Bertino Gaetano, Ardiri Annalisa Maria, Calvagno Giuseppe Stefano, Bertino Nicoletta, Boemi Patrizia Maria
Department of Internal Medicine and Systemic Diseases, Santa Marta Hospital, Catania University, Catania, Italy.
Drug News Perspect. 2010 Oct;23(8):498-508. doi: 10.1358/dnp.2010.23.8.1444236.
Des-γ-carboxy prothrombin (DCP) is an abnormal prothrombin induced by the absence of vitamin K₂ that is increased in the serum of patients with hepatocellular carcinoma (HCC). In hepatoma cells, genetic alterations, membrane receptors, the inability to uptake labeled low-density lipoprotein, cytoskeletal changes and hepatocyte cytoplasmic transfers involved in vitamin K metabolism could play an important role in producing detectable DCP serum levels. Serum DCP was found to have a sensitivity ranging from 48% to 62%, a specificity of 81% to 98% and a diagnostic accuracy of 59% to 84% for detecting HCC. Plasma DCP does not correlate with α-fetoprotein (AFP) levels. However, when used together, the DCP and AFP assays increase the sensitivity of detecting HCC in more than 85% of patients. The specificity of the DCP assay appears to be superior to that of AFP. These biomarkers can complement ultrasound for early HCC detection, but neither DCP nor AFP is optimal. For small HCC, a high preoperative DCP level appears to be indicative of tumor recurrence. Recently, there has been attention given to DCP because of its role in detecting HCC recurrence after living donor liver transplant. More recent research has demonstrated that DCP stimulates human vascular endothelial cell growth and migration. All the data presented above demonstrate the importance of DCP in formulating a prognosis for patients with HCC.
去γ-羧基凝血酶原（DCP）是一种因缺乏维生素K₂而诱导产生的异常凝血酶原，在肝细胞癌（HCC）患者血清中水平升高。在肝癌细胞中，基因改变、膜受体、摄取标记低密度脂蛋白的能力缺失、细胞骨架变化以及参与维生素K代谢的肝细胞胞质转运可能在产生可检测的血清DCP水平中起重要作用。血清DCP检测HCC的敏感性为48%至62%，特异性为81%至98%，诊断准确性为59%至84%。血浆DCP与甲胎蛋白（AFP）水平无关。然而，联合使用时，DCP和AFP检测可使超过85%的患者检测HCC的敏感性增加。DCP检测的特异性似乎优于AFP。这些生物标志物可补充超声用于早期HCC检测，但DCP和AFP都不是最佳的。对于小肝癌，术前DCP水平高似乎提示肿瘤复发。最近，由于DCP在活体肝移植后检测HCC复发中的作用而受到关注。最新研究表明，DCP可刺激人血管内皮细胞生长和迁移。上述所有数据均证明了DCP在制定HCC患者预后中的重要性。
