α-L-岩藻糖苷酶作为南非黑人肝细胞癌的血清标志物

Alpha-L-fucosidase as a serum marker of hepatocellular carcinoma in southern African blacks.

作者信息

Bukofzer S, Stass P M, Kew M C, de Beer M, Groeneveld H T

机构信息

Department of Medicine, Witwatersrand University Medical School, Johannesburg, South Africa.

出版信息

Br J Cancer. 1989 Mar;59(3):417-20. doi: 10.1038/bjc.1989.84.

DOI:10.1038/bjc.1989.84

PMID:2467686

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2247057/

Abstract

The purpose of this study was to compare alpha-L-fucosidase and alpha-fetoprotein as serum markers of hepatocellular carcinoma in 72 southern African blacks with this tumour and 64 matched patients with benign hepatic diseases which might be mistaken clinically for hepatocellular carcinoma. Alpha-L-fucosidase activity was assayed using p-nitrophenyl-L-fucopyranoside (pNpf) as a substrate and alpha-fetoprotein concentrations were measured by radioimmunoassay. Serum alpha-L-fucosidase activity in the patients with hepatocellular carcinoma (mean 1,268, s.e.m. +/- 83.7, median 1,150 and range 38-3,698 nmol pNpf ml-1 h-1) was significantly higher than that in the matched controls (mean 798, s.e.m. +/- 65.8, median 648 and range 273-3,825 nmol pNpf ml-1 h-1) (P = 0.0001). However, alpha-L-fucosidase was both less sensitive (75 versus 87%) and less specific (70 versus 87%) than alpha-fetoprotein as a serum marker of hepatocellular carcinoma. When, in an endeavour to eliminate false-positive results, the diagnostic cut-off level for alpha-L-fucosidase was increased to 1,500 nmol pNpf ml-1 h-1 and for alpha-fetoprotein to 400 ng ml-1, the sensitivity of alpha-L-fucosidase fell to 21% whereas that of alpha-fetoprotein remained satisfactory at 78%. If the two markers were used together, the number of false-negative alpha-fetoprotein results was reduced from 13 to 5.5%. We conclude that alpha-L-fucosidase is less useful than alpha-fetoprotein as a single marker of hepatocellular carcinoma in southern African blacks. However, the two markers can profitably be used together.

摘要

本研究旨在比较α-L-岩藻糖苷酶和甲胎蛋白作为肝细胞癌血清标志物的情况。研究对象包括72名患有该肿瘤的南非黑人以及64名匹配的患有可能在临床上被误诊为肝细胞癌的良性肝病患者。采用对硝基苯基-L-岩藻糖苷（pNpf）作为底物测定α-L-岩藻糖苷酶活性，通过放射免疫测定法测量甲胎蛋白浓度。肝细胞癌患者的血清α-L-岩藻糖苷酶活性（均值1268，标准误±83.7，中位数1150，范围38 - 3698 nmol pNpf ml-1 h-1）显著高于匹配的对照组（均值798，标准误±65.8，中位数648，范围273 - 3825 nmol pNpf ml-1 h-1）（P = 0.0001）。然而，作为肝细胞癌的血清标志物，α-L-岩藻糖苷酶的敏感性（75%对87%）和特异性（70%对87%）均低于甲胎蛋白。为了消除假阳性结果，将α-L-岩藻糖苷酶的诊断临界值提高到1500 nmol pNpf ml-1 h-1，甲胎蛋白提高到400 ng ml-1时，α-L-岩藻糖苷酶的敏感性降至21%，而甲胎蛋白的敏感性仍保持在78%，令人满意。如果将这两种标志物联合使用，甲胎蛋白假阴性结果的数量从13%减少到5.5%。我们得出结论，在南非黑人中，α-L-岩藻糖苷酶作为肝细胞癌的单一标志物不如甲胎蛋白有用。然而，这两种标志物联合使用会有好处。