Ohhira M, Ohtake T, Saito H, Ikuta K, Tanaka K, Tanabe H, Kawashima T, Fujimoto Y, Naraki T, Ono M, Kohgo Y
Third Department of Internal Medicine, Asahikawa Medical College, Hokkaido, Japan.
Alcohol Clin Exp Res. 1999 Apr;23(4 Suppl):67S-70S. doi: 10.1111/j.1530-0277.1999.tb04537.x.
The purpose of this study is to determine serum des-gamma-carboxy prothrombin (DCP) levels in benign liver diseases by a new sensitive method, and to demonstrate the elevation of serum DCP in alcoholic liver disease (ALD) without hepatocellular carcinoma (HCC). Median values of serum DCP were 16.2 mAU/ml (range: 3.2 to 1570 mAU/ml) in ALD and 16.7 mAU/ml (1.2 to 75.4 mAU/ml) in viral liver disease (VLD). Using the cut-off value of 40 mAU/ml as a tumor marker for HCC, 21% (11/52) was positive in ALD and 2% (1/57) was positive in VLD (p = 0.0014, Fisher's exact probability test), and 27% (9/33) was positive in alcoholic liver cirrhosis and 3% (1/39) was positive in viral liver cirrhosis (p = 0.0042, Fisher's exact probability test). The positive rate of DCP was significantly (p < 0.001, Spearman's rank correlation test) correlated with the severity of liver disease in ALD. Serum vitamin K level was not decreased in cases with ALD. In a demonstrable case, serum DCP was decreased after abstinence and was increased again after the beginning of ethanol intake, suggesting the involvement of ethanol to the elevation of serum DCP in ALD. In conclusion, serum DCP was significantly elevated in ALD, compared with VLD, although the mechanism of the elevation of DCP was not clarified. Ethanol intake may act, in part, on the increase of serum DCP in ALD.
本研究旨在通过一种新的敏感方法测定良性肝病患者血清去γ-羧基凝血酶原（DCP）水平，并证实酒精性肝病（ALD）无肝细胞癌（HCC）时血清DCP升高。ALD患者血清DCP中位数为16.2 mAU/ml（范围：3.2至1570 mAU/ml），病毒性肝病（VLD）患者为16.7 mAU/ml（1.2至75.4 mAU/ml）。以40 mAU/ml作为HCC的肿瘤标志物临界值，ALD患者阳性率为21%（11/52），VLD患者为2%（1/57）（p = 0.0014，Fisher确切概率检验），酒精性肝硬化患者阳性率为27%（9/33），病毒性肝硬化患者为3%（1/39）（p = 0.0042，Fisher确切概率检验）。ALD患者中DCP阳性率与肝病严重程度显著相关（p < 0.001，Spearman等级相关检验）。ALD患者血清维生素K水平未降低。在一个可证实的病例中，戒酒血清DCP降低，重新摄入乙醇后又升高，提示乙醇参与ALD患者血清DCP升高。总之，与VLD相比，ALD患者血清DCP显著升高，尽管DCP升高机制尚不清楚。乙醇摄入可能部分作用于ALD患者血清DCP升高。
