去γ-羧基凝血酶原对肝细胞癌患者的诊断敏感性和特异性因肿瘤大小而异。

Sensitivity and specificity of des-gamma-carboxy prothrombin for diagnosis of patients with hepatocellular carcinomas varies according to tumor size.

作者信息

Nakamura Shinichiro, Nouso Kazuhiro, Sakaguchi Kohsaku, Ito Yoichi M, Ohashi Yasuo, Kobayashi Yoshiyuki, Toshikuni Nobuyuki, Tanaka Hironori, Miyake Yasuhiro, Matsumoto Eiji, Shiratori Yasushi

机构信息

Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.

出版信息

Am J Gastroenterol. 2006 Sep;101(9):2038-43. doi: 10.1111/j.1572-0241.2006.00681.x. Epub 2006 Jul 18.

DOI:10.1111/j.1572-0241.2006.00681.x

PMID:16848811

Abstract

OBJECTIVES

Serum levels of des-gamma-carboxy prothrombin (DCP) and alpha-fetoprotein (AFP) are known to be useful tumor markers for the diagnosis of hepatocellular carcinoma (HCC). The aim of this study was to examine the diagnostic efficacy of DCP and AFP in differentiating HCC from chronic liver diseases.

METHODS

We examined 1,377 HCC patients and 355 patients with chronic hepatitis or cirrhosis (non-HCC) who visited our institute and affiliated hospitals between June 1997 and September 2003.

RESULTS

The median values of DCP and AFP were 60 mAU/mL and 34 ng/mL in HCC patients, respectively, and 18 mAU/mL and 3 ng/mL in non-HCC patients, respectively. The areas under the receiver operating characteristic (ROC) curves of DCP and AFP were 0.812 and 0.887, respectively (p < 0.0001). The area under the DCP ROC curve was significantly smaller than that of AFP in tumors less than 3 cm in diameter (p < 0.0001). However, the ROC area of DCP was significantly larger than that of AFP in tumors greater than 5 cm in diameter (p < 0.0001).

CONCLUSIONS

The utility of DCP for the diagnosis of HCC was lower than that of AFP for small tumors, but higher than that of AFP for large tumors.

摘要

目的

血清去γ-羧基凝血酶原（DCP）和甲胎蛋白（AFP）水平是诊断肝细胞癌（HCC）的有用肿瘤标志物。本研究旨在检测DCP和AFP在鉴别HCC与慢性肝病方面的诊断效能。

方法

我们检测了1997年6月至2003年9月间来我院及附属医院就诊的1377例HCC患者和355例慢性肝炎或肝硬化（非HCC）患者。

结果

HCC患者中DCP和AFP的中位数分别为60 mAU/mL和34 ng/mL，非HCC患者中分别为18 mAU/mL和3 ng/mL。DCP和AFP的受试者操作特征（ROC）曲线下面积分别为0.812和0.887（p<0.0001）。在直径小于3 cm的肿瘤中，DCP的ROC曲线下面积显著小于AFP（p<0.0001）。然而，在直径大于5 cm的肿瘤中，DCP的ROC面积显著大于AFP（p<0.0001）。