Nikolić J A, Stajić M, Cuperlović M, Hajduković L, Golubović G
INEP-Institute of Endocrinology, Immunology and Nutrition, Belgrade University, Zemun, Yugoslavia.
J Hepatol. 1990 Sep;11(2):252-6. doi: 10.1016/0168-8278(90)90121-7.
Serum alpha-fetoprotein levels were determined in patients (268) with liver disease. Markedly elevated concentrations (greater than 100 micrograms/l) were found in twelve patients with malignant tumours and two with cirrhosis. Molecular variants of alpha-fetoprotein were distinguished by lectin affinity chromatography of these sera. Reversible binding to concanavalin A (86 +/- 5%) and to lentil agglutinin (61 +/- 19%) conformed to expected values for primary hepatocellular carcinoma except in one patient with a metastatic carcinoma whose alpha-fetoprotein binding to concanavalin A was similar to non-liver alpha-fetoprotein (44 +/- 13%), and the two patients with cirrhosis in whom binding to lentil agglutinin was typical for benign liver disorders (less than 20%). Since low levels of serum alpha-fetoprotein and non-characteristic alpha-fetoprotein binding patterns assisted in the regrouping of eleven out of 24 patients initially thought to have primary hepatocellular carcinoma, it was concluded that alpha-fetoprotein determination and lectin affinity chromatography are helpful in distinguishing primary hepatocellular carcinoma from metastatic and benign liver diseases. Slight increases in the alpha-fetoprotein level in the presence of serum hepatitis B surface antigen indicated seven patients at risk for primary hepatocellular carcinoma who should be monitored frequently.
对268例肝病患者测定了血清甲胎蛋白水平。在12例患有恶性肿瘤的患者和2例患有肝硬化的患者中发现甲胎蛋白浓度显著升高（大于100微克/升）。通过这些血清的凝集素亲和色谱法区分了甲胎蛋白的分子变体。除了1例转移性癌患者的甲胎蛋白与伴刀豆球蛋白A的结合类似于非肝脏来源的甲胎蛋白（44±13%），以及2例肝硬化患者与扁豆凝集素的结合符合良性肝脏疾病的典型情况（低于20%）外，与伴刀豆球蛋白A（86±5%）和扁豆凝集素（61±19%）的可逆结合符合原发性肝细胞癌的预期值。由于低水平的血清甲胎蛋白和非典型的甲胎蛋白结合模式有助于对最初被认为患有原发性肝细胞癌的24例患者中的11例进行重新分类，因此得出结论，甲胎蛋白测定和凝集素亲和色谱法有助于区分原发性肝细胞癌与转移性和良性肝脏疾病。在血清乙型肝炎表面抗原存在的情况下甲胎蛋白水平略有升高表明7例患者有患原发性肝细胞癌的风险，应对其进行频繁监测。
