Gralnick H R, Givelber H, Abrams E
N Engl J Med. 1978 Aug 3;299(5):221-6. doi: 10.1056/NEJM197808032990503.
Abnormal coagulation studies indicative of a dysfibrinogen were found in the plasma of four of seven patients with malignant hepatoma. The abnormal fibrinogen was characterized by prolonged prothrombin, thrombin and reptilase times and inhibition of the coagulation of normal plasma. Purified fibrinogen revealed abnormalities similar to those in plasma. The functional defect was one of delayed polymerization of the fibrin monomer. The carbohydrate content of the abnormal fibrinogen was increased, and this change was related to the abnormal fibrinogen function. Enzymatic cleavage of sialic acid from the abnormal fibrinogen restored fibrinogen function to normal. This hepatoma-associated dysfibrinogen (acquired dysfibrinogenemia) is similar in many respects to fetal fibrinogen and may represent the presence of a fetal form of fibrinogen in hepatoma.
在7例恶性肝癌患者中,有4例患者的血浆凝血研究异常,提示存在异常纤维蛋白原。异常纤维蛋白原的特征是凝血酶原时间、凝血酶时间和爬虫酶时间延长,以及对正常血浆凝血的抑制。纯化的纤维蛋白原显示出与血浆中相似的异常。功能缺陷是纤维蛋白单体延迟聚合之一。异常纤维蛋白原的碳水化合物含量增加,这种变化与异常纤维蛋白原功能有关。从异常纤维蛋白原中酶促裂解唾液酸可使纤维蛋白原功能恢复正常。这种与肝癌相关的异常纤维蛋白原(获得性异常纤维蛋白原血症)在许多方面与胎儿纤维蛋白原相似,可能代表肝癌中存在胎儿形式的纤维蛋白原。