Zhou X D, Stahlhut M W, Hann H L, London W T
Fox Chase Cancer Center, Philadelphia, Pennsylvania.
Hepatogastroenterology. 1988 Feb;35(1):1-4.
The serum ferritin level was detected by radioimmunoassay in 142 patients with hepatocellular carcinoma (HCC). Serum ferritin level was raised (greater than ng/ml) in 38% (54/142) of patients with HCC. There was no difference in serum ferritin levels between stages 1, 2 and 3 HCC. None of the 4 patients with stage 1 HCC had serum ferritin levels above 300 ng/ml. In this small group of patients, measurement of serum ferritin was not a satisfactory indicator of stage 1 HCC. A combination of serum ferritin alpha fetoprotein (AFP) measurements may be useful for a rising suspicion of HCC. We found that a correct diagnosis of HCC was made in 38% (54/142) of patients by measurement of ferritin alone, and in 83.8% (119/142) by measurement of AFP alone, but in 92.3% (131/142) by measurement of a combination of these two markers. Serum ferritin estimation may be helpful in detection of HCC without elevated AFP. Among 12 cases of HCC with serum AFP less than 500 ng/ml, 6 cases (50%) had serum ferritin levels greater than ng/ml. There was no correlation between serum ferritin and AFP, nor between serum ferritin and HBsAg. However, among 12 patients with very high ferritin levels (range 992-3000 ng/ml), 11 (91.7%) had AFP levels of more than 500 ng/ml (mean = 4800 ng/ml, range 500-32000 ng/ml).
采用放射免疫分析法对142例肝细胞癌（HCC）患者检测血清铁蛋白水平。38%（54/142）的HCC患者血清铁蛋白水平升高（大于ng/ml）。HCC 1期、2期和3期患者的血清铁蛋白水平无差异。4例1期HCC患者中无一例血清铁蛋白水平高于300 ng/ml。在这一小群患者中，血清铁蛋白测量并非1期HCC的满意指标。血清铁蛋白与甲胎蛋白（AFP）联合测量可能有助于提高对HCC的怀疑。我们发现，仅通过铁蛋白测量，38%（54/142）的患者被正确诊断为HCC；仅通过AFP测量，83.8%（119/142）的患者被正确诊断；而通过这两种标志物联合测量，92.3%（131/142）的患者被正确诊断。血清铁蛋白估计可能有助于检测AFP未升高的HCC。在12例血清AFP低于500 ng/ml的HCC病例中，6例（50%）血清铁蛋白水平高于ng/ml。血清铁蛋白与AFP之间、血清铁蛋白与乙肝表面抗原（HBsAg）之间均无相关性。然而，在12例铁蛋白水平非常高（范围992 - 3000 ng/ml）的患者中，11例（91.7%）的AFP水平超过500 ng/ml（平均值 = 4800 ng/ml；范围500 - 32000 ng/ml）。
