Aoyagi Y, Suzuki Y, Igarashi K, Saitoh A, Oguro M, Yokota T, Mori S, Nomoto M, Isemura M, Asakura H
Department of Internal Medicine, Niigata University School of Medicine, Japan.
Cancer. 1991 May 1;67(9):2390-4. doi: 10.1002/1097-0142(19910501)67:9<2390::aid-cncr2820670928>3.0.co;2-v.
The degrees of glucosaminylation (glucosaminylation index) and fucosylation (fucosylation index) of alpha-fetoprotein (AFP) were determined in serum samples of 351 patients with hepatocellular carcinoma (HCC), 47 with carcinoma metastatic to the liver from digestive organs, five with mixed cholangiocellular and HCC, and 176 with benign liver diseases. The glucosaminylation index of AFP in patients with carcinoma metastatic to the liver (42 +/- 23%, mean +/- SD) was significantly higher than that in patients with HCC (5 +/- 7%, P less than 0.001) or that in patients with benign liver diseases (2 +/- 4%, P less than 0.001). The fucosylation indices of AFP in patients with carcinoma metastatic to the liver, with HCC, and with benign liver diseases were 76 +/- 25%, 42 +/- 30%, and 4 +/- 6%, respectively. Thus, the fucosylation indices of AFP were high in two neoplastic liver diseases (carcinoma metastatic to the liver and HCC) and low in benign liver diseases, whereas the glucosaminylation indices were high in carcinoma metastatic to the liver but low in HCC and benign liver diseases. When the values of 30% and 80% were used as the level of the glucosaminylation and fucosylation indices, respectively, to discriminate carcinoma metastatic to the liver from HCC, 40 of 47 patients with carcinoma metastatic to the liver (85%) were able to be discriminated from HCC (sensitivity). The specificity, the positive predictive value, and the overall accuracy were 86% (302/351), 45% (40/40 + 47 + 3 - 2) and 86% (40 + 302/47 + 351), respectively. These data suggest that the combined information in these two indices provides a potent criterion for the diagnosis of neoplastic diseases of the liver.
测定了351例肝细胞癌（HCC）患者、47例消化器官癌肝转移患者、5例胆管细胞癌与HCC混合型患者以及176例良性肝病患者血清样本中甲胎蛋白（AFP）的糖胺化程度（糖胺化指数）和岩藻糖基化程度（岩藻糖基化指数）。肝转移癌患者AFP的糖胺化指数（42±23%，均值±标准差）显著高于HCC患者（5±7%，P<0.001）或良性肝病患者（2±4%，P<0.001）。肝转移癌患者、HCC患者和良性肝病患者AFP的岩藻糖基化指数分别为76±25%、42±30%和4±6%。因此，AFP的岩藻糖基化指数在两种肝脏肿瘤性疾病（肝转移癌和HCC）中较高，在良性肝病中较低，而糖胺化指数在肝转移癌中较高，在HCC和良性肝病中较低。当分别以30%和80%作为糖胺化指数和岩藻糖基化指数的水平来区分肝转移癌与HCC时，47例肝转移癌患者中有40例（85%）能够与HCC区分开（敏感性）。特异性、阳性预测值和总体准确率分别为86%（302/351）、45%（40/40 + 47 + 3 - 2）和86%（40 + 302/47 + 351）。这些数据表明，这两个指数的联合信息为肝脏肿瘤性疾病的诊断提供了有力标准。
