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Tsung-Ming Chen

Publications and source records attributed to Tsung-Ming Chen.

At least 19 recordsLinked to original sources

Microsatellite in the 3' untranslated region of human fibroblast growth factor 9 (FGF9) gene exhibits pleiotropic effect on modulating FGF9 protein expression.

Fibroblast growth factor 9 (FGF9) is a member of secreted polypeptide families and involved in many important biological processes, including implantation and morphogenesis during embryogenesis and adult life. Recently, Fgf9-knockout mice exhibited male-to-female sex reversal, demonstrating a novel function for FGF9 in testicular development. We hypothesized that FGF9 is involved in sex development at an early embryonic stage in humans. In this study, we systematically screened sequences of the FGF9 gene in 21 XY females and 72 XX females and XY males to examine whether sequence variants of the FGF9 gene play a pathophysiological role on human gonadal dysgenesis. No mutation was identified, but a single nucleotide variant and two microsatellites were found. The allelic distribution of polymorphic microsatellite in the 3'-UTR of FGF9 between patients and controls was slightly different with Bonferroni correction (P=0.06). We further applied reporter gene system and quantitative RT-PCR to study the function of this microsatellite motif and results demonstrated that the (TG)(n) motif modulated gene expression at both pre- and post-transcriptional levels. The (TG)(14) allele, which showed a potential association with male-to-female sex reversal (odds ratio=6.08, 95% confidence interval=1.39-26.63), displayed the strongest promoter activity and longest mRNA stability. These data demonstrated that 3'-UTR microsatellite of the FGF9 is a functional polymorphism that plays dual roles in regulating FGF9 expression. Although our preliminary result suggested a possible association between FGF9 and human gonadal dysgenesis, the major limitation of small dataset in this study points out the requirement for further investigation.

3' Untranslated Regions↗

Thrombocytopenia as a surrogate for cirrhosis and a marker for the identification of patients at high-risk for hepatocellular carcinoma.

BACKGROUND: The objective of this study was to examine the usefulness of platelet counts in the diagnosis of cirrhosis and for identifying high-risk individuals in a community-based hepatocellular carcinoma (HCC) screening program. METHODS: Pilot Study 1 determined the correlation between platelet counts and pathologic hepatic fibrosis scores among individuals with chronic hepatitis B virus (HBV) infection (n = 122 patients) and hepatitis C virus (HCV) infection (n = 244 patients). Pilot Study 2 investigated proportions of individuals with thrombocytopenia (<150 x 10(3)/mm(3)) among patients with HCC (n = 4042 patients). Pilot Study 3 demonstrated the correlation between platelet counts and ultrasonographic (US) parenchyma scores among anti-HCV-positive individuals (n = 75 patients). The core study was a 2-stage, community-based screening for HCC among residents age 40 years or older in townships with a high prevalence of anti-HCV (n = 4616 individuals) and in townships with a low prevalence of anti-HCV (n = 1694 individuals). Patients with thrombocytopenia were identified for US and alpha-fetoprotein screening. RESULTS: Among the individuals who were positive for anti-HCV, platelet counts decreased according to increased pathologic fibrosis scores or US scores for liver parenchyma disease: The best cutoff platelet count was 150 x 10(3)/mm(3) for a diagnosis of cirrhosis. The sensitivity and specificity were 68.2% and 76.4%, respectively, for pathologic cirrhosis and 76.2% and 87.8%, respectively, for US cirrhosis. Forty-eight percent of patients with HCC were thrombocytopenic. The proportion of thrombocytopenia was significantly greater in patients with HCV-related HCC (63%) than in patients with HBV-related HCC (42%). In the townships with high and low anti-HCV prevalence, the prevalence of thrombocytopenia was 17.9% and 6.1%, respectively, (P < .001), respectively. Twenty-five patients were diagnosed with HCC, and all of those patients resided in the high-prevalence township. CONCLUSIONS: Thrombocytopenia was a valid surrogate of cirrhosis and a valid marker for the identification of individuals at high-risk for HCC, especially in areas that had a high prevalence of HCV.

Adult↗

Prostaglandin E2 induces fibroblast growth factor 9 via EP3-dependent protein kinase Cdelta and Elk-1 signaling.

