurse, Timothy was brought up in a Christian environment and from a tender age aspired to serving and curing people. He said, ‘It is always most rewarding to see patients getting better everyday.’ Timothy has not only earned numerous awards and scholarships during his studies at CUHK, but also seized opportunities to serve the community. He was the service leader of the Prince of Wales Hospital Children’s Service. He took a service trip to Inner Mongolia to teach local secondary school teachers English, did voluntary work in Yunnan, and went to Kenya for a medical elective where he served in a small hospital in the Rift Valley region. Timothy said, ‘Such experience taught me about human limitations but at the same time, I was deeply moved when so much suffering happened before my eyes. Even though I know what I can change is minuscule, I still have to do something for the unfortunate.’ Unlike many medical students, Timothy’s world was not limited to anatomy and pathology. While on exchange at Williams College in the US, he expanded his horizon by taking courses in English literature, political science, fine arts and sculpture, and joining the rowing team. That way he sharpened his cultural sensitivities and strengthened his muscles. Timothy is presently doing his internship at a hospital and plans to go to Oxford in October to begin a research degree in the medical sciences and participate in cancer research. He has his eyes on a medical career in Hong Kong after Oxford, to continue his trajectory of caring and serving.