Leandro G, Zizzari S, Fabris C, Basso D, Elba S, Del Favero G, Meggiato T, Angonese C, Di Mario F, Manghisi O G
Istituto di Medicina Interna, Università degli Studi di Padova, Italia.
Oncology. 1989;46(6):381-5. doi: 10.1159/000226756.
This study was undertaken in order to compare the ability of 4 tumour markers to discriminate between liver cirrhosis patients with or without hepatocellular carcinoma (HCC). Serum alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), CA 19-9 and tissue polypeptide antigen (TPA) were determined in 63 patients with liver cirrhosis and in 25 patients with HCC in liver cirrhosis. All 4 serum markers were found to be increased in a number of liver cirrhosis patients, regardless of the presence of HCC. AFP was found to be more elevated in HCC patients as compared to the other group; no difference was observed for CA 19-9, CEA and TPA. A significant correlation was detected in HCC patients between AFP and TPA. Significant correlation were detected in all except HCC patients between liver function tests and TPA. We can conclude that AFP determination remains as yet the only suitable marker able to detect HCC in liver cirrhosis. The newly introduced serum marker CA 19-9 is, as previously reported, unhelpful for CEA. TPA can in some instances (i.e. in the absence of an important hepatic cell necrosis or cholestasis) provide a clue to neoplastic growth.
本研究旨在比较4种肿瘤标志物区分肝硬化合并或不合并肝细胞癌（HCC）患者的能力。对63例肝硬化患者和25例肝硬化合并HCC患者测定了血清甲胎蛋白（AFP）、癌胚抗原（CEA）、CA 19-9和组织多肽抗原（TPA）。发现所有4种血清标志物在一些肝硬化患者中均升高，无论是否存在HCC。与其他组相比，HCC患者的AFP升高更明显；CA 19-9、CEA和TPA未观察到差异。在HCC患者中检测到AFP与TPA之间存在显著相关性。除HCC患者外，在所有患者中均检测到肝功能检查与TPA之间存在显著相关性。我们可以得出结论，AFP测定仍然是目前唯一能够检测肝硬化中HCC的合适标志物。如先前报道，新引入的血清标志物CA 19-9对CEA检测无帮助。TPA在某些情况下（即不存在重要的肝细胞坏死或胆汁淤积时）可为肿瘤生长提供线索。