Fibroblast growth factor 9 (FGF-9) is a potent mitogen that controls the proper development of many tissues and organs. In contrast, aberrant expression of FGF-9 also results in the evolution of many human diseases, such as cancers and endometriosis. Despite its vital function being reported, the cellular and molecular mechanisms responsible for the regulation of FGF-9 expression are mostly unknown. We report here that prostaglandin E2 (PGE2) induces expression of FGF-9, which promotes endometriotic stromal cell proliferation, through the EP3 receptor-activated protein kinase Cdelta (PKCdelta) signaling pathway. Activation of PKCdelta leads to phosphorylation of ERK1/2, and the transcription factor Elk-1 thereby promotes transcription of FGF-9. Two Elk-1 cis-binding sites located at nucleotides -1324 to -1329 and -1046 to -1051 of the human FGF-9 promoter are identified as crucial for mediating PGE2 actions. Collectively, we demonstrate, for the first time, that PGE2 can directly induce FGF-9 expression via a novel signaling pathway involving EP3, PKCdelta, and a member of the ETS domain-containing transcription factor superfamily in primary human endometriotic stromal cells. Our findings may also provide a molecular framework for considering roles for PGE2 in FGF-9-related embryonic development and/or human diseases.

Cell Proliferation↗

Sarcomatoid carcinoma of the parotid gland with apparent metastasis of epidermoid elements to cervical lymph nodes.

A case of sarcomatoid carcinoma of the parotid gland is described in a 47-year-old male. Despite radical surgery and postoperative chemoradiation therapy, a distant metastasis occurred 1 month after treatment. The primary site was composed of well-differentiated squamous cell carcinoma intermingled with spindle-shaped malignant mesenchymal cells. Immunohistochemical studies showed that keratin was present in both epithelial cells and spindle cells, whereas vimentin was present in spindle cells and absent in epithelial cells. Two lymph nodes were metastasized by the epidermoid component. The origin of the sarcomatoid component and the differential diagnosis from malignant mixed tumours are discussed.

Biopsy, Needle↗

Nasopharyngeal carcinoma with cranial nerve palsy: the importance of MRI for radiotherapy.

PURPOSE: To evaluate various prognostic factors and the impact of imaging modalities on tumor control in patients with nasopharyngeal cancer (NPC) with cranial nerve (CN) palsy. MATERIAL AND METHODS: Between September 1979 and December 2000, 330 NPC patients with CN palsy received radical radiotherapy (RT) by the conventional opposing technique at Chang Gung Memorial Hospital-Linkou. Imaging methods used varied over that period, and included conventional tomography (Tm) for 47 patients, computerized tomography (CT) for 195 patients, and magnetic resonance image (MRI) for 88 patients. Upper CN (II-VI) palsy was found in 268 patients, lower CN (IX-XII) in 13, and 49 patients had both. The most commonly involved CN were V or VI or both (23%, 12%, and 16%, respectively). All patients had good performance status (World Health Organization <2). The median external RT dose was 70.2 Gy (range, 63-77.5 Gy). Brachytherapy was also given to 156 patients in addition to external RT, delivered by the remote after-loading, high-dose-rate technique. A total of 139 patients received cisplatin-based chemotherapy, in 115 received as neoadjuvant or adjuvant chemotherapy and in 24 concomitant with RT. Recovery from CN palsy occurred in 171 patients during or after radiotherapy. Patients who died without a specific cause identified were regarded as having died with persistent disease. RESULTS: The 3-year, 5-year, and 10-year overall survival was 47.1%, 34.4%, and 22.2%. The 3-year, 5-year, and 10-year disease-specific survival (DSS) rates were 50.4%, 37.8%, and 25.9%. The 5-year DSS for patients staged with MRI, CT, and Tm were 46.9%, 36.7%, and 21.9%, respectively (p = 0.016). The difference between MRI and CT was significant (p = 0.015). The 3-year and 5-year local control rates were 62% and 53%, respectively. The 5-year local control was 68.2% if excluding patients who died without a specific cause. Patients who had an MRI had a significantly better tumor control rate than those evaluated with CT or Tm, with a 15-30% improvement in local tumor control and survival. Patients with extensive CN palsy had worse survival than those with only lower CN or upper CN involvement (5-year DSS 20.4% vs. 43.2% and 40.4%, respectively; p < 0.001). Patients who recovered from CN palsy had better survival than those who did not (47% vs. 26%, p < 0.001). Brachytherapy was associated with poorer local control, whereas a total external dose of more than 70 Gy improved local tumor control and marginally improved DSS. Subgroup analysis in CT and MRI patients group, either DSS or OS was significantly associated with imaging modality, N stage, or location of or remission of CN palsy. CONCLUSION: The use of MRI was associated with improved tumor control and survival of patients with NPC causing CN palsy. Patients recovering from CN palsy had better survival. A higher radiation dose delivered by external beam may achieve better tumor control than brachytherapy.

