Alexopoulos A, Hutchinson W, Bari A, Keating J J, Johnson P J, Williams R
Kings College Hospital School of Medicine and Dentistry, Denmark Hill, London, UK.
Br J Cancer. 1988 Mar;57(3):313-6. doi: 10.1038/bjc.1988.69.
Serum thyroxine was significantly higher in 59 patients with hepatocellular carcinoma than in normal subjects, patients with uncomplicated cirrhosis (48), or other primary tumours with or without hepatic metastases (50). Elevated thyroxine levels appeared attributable to high levels of thyroxine binding globulin which showed a positive linear correlation with serum thyroxine in all groups studied. Despite this hyperthyroxinaemia all patients appeared clinically euthyroid and, consistent with this, T3 was elevated in only one patient and the free thyroxine index was normal in all. Amongst a group of 25 cirrhotic patients who were followed-up for between 12 and 72 months, there was a striking dissociation between the TBG values of those destined to develop HCC and those who did not. In the former group TBG rose steadily with time whereas in the latter group levels remained stable, or, more often, fell. The rises in TBG occurred prior to any clinical signs of tumour development and may be one of the earliest serological changes to occur during carcinogenesis in the cirrhotic liver.
59例肝细胞癌患者的血清甲状腺素水平显著高于正常受试者、无并发症肝硬化患者（48例）或有或无肝转移的其他原发性肿瘤患者（50例）。甲状腺素水平升高似乎归因于甲状腺素结合球蛋白水平升高，在所有研究组中，甲状腺素结合球蛋白与血清甲状腺素呈正线性相关。尽管存在这种甲状腺素血症，但所有患者临床均表现为甲状腺功能正常，与此一致的是，仅1例患者T3升高，所有患者的游离甲状腺素指数均正常。在一组随访12至72个月的25例肝硬化患者中，注定要发生肝癌的患者与未发生肝癌的患者的甲状腺素结合球蛋白值存在显著差异。在前一组中，甲状腺素结合球蛋白随时间稳步上升，而在后一组中，其水平保持稳定，或更常见的是下降。甲状腺素结合球蛋白的升高发生在肿瘤发展的任何临床体征出现之前，可能是肝硬化肝脏癌变过程中最早出现的血清学变化之一。
