Leandro G, Basso D, Fabris C, Zizzari S, Elba S, Del Favero G, Di Mario F, Meggiato T, Angonese C, Naccarato R
Istituto di Ricovero e Cura a Carattere Scientifico Specializzato in Gastroenterologia, Gastellana Grotte, Italy.
J Cancer Res Clin Oncol. 1989;115(3):276-8. doi: 10.1007/BF00391702.
This study was undertaken in order to compare the usefulness of three indices of tumour proliferation in detecting primary hepatocellular carcinoma (HCC) and in differentiating this neoplasm from liver cirrhosis. In 10 patients with HCC and in 63 with liver cirrhosis serum alpha-fetoprotein (AFP), tissue polypeptide antigen (TPA) and ferritin were assayed. Increased levels of AFP but not of TPA and ferritin were observed in HCC as compared to liver/cirrhosis. The receiver-operating characteristic curves demonstrated that AFP is more discriminating between HCC and liver cirrhosis than the other two markers. Correlations between liver function tests and serum markers were observed in liver cirrhosis but no in HCC. We can conclude that AFP is more useful than TPA and ferritin in detecting HCC in patients with liver cirrhosis, owing to the high frequency of false positive results of the latter two indices in liver cirrhosis. Liver dysfunction is probably involved in increasing all these markers of malignancy, thus reducing the specificity of these tests.
本研究旨在比较三种肿瘤增殖指标在检测原发性肝细胞癌（HCC）以及将该肿瘤与肝硬化相鉴别方面的效用。对10例HCC患者和63例肝硬化患者的血清甲胎蛋白（AFP）、组织多肽抗原（TPA）和铁蛋白进行了检测。与肝硬化相比，HCC患者中观察到AFP水平升高，而TPA和铁蛋白水平未升高。受试者工作特征曲线表明，AFP在区分HCC和肝硬化方面比其他两种标志物更具鉴别力。在肝硬化患者中观察到肝功能检查与血清标志物之间存在相关性，但在HCC患者中未观察到。我们可以得出结论，由于后两种指标在肝硬化中假阳性结果的高频率，AFP在检测肝硬化患者的HCC方面比TPA和铁蛋白更有用。肝功能障碍可能参与了所有这些恶性肿瘤标志物的升高，从而降低了这些检测的特异性。