Adolescent↗

Hepatitis B virus infection in adolescents in a rural township--15 years subsequent to mass hepatitis B vaccination in Taiwan.

In Taiwan, decrease of both infection and carrier rates of hepatitis B virus (HBV) have been documented especially in metropolitan areas after universal HBV vaccination. This study investigated HBV infection status in a rural township 15 years after the program began. Three cross-sectional studies were conducted in 1999, 2000 and 2003, to recruit all the students of the only junior middle school, born from July 1984 to June 1991, in a township in central Taiwan. Serum samples were tested for HBsAg, anti-HBs and anti-HBc. Subjects identified to be neither positive for HBsAg nor anti-HBs were given a booster dose of HBV vaccine. Subjects lacking an anamnestic anti-HBs response were given a complete 3-dose vaccination. A total of 1454 (98.5%) students responded. The prevalence rate of HBsAg decreased 57% [from 12.5% in 1984 to 5.4% in 1991, P < 0.005 (chi2-test for linear trends)], and anti-HBc positive rate dropped 68% (from 31.9 to 10.2%, P < 0.001). An anamnestic anti-HBs response developed after a vaccine booster among 433 (72%) anti-HBs negative and 12 (66.7%) anti-HBc alone subjects. And 93 (94.9%) anti-HBs negative and 1 (16.7%) anti-HBc alone subject developed a primary anti-HBs response after catch-up vaccination. Viremia was detected for two anti-HBc alone subjects without anamnestic or primary response. The vaccination program has decreased the number of those infected and carrier rates in either urban or rural areas in Taiwan. However, the prevalence of HBsAg and anti-HBc in rural area were much higher than urban area.

Adolescent↗

Nasopharyngeal carcinoma staging by (18)F-fluorodeoxyglucose positron emission tomography.

PURPOSE: Nasopharyngeal carcinoma (NPC) has a high rate of neck lymph node and/or distant metastasis. We evaluated the value of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) in staging NPC, especially in the detection of distant metastasis. METHODS AND MATERIALS: A total of 95 patients, including 85 with primary and 10 with recurrent, NPC were enrolled. Dual-phase FDG-PET was used, in addition to the conventional workup. Eighty-one patients without distant metastases underwent repeat studies 3-4 months after initial radical treatment. RESULTS: Of 14 patients with distant metastases, all had lesions detected by FDG-PET, and the conventional workup detected the metastases in only 4. Two patients had false-positive MRI findings for neck node metastasis, but the FDG-PET findings were accurate. Four patients without distant metastases on their initial workup were found to have new lesions on FDG-PET 3-4 months after initial treatment. Patients with advanced node disease had a significantly greater incidence of distant metastases on FDG-PET, especially for N3 disease. Of the 95 patients, the FDG-PET results for distant metastasis were true positive in 14 patients, false positive in 8, and true negative in 73. None of our patients had a false-negative result. For a patient base, the sensitivity and specificity of FDG-PET for distant metastasis was 100% and 90.1% (95% confidence interval 81.5-95.6%), respectively, in this study. The accuracy was 91.6% (95% confidence interval 84.1-96.3%), the positive predictive value was 63.6 (95% confidence interval 40.7-82.8%), and the negative predictive value was 100%. CONCLUSION: FDG-PET stages N and M disease of NPC more accurately and sensitively than does the conventional workup. Patients with advanced node disease, particularly N3 disease, would benefit the most from FDG-PET.

Adolescent↗

Extrathyroid carcinoma showing thymus-like differentiation (CASTLE) tumor--a new case report and review of literature.

BACKGROUND: We report a case of extrathyroid carcinoma showing thymus-like differentiation (CASTLE) tumor. METHODS: A 47-year-old man had a left neck mass that gradually enlarged over approximately 3 months. Sonography and CT scans showed a soft tissue mass located at the left parapharyngeal space with displacement of left carotid artery and submandibular gland. RESULTS: After total excision, the pathologic diagnosis was CASTLE tumor. The patient then received radiotherapy with a total dosage of 6600 cGy. After 21 months of postoperative follow up, there was no evidence of recurrence. CONCLUSION: Generally, the treatment of choice is surgical excision with or without radiotherapy. Because CASTLE tumors have been reported to be radiosensitive, however, and because local recurrence is common, surgical excision with postoperative radiotherapy is suggested.

