Ikoma Jiro, Kaito Masahiko, Ishihara Tomoaki, Nakagawa Naoki, Kamei Akira, Fujita Naoki, Iwasa Motoh, Tamaki Shigenori, Watanabe Shozo, Adachi Yukihiko
Third Department of Internal Medicine, Mie University School of Medicine, Edobashi 2-174, Tsu, Mie 514-8507, Japan.
Hepatogastroenterology. 2002 Jan-Feb;49(43):235-8.
BACKGROUND/AIMS: Measurement of des-gamma-carboxy prothrombin by conventional methods is of limited use for the early detection of hepatocellular carcinoma for its low sensitivity. The aim of the present study was to investigate the usefulness of measuring des-gamma-carboxy prothrombin by a highly sensitive assay for the early diagnosis of hepatocellular carcinoma in patients with chronic liver disease and for the detection of recurrence after treatment of hepatocellular carcinoma.
Des-gamma-carboxy prothrombin levels by a sensitive assay and alpha-fetoprotein levels were sequentially measured in 188 patients with type B or C chronic liver disease and in 63 patients with hepatocellular carcinoma.
The positive rate of des-gamma-carboxy prothrombin was 62% in all of hepatocellular carcinoma patients. Hepatocellular carcinoma was detected in 14 of 188 chronic liver disease patients during their follow-up period, the positive rate of des-gamma-carboxy prothrombin and of alpha-fetoprotein being 57% and 71% in these 14 patients, respectively. Des-gamma-carboxy prothrombin level normalized in 67% of 39 patients after the treatment of hepatocellular carcinoma. Of the 19 patients with tumor recurrence, 84% showed re-elevation of des-gamma-carboxy prothrombin level.
Measurement of des-gamma-carboxy prothrombin by this highly sensitive assay combined with alpha-fetoprotein is useful for detecting hepatocellular carcinoma in chronic liver disease patients and for monitoring recurrence after treatment of hepatocellular carcinoma.
背景/目的：采用传统方法检测脱γ-羧基凝血酶原对肝细胞癌的早期检测作用有限，因为其灵敏度较低。本研究的目的是探讨通过高灵敏度检测法测定脱γ-羧基凝血酶原对慢性肝病患者肝细胞癌早期诊断以及肝细胞癌治疗后复发检测的有用性。
对188例B型或C型慢性肝病患者和63例肝细胞癌患者依次采用灵敏检测法测定脱γ-羧基凝血酶原水平和甲胎蛋白水平。
所有肝细胞癌患者中脱γ-羧基凝血酶原的阳性率为62%。188例慢性肝病患者在随访期间有14例检测出肝细胞癌，这14例患者中脱γ-羧基凝血酶原和甲胎蛋白的阳性率分别为57%和71%。39例肝细胞癌患者治疗后67%的患者脱γ-羧基凝血酶原水平恢复正常。19例肿瘤复发患者中，84%的患者脱γ-羧基凝血酶原水平再次升高。
采用这种高灵敏度检测法结合甲胎蛋白测定脱γ-羧基凝血酶原，对于检测慢性肝病患者的肝细胞癌以及监测肝细胞癌治疗后的复发情况是有用的。
