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肝细胞癌血清标志物。

Hepatocellualar carcinoma serum markers.

机构信息

Hepatology Unit, Department of Medical and Pediatric Sciences, Policlinic of Catania, University of Catania, Catania, Italy.

出版信息

Semin Oncol. 2012 Aug;39(4):410-33. doi: 10.1053/j.seminoncol.2012.05.001.

Abstract

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in some areas of the world. In most cases, HCC is diagnosed at a late stage. Therefore, the prognosis of patients with HCC is generally poor. The recommended screening strategy for patients with cirrhosis includes the determination of serum α-fetoprotein (AFP) levels and an abdominal ultrasound every 6 months to detect HCC at an earlier stage. AFP, however, is a marker characterized by poor sensitivity and specificity, and abdominal ultrasound is highly dependent on the operator's experience. In addition to AFP, Lens culinaris agglutinin-reactive AFP (AFP-L3), des-γ-carboxy prothrombin (DCP), glypican-3 (GPC-3), osteopontin (OPN), and several other biomarkers (such as squamous cell carcinoma antigen-immunoglobulin M complexes [SCCA-IgM], alpha-1-fucosidase [AFU], chromogranin A [CgA], human hepatocyte growth factor, insulin-like growth factor) have been proposed as markers for the early detection of HCC. For these markers, we describe the mechanisms of production, and their diagnostic and prognosis roles. None of them is optimal; however, when used together, their sensitivity in detecting HCC is increased. Recent research has shown that some biomarkers have mitogenic and migratory activities in the angiogenesis of HCC and are a factor of tumor growth.

摘要

肝细胞癌(HCC)是世界上某些地区最常见的恶性肿瘤之一。在大多数情况下,HCC 被诊断为晚期。因此,HCC 患者的预后通常较差。推荐对肝硬化患者进行筛查的策略包括每 6 个月检测血清甲胎蛋白(AFP)水平和腹部超声,以更早地发现 HCC。然而,AFP 是一种灵敏度和特异性均较差的标志物,并且腹部超声高度依赖于操作者的经验。除了 AFP 之外,扁豆凝集素反应性 AFP(AFP-L3)、去γ-羧基凝血酶原(DCP)、高尔基糖蛋白-3(GPC-3)、骨桥蛋白(OPN)和其他几种生物标志物(如鳞状细胞癌抗原-免疫球蛋白 M 复合物[SCCA-IgM]、α-1-岩藻糖苷酶[AFU]、嗜铬粒蛋白 A [CgA]、人肝细胞生长因子、胰岛素样生长因子)已被提议作为 HCC 早期检测的标志物。对于这些标志物,我们描述了它们的产生机制及其诊断和预后作用。没有一种是最佳的;然而,当一起使用时,它们检测 HCC 的灵敏度会提高。最近的研究表明,一些生物标志物在 HCC 的血管生成中具有有丝分裂和迁移活性,是肿瘤生长的一个因素。

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