Hirsch-Marie H, Caroli J
Ann Med Interne (Paris). 1975 Feb;126(2):81-6.
The identification of AFP in the serum after birth is always due to a hepatoma or, more rarely, a teratocarcinoma. The increasing sensitivity of methods of immuno-chemical investigation and radioimmunoassay, permit today its identification in cases other than hepatoma. In the foetus, the hepatocyte or its precursor is the site of main synthesis but is not exclusive. The synthesis of AFP has been demonstrated both in the cells of endodermic origin, yolk sack, anterior part of the intestine, stomach and colon. In hepatomas, only a small proportion of neo-hepatocytes is AFP positive on immunofluorescence or on electron microscopy. A quantitative study of AFP is useful above all: a) During pregnancy: detection of foetal distress or malformation when AFP is present in the amniotic fluid. b) For the supervision of patients after surgical treatment. The interest of AFP detection and estimation using high sensitivity methods is emphasized.
出生后血清中甲胎蛋白(AFP)的出现总是由于肝癌,或更罕见的是畸胎癌。免疫化学研究方法和放射免疫测定法灵敏度的提高,使得如今在肝癌以外的病例中也能识别出AFP。在胎儿中,肝细胞或其前体是主要合成部位,但并非唯一部位。已证实在内胚层来源的细胞、卵黄囊、肠前部、胃和结肠中均有AFP合成。在肝癌中,通过免疫荧光或电子显微镜观察,只有一小部分新生肝细胞呈AFP阳性。AFP的定量研究尤其有用:a)在孕期:当羊水存在AFP时,检测胎儿窘迫或畸形。b)用于手术后患者的监测。强调了使用高灵敏度方法检测和评估AFP的意义。