Oncology Frontier: You have also discussed the non-cirrhotic patient here at the meeting. Thirty percent of study participants were of Asian descent. What is the significance of that?

　　《肿瘤瞭望》：在您刚才的讲座中，您谈及非肝硬化患者，在您所介绍的那项试验研究中，30%的受试者是亚裔，亚裔患者对研究很重要吗？

　　Dr Kim: That was probably not good for the purposes of the study because globally the majority of hepatitis B patients are Asian. People are looking for data that is applicable to their own populations， so in that regard， arguably the tenofovir study may not have been completely representative of the worldwide hepatitis B picture. In that study and other studies， there is little question that the Asian population is at a higher risk of developing HCC controlling for all of the other factors. Whether that is due to genetics or environmental exposures such as aflatoxin that impact on liver cancer， we are not sure. But certainly there are many data sets where Asian populations are shown to be at higher risk of HCC than others.

　　Kim博士：全球大部分乙型肝炎患者是亚洲人，因此亟需亚洲患者相关的数据。从这方面来说，抗HBV药物替诺福韦的研究结果不具有全球代表性。替诺福韦研究和其它数据资源都显示，即使对其他风险因素进行控制，亚洲人的HCC发病率还是比其他种族高许多，目前还不能确定是不是遗传和环境因素（如黄曲霉毒素）的影响。

　　Oncology Frontier: You said it was more of a challenge to control HCC in the non-cirrhotic patient. Why would that be the case?

　　《肿瘤瞭望》：为何您认为非肝硬化所致HCC的治疗更困难。

　　Dr Kim: It is paradoxical to think that it is easier to control cirrhosis. I say that because we are taught that cirrhosis is irreversible， but we are learning more and more that cirrhosis is reversible at least in patients with viral hepatitis. By reversing cirrhosis and eliminating the underlying huge risk factor for HCC， you can make a substantial impact in cirrhotic patients. With non-cirrhotic patients， we don’t have the big factor driving HCC that is cirrhosis. We are concerned with other factors like the viral influence on the genetic mechanisms of the host and at what point of the carcinogenesis that is virally induced， can you turn off the virus and expect the process to stop. I don’t have an answer to that question. But my data and some of the other data suggest that it can happen and it may happen in as much as 50% of patients.

　　Kim博士：过去人们认为肝硬化不可逆转，可是目前研究发现肝硬化是可逆的，至少病毒性肝炎患者的肝硬化可逆转，因此可以通过逆转肝硬化来预防HCC。那么，还有一小部分HBV诱发的癌症没有肝硬化这个过程，没有肝硬化的HBV患者如何预防肝癌？这时需要考虑其他因素，如病毒如何影响宿主的遗传机制？HBV病毒引发癌变的截点？能否关闭病毒以停止癌变进程？数据显示50%的患者可以实现这个目标。