Hutchinson W L, Johnson P J, White Y S, Williams R
Liver Unit, King's College Hospital, School of Medicine & Dentistry, Denmark Hill, London, U.K.
J Hepatol. 1989 Sep;9(2):265-71. doi: 10.1016/0168-8278(89)90062-7.
To determine whether previous observations suggesting reduced ability of thyroxine-binding globulin (TBG) to bind exogenous thyroid hormones in hepatocellular carcinoma (HCC) might form the basis of a useful clinical test, we have investigated a larger series involving 49 patients and 10 healthy subjects. The binding ratio (mol hormone bound/mol TBG at a given hormone concentration) for both T4 and T3 was significantly reduced when compared to both cirrhotic and normal subjects. No overlap in T4 binding occurred between HCC patients and the control groups. Serial measurements on serum samples obtained from five cirrhotic patients who ultimately developed HCC revealed significant reductions in binding for both hormones up to 60 months prior to the clinical diagnosis of HCC. A reduced ability to bind thyroid hormones appears to be a specific feature of serum TBG from HCC patients and is one of the earliest alterations seen among cirrhotic subjects who ultimately develop the disease.
为了确定先前的观察结果，即提示甲状腺素结合球蛋白（TBG）在肝细胞癌（HCC）中结合外源性甲状腺激素的能力降低，是否可能构成一项有用的临床检测的基础，我们对一个更大的队列进行了研究，该队列包括49例患者和10名健康受试者。与肝硬化患者和正常受试者相比，T4和T3的结合率（在给定激素浓度下，结合的激素摩尔数/ TBG摩尔数）均显著降低。HCC患者与对照组之间在T4结合方面没有重叠。对最终发展为HCC的5例肝硬化患者的血清样本进行的连续测量显示，在HCC临床诊断前长达60个月时，两种激素的结合均显著降低。甲状腺激素结合能力降低似乎是HCC患者血清TBG的一个特异性特征，并且是最终发展为该疾病的肝硬化患者中最早出现的改变之一。
