Kelsten M L, Chan D W, Bruzek D J, Rock R C
Department of Laboratory Medicine, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
Clin Chem. 1988 Jan;34(1):76-81.
A monoclonal immunoenzymometric assay for alpha-fetoprotein (M-AFP) was evaluated with respect to its utility in monitoring hepatocellular carcinoma (HCC) patients. Earlier (Clin Chem 1986;32:1318-22), we found this immunoassay to demonstrate abilities similar to polyclonal AFP assays, and we suggested that changes in M-AFP correlated with changes in intrahepatic tumor volume in most HCC patients. In the present study, 107 HCC patients were evaluated between 1978 and 1986. Patient demographics characterized this study population as being similar to those seen in regions with low incidence of HCC. Changes in serum M-AFP concentration correlated moderately (r = 0.55) with changes in intrahepatic tumor volume. The AFP concentration in serum was found to be a statistically significant independent predictor of survival; patients with above-normal M-AFP (AFP[+]) at presentation demonstrated a median survival time of 10 months, compared with 16 months for patients with "normal" values for M-AFP (AFP[-]) (P = 0.008). This prognostic pattern persisted when adjusted for serum bilirubin concentration (AFP[+] 12 months vs AFP[-] 29 months, P = 0.01).
评估了一种用于甲胎蛋白（M-AFP）的单克隆免疫酶测定法在监测肝细胞癌（HCC）患者中的效用。此前（《临床化学》1986年；32：1318 - 22），我们发现这种免疫测定法表现出与多克隆AFP测定法相似的能力，并且我们认为在大多数HCC患者中，M-AFP的变化与肝内肿瘤体积的变化相关。在本研究中，对1978年至1986年间的107例HCC患者进行了评估。患者人口统计学特征表明该研究人群与HCC低发地区所见人群相似。血清M-AFP浓度的变化与肝内肿瘤体积的变化呈中度相关（r = 0.55）。发现血清中的AFP浓度是生存的统计学显著独立预测因子；就诊时M-AFP高于正常水平（AFP[+]）的患者中位生存时间为10个月，而M-AFP值“正常”（AFP[-]）的患者为16个月（P = 0.008）。在对血清胆红素浓度进行校正后，这种预后模式仍然存在（AFP[+]为12个月，AFP[-]为29个月，P = 0.01）。
