Leandro G, Zizzari S, Piccoli A, Manghisi O G
Ospedale S. De. Bellis, Istituto di Ricovero e Cura a Carattere Scientifico, Castellana Grotte, Bari, Italy.
Hepatogastroenterology. 1990 Oct;37(5):449-51.
The aim of our work was to assess the performance of tissue polypeptide antigen in detecting hepatocellular carcinoma in cirrhotic patients, while also checking for any influence of liver dysfunction on the serum level of the marker. One hundred and twenty-five consecutive cirrhotic patients, 35 with and 90 without, hepatocellular carcinoma were studied. Tissue polypeptide antigen had a different distribution in the two groups and the best diagnostic accuracy with 48.6% sensitivity and 85.6% specificity was found at the cut-off value of 240 UL-1. In cirrhotic patients significant linear correlations were found between tissue polypeptide antigen and alanine-transaminase, aspartate-transaminase, G-glutamyl-transpeptidase and alkaline phosphatase; there was no correlation with bilirubin or pseudo-cholinesterase. In patients with hepatocellular carcinoma a significant linear correlation was found only with alanine and aspartate transaminase and G-glutamyl-transpeptidase. The analysis of covariance still showed a significant difference between mean tissue polypeptide antigen levels in the two groups also accounting for covariates. These results suggest that: a) the liver dysfunction may be involved in increasing tissue polypeptide antigen values; b) tissue polypeptide antigen has a different distribution in cirrhotic patients with and without hepatocellular carcinoma also accounting for covariates; these findings further support the specificity of tissue polypeptide antigen.
我们研究的目的是评估组织多肽抗原在检测肝硬化患者肝细胞癌方面的性能，同时检查肝功能障碍对该标志物血清水平的影响。对125例连续性肝硬化患者进行了研究，其中35例患有肝细胞癌，90例未患肝细胞癌。组织多肽抗原在两组中的分布不同，在截断值为240 UL-1时诊断准确性最佳，灵敏度为48.6%，特异度为85.6%。在肝硬化患者中，组织多肽抗原与丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转肽酶和碱性磷酸酶之间存在显著的线性相关性；与胆红素或假性胆碱酯酶无相关性。在肝细胞癌患者中，仅与丙氨酸转氨酶、天冬氨酸转氨酶和γ-谷氨酰转肽酶存在显著的线性相关性。协方差分析仍显示两组间平均组织多肽抗原水平存在显著差异，同时考虑了协变量。这些结果表明：a）肝功能障碍可能与组织多肽抗原值升高有关；b）在考虑协变量的情况下，组织多肽抗原在患有和未患肝细胞癌的肝硬化患者中分布不同；这些发现进一步支持了组织多肽抗原的特异性。
