Soulier J P, Gozin D, Lefrere J J
Gastroenterology. 1986 Nov;91(5):1258-62. doi: 10.1016/s0016-5085(86)80025-7.
A new method for assaying the activity of des-gamma-carboxyprothrombin (DCP), using staphylocoagulase on undiluted adsorbed plasma, is described. The thrombin-coagulase formed is measured on a chromogenic substrate, and the results are expressed in milliunits per milliliter of increment of the optical density following the release of p-nitroaniline. Levels of DCP in 96 normal subjects were under 10 mU/ml (mean, 3.58 mU/ml). Of 70 nonhepatectomized patients with hepatocellular carcinomas, 74% had increased DCP levels of between 20 and 420 mU/ml (most of the values were between 20 and 100 mU/ml). Des-carboxyprothrombin and alpha-fetoprotein measurements gave complementary information, one marker or the other being positive in 87% of hepatocellular carcinoma. Fourteen of 15 patients with metastatic carcinoma of the liver had normal DCP levels, as did 95 patients with liver cirrhosis and 13 patients with chronic hepatitis. When the level of "total factor II" is below 40%, it is recommended that a second determination of DCP be performed 5 days after the injection of vitamin K, to exclude any vitamin K deficiency (in the case of hepatocellular carcinoma the DCP level will remain elevated). The DCP assay appears more sensitive and more specific than the alpha-fetoprotein assay for the diagnosis of hepatocellular carcinoma; furthermore, both tests are complementary.
本文描述了一种使用葡萄球菌凝固酶检测未稀释吸附血浆中去γ-羧基凝血酶原（DCP）活性的新方法。在生色底物上测定形成的凝血酶-凝固酶，并将结果表示为对硝基苯胺释放后每毫升光密度增加的毫单位数。96名正常受试者的DCP水平低于10 mU/ml（平均3.58 mU/ml）。在70例未行肝切除术的肝细胞癌患者中，74%的患者DCP水平升高，介于20至420 mU/ml之间（大多数值介于20至100 mU/ml之间）。去羧基凝血酶原和甲胎蛋白检测提供了互补信息，在87%的肝细胞癌患者中，这两种标志物之一呈阳性。15例肝转移癌患者中有14例DCP水平正常，95例肝硬化患者和13例慢性肝炎患者的DCP水平也正常。当“总因子II”水平低于40%时，建议在注射维生素K 5天后再次测定DCP，以排除任何维生素K缺乏（对于肝细胞癌患者，DCP水平将保持升高）。对于肝细胞癌的诊断，DCP检测似乎比甲胎蛋白检测更敏感、更特异；此外，这两种检测是互补的。