CD5 Antigens↗

Staging of untreated squamous cell carcinoma of buccal mucosa with 18F-FDG PET: comparison with head and neck CT/MRI and histopathology.

UNLABELLED: This prospective, nonrandomized, case-control study evaluated the impact of (18)F-FDG PET in staging untreated squamous cell carcinoma of the buccal mucosa (BSCC) and compared the results with CT/MRI and histopathology. METHODS: Between January 2002 and April 2004, 102 untreated BSCC patients with cM0 (no evidence of distant metastatic focus on chest radiograph, liver ultrasonograph, and bone scan) were enrolled with either conventional work-up (CWU, n = 51) or PET (CWU+PET, n = 51). All were monitored for at least 6 mo. The comparative diagnostic efficacies of PET and CT/MRI were evaluated using the area under the receiver-operating-characteristic curve (AUC). The primary endpoint was the percentage reduction in futile surgery (preoperative detection of distant metastatic lesions). The secondary endpoint was the 2-y cumulative recurrence rate among study participants (with PET) compared with that of comparable control subjects (without PET). RESULTS: Significant benefits of PET compared with those of CT/MRI for BSCC patients were in the detection of locoregional (AUC, 0.973 vs. 0.928; P = 0.026), regional (AUC, 0.939 vs. 0.837; P = 0.026), and level II (AUC, 0.974 vs. 0.717; P = 0.02) lymph nodes. Two percent (1/51) of the patients experienced a reduction in futile surgery in the CWU+PET group compared with 0% (0/51) in the CWU group. However, no statistical difference was found in the 2-y locoregional control rate between the CWU and the CWU+PET groups. CONCLUSION: The role of (18)F-FDG PET for BSCC with cM0 is limited. Although PET is superior to CT/MRI in identifying cervical nodal metastases, it does not improve locoregional recurrence.

Adult↗

Migrating fish bone complicating a deep neck abscess.

Deep neck infections are not uncommon; however, a migrating fish bone is seldom a cause of a deep neck abscess. Fish bones are a sharp foreign body and can penetrate the oropharynx or esophagus. However, this rarely occurs. We report a case of deep neck abscess resulting from the intracorporeal migration of a fish bone. Initial radiography and esophagoscopy of the neck were both negative; migration of the bone was ultimately documented by computed tomography. Surgical exploration was performed via a lateral neck incision, and the fish bone was successfully retrieved. Although fish bones are a rare etiology of deep neck abscesses, should be kept in mind when a patient has the history of fish bone ingestion.

Abscess↗

Telomerase as an independent prognostic factor in head and neck squamous cell carcinoma.

BACKGROUND: Telomerase activity has been found to be associated with many cancers, including head and neck squamous cell carcinoma (HNSCC). We examined the association of telomerase activity with the clinical outcome of patients with HNSCC. METHODS: A PCR-based enzyme immunoassay method was used to measure telomerase activity in 217 matched (grossly normal and cancerous) tissues from patients with HNSCC. Pearson chi-square test was used to analyze the correlation of telomerase activity with clinicopathologic parameters. Kaplan-Meier method and Cox logistic regression model were used for prognostic analysis. RESULTS: Of the 217 tissues assayed, 4.1% of the normal and 63.3% of the cancer tissues had high levels of telomerase activity. Telomerase activity was shown to be statistically correlated with extracapsule spreading (ECS) of lymph nodes (p =.005) and overall survival (p =.003). On multivariant analysis, overall stage (p =.007), tumor depth (p =.045), and telomerase activity (p =.008) showed independent variables associated with poor survival. CONCLUSIONS: Telomerase activity has been shown to be an independent prognostic factor for survival in cases of HNSCC. Telomerase may be a potential molecular target for clinical use in prognostication and therapy in cases of the disease.

Adult↗

Molecular epidemiological and clinical aspects of hepatitis D virus in a unique triple hepatitis viruses (B, C, D) endemic community in Taiwan.

