Williams R, Melia W M, Johnson P J
Ann Acad Med Singap. 1980 Apr;9(2):245-50.
The value of serum alpha-foetoprotein (AFP) estimation using radioimmunoassay in patients with hepatocellular carcinoma (HCC) has been investigated. Serum AFP concentration was raised in 97% of patients with cirrhosis complicated by tumour, while only one of 100 patients with uncomplicated cirrhosis had increased concentrations. Serial serum AFP estimation was therefore a valuable screening test in this high-risk group. Raised serum AFP was found to be an additional adverse prognostic factor in HCC patients: 81% of a group of HCC patients with normal serum AFP survived one year while only 12% of patients with raised AFP levels did so. However, this mainly reflects underlying cirrhosis in those HCC patients with raised AFP. Serum AFP doubling time was determined in 28 HCC patients with raised serum AFP and showed a significant correlation with survival, those slowest doubling times surviving longest. Serial AFP determinations were useful in predicting the outcome of chemotherapy: an exponential rise in AFP occurred in those who failed to respond to treatment, but serum AFP fell in those who achieved clinical remission, with a sustained fall in those with complete remission.
已对采用放射免疫测定法检测血清甲胎蛋白（AFP）在肝细胞癌（HCC）患者中的价值进行了研究。97%合并肿瘤的肝硬化患者血清AFP浓度升高，而100例无并发症的肝硬化患者中只有1例浓度升高。因此，连续检测血清AFP是该高危人群一项有价值的筛查试验。血清AFP升高被发现是HCC患者的另一个不良预后因素：一组血清AFP正常的HCC患者中81%存活了一年，而AFP水平升高的患者中只有12%存活了一年。然而，这主要反映了AFP升高的HCC患者存在潜在的肝硬化。对28例血清AFP升高的HCC患者测定了血清AFP倍增时间，结果显示其与生存率显著相关，倍增时间最慢的患者存活时间最长。连续测定AFP有助于预测化疗结果：对治疗无反应者AFP呈指数上升，而临床缓解者血清AFP下降，完全缓解者血清AFP持续下降。