The molecular epidemiological and clinical aspects of hepatitis D virus (HDV) in a unique HBV, HCV, and HDV triple virus endemic community in southern Taiwan were investigated. A total of 2,909 residents aged 45 or older were screened for hepatitis B surface antigen (HBsAg), anti-HCV antibody, and anti-HDV antibody (specifically for HBsAg-positive carriers). Factors that might be associated with HDV infection, viral nucleic acid detection, and genotyping of HBV, HCV, and HDV were investigated. The prevalence of HBsAg and anti-HCV were 12.6% (366/2,909) and 41.6% (1,227/2,909), respectively. For HBsAg carriers, 15.3% (56/366) were positive for anti-HDV assay. Living in a higher endemic district of HCV infection (odds ratio [OR] = 3.2; 95% confidence interval [CI] = 1.7-6.3), male gender (OR = 1.9; 95% CI = 1.1-3.6) and co-infection with HCV (OR = 1.8; 95% CI = 1.0-3.3) were significantly independent factors associated with HDV infection. The detection rate of HDV RNA among anti-HDV-positive patients was only 12.7% (7/55). The mean HBV titer of triple infection group was significantly lower than in the HBV/HDV co-infection group (2.23 vs 3.05 in log(10), copies/ml, P = 0.046). HCV RNA detection among the triple infection group showed 47.4% (9/19) viremia rate and viral loads of 579,121 IU/ml in median (16,803-1,551,190 IU/ml). The prevalent genotype of HBV was type B (23/25); HCV was 1b (7/9) and HDV was IIa/IIb (4/4). Only the presence of HCV RNA predicted the presence of elevated ALT significantly (OR = 25.0; 95% CI = 3.39-184.6). In conclusion, the geographical aggregation of HDV infection paralleled that of HCV infection in this community. HCV suppressed the replication of HBV among triple vital infection patients. HBV and HDV lapsed into a remission or nonreplicative phase in most cases, and HCV acted as a dominant factor in triple viral-infected individuals. Only the presence of HCV RNA was associated with elevated ALT values, but not HBV or HDV.

Female↗

Correlation between ultrasonographic and pathologic diagnoses of hepatitis B and C virus-related cirrhosis.

UNLABELLED: BACKGROUND. We aimed to evaluate the validity of ultrasonography (US) in the diagnosis of cirrhosis in patients with chronic hepatitis B virus (HBV) or C virus (HCV) infection. METHODS: A total of 210 patients, 67 with chronic HBV and 143 with HCV infection, were evaluated for the cirrhotic status of liver by both needle biopsy and US. According to the pathological findings, a fibrosis score 4 on the histology activity index was the gold standard for the diagnosis of cirrhosis. A US scoring system consisting of liver surface, parenchyma, vascular structure, and splenic size was used to describe the severity of hepatic parenchymal damage. RESULTS: Cirrhosis was found in 27 (40%) of the 67 HBV patients and in 51 (36%) of the 143 HCV patients pathologically. The mean fibrosis scores were 0.95, 1.24, 2.35, 2.95, 3.8 and 3.7 in patients with US scores of 4, 5, 6, 7, 8, and 9 or more, respectively. The US scores were significantly correlated with the hepatic fibrosis scores (P < 0.05). Based on the receiver operating characteristic (ROC) curve, a US score of 7 was the best cutoff point for the prediction of HBV-related cirrhosis, with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 77.8%, 92.5%, 87.5%, 86.0%, and 86.6%, respectively. In HCV-related cirrhosis, a US score of 6 provided results of 82.4%, 70.7%, 60.9%, 87.8%, and 74.8%, respectively. The specificity, positive predictive value, and accuracy were significantly higher in patients with HBV than in those with HCV infection (P = 0.012, P = 0.032, and P= 0.079, respectively). CONCLUSIONS: Cirrhosis can be predicted well by US, especially in patients with HBV infection.

Adolescent↗

Surgical treatment of oral verrucous carcinoma.

BACKGROUND: The aim of this study was to evaluate the outcome of patients with Verrucous carcinoma (VC) of oral cavity treated at the Chung Gung Memory Hospital with respect to the tumor control rates after surgery, the risk of lymph node metastasis and the role of radiation therapy. METHODS: Thirty-eight patients underwent primary treatment for VC of the oral cavity from January 1996 through February 2002. All of the patients had surgery as their primary treatment. In addition, all patients with sufficient details of the therapy and a minimum 1-year follow-up were selected for evaluation of survival and outcomes. RESULTS: In this study, 94.7% of patients were male and most of them had been exposed to betel nuts, cigarettes, and/or alcohol. The most common site was the buccal mucosa (57.9%), followed by the tongue (13.2%). T3 lesions were the most common type (34.2%). Only two patients had palpable cervical adenopathy during the initial evaluation. Twenty-five patients had free flap for reconstruction. The tumor control rate was 100%. At the time of analysis, no patient had suffered from recurrence in primary site or neck area. CONCLUSION: Surgical excision alone was effective for controlling VC, but elective neck dissection was not necessary even in patients in the advanced stages.

Adult↗

Durability of lamivudine-induced HBeAg seroconversion for chronic hepatitis B patients with acute exacerbation.

BACKGROUND/AIMS: Lamivudine-induced hepatitis B e antigen (HBeAg) seroconversion in patients with chronic hepatitis B was reported to be durable by several studies but controversy still exists. The aim of this study was to evaluate the durability of the responses of lamivudine treatment. METHODS: Among 53 chronic hepatitis B patients who had acute exacerbation and had finished lamivudine therapy after at least 6 months of treatment, 31 patients achieved full HBeAg seroconversion twice at least 1 month apart, and subsequently stopped lamivudine therapy. Post-treatment monitoring was continued for up to 87 weeks. Alanine transaminase (ALT), HBeAg and hepatitis B virus (HBV) DNA were used as indicators for relapse. RESULTS: The cumulative relapse rates at 48 and 72 weeks post-treatment were 45.4% and 56.3%, respectively. During follow up, normal ALT levels precluded relapse while ALT levels over two times the upper limit of normal indicated relapse, which correlated well with HBeAg or HBV DNA reappearance. Patients older than 25 years were more likely to experience post-treatment relapse. CONCLUSIONS: Lamivudine-induced full HBeAg seroconversion was not durable in the Taiwanese population. ALT levels were useful for relapse detection. Age was the only independent predictive factor for relapse.

Acute Disease↗

Is delayed normalization of alanine aminotransferase a poor prognostic predictor in chronic hepatitis C patients treated with a combined interferon and ribavirin therapy?

BACKGROUND AND AIMS: Decreased alanine aminotransferase (ALT) level is the accepted basic indicator of an interferon (IFN) therapeutic effect in chronic hepatitis C. This study assessed whether delayed normalization of ALT predicts a poor response to a combined therapy of IFN and ribavirin in patients with chronic hepatitis C virus (HCV) infection. METHODS: Patients were treated with IFN-alpha 2b three times weekly and oral ribavirin for 24 weeks. The ALT values were assessed monthly and patterns of changes in ALT activity were analyzed. Serum HCV-RNA was checked at weeks 0, 12, 24, and 48. RESULTS: A total of 103 patients completed therapy and 69 (67%) of them achieved a sustained viral response (SVR). There was no significant difference in the SVR between patients with or without early normalization (week 12) of ALT level (69 vs 56%). Of the sustained responders, nine patients (13%) with delayed ALT normalization had a SVR. Nine of the 12 patients (75%) with abnormal ALT and negative HCV-RNA at week 12 had a SVR compared with none of four patients who had positive HCV-RNA at week 12 (P = 0.0192). CONCLUSIONS: Lack of normalization of the ALT level at week 12 does not preclude successful virological outcome in hepatitis C patients receiving a combined therapy of IFN and ribavirin. Hepatitis C virus RNA at week 12 may be a useful predictor of treatment outcome in patients without early biochemical response.

Alanine Transaminase↗

Predicting the prevalence of antibody to hepatitis C virus (HCV) in a community by the prevalence of elevated levels of alanine aminotransferase: a method to identify areas endemic for HCV.

To identify areas endemic for hepatitis C virus (HCV), we attempted to predict the prevalence of antibody to HCV (anti-HCV) in a community by the prevalence of elevated levels of alanine aminotransferase (ALT). The results of health examinations of 2,273 women > or = 40 years old in five townships in central Taiwan were analyzed. The overall prevalence of elevated ALT levels was 11.6%. A township (20.3%) and 10 villages were identified as having a high prevalence (17.9-40.0%) of elevated ALT levels. Five communities with variant rates of elevated ALT levels, which ranged from 8.0% to 27.3%, were selected for correlation with the prevalence of anti-HCV among adults (> or = 40 years old). The prevalence of anti-HCV, which ranged from 10.1% to 72.1%, were obtained by community screenings and/or hospital-based studies. The correlation equation used was the prevalence of anti-HCV (%) = 3.33 x (prevalence of elevated ALT levels (%) - 5.7%) (r2 = 0.94, P < 0.01). Using this method, areas endemic for HCV can be identified by determining the community prevalence of elevated ALT levels.

Adult↗