Liebman H A, Furie B C, Tong M J, Blanchard R A, Lo K J, Lee S D, Coleman M S, Furie B
N Engl J Med. 1984 May 31;310(22):1427-31. doi: 10.1056/NEJM198405313102204.
We detected des-gamma-carboxy prothrombin, an abnormal prothrombin, in the serum of 69 of 76 patients (91 per cent) with biopsy-confirmed hepatocellular carcinoma (the mean level of the abnormal prothrombin was 900 ng per milliliter). In contrast, levels of the abnormal prothrombin were low in patients with chronic active hepatitis (mean, 10 ng per milliliter) or metastatic carcinoma involving the liver (mean, 42 ng per milliliter), and undetectable in normal subjects. In five patients treated with vitamin K there was no reduction in abnormal prothrombin, indicating that its presence was not due to vitamin K deficiency. Surgical resection of tumors in two patients and chemotherapy in one patient markedly reduced abnormal-prothrombin concentrations, which later increased with recurrence of disease. Serum alpha-fetoprotein levels correlated poorly with abnormal-prothrombin levels. Together, the assay for abnormal prothrombin and the alpha-fetoprotein assay identified 64 of 76 patients with hepatoma (84 per cent). Abnormal prothrombin may be useful in the laboratory diagnosis of primary hepatocellular carcinoma.
我们在76例经活检证实为肝细胞癌的患者中的69例（91%）血清中检测到了脱γ-羧基凝血酶原，一种异常的凝血酶原（异常凝血酶原的平均水平为每毫升900纳克）。相比之下，慢性活动性肝炎患者（平均每毫升10纳克）或肝转移性癌患者（平均每毫升42纳克）的异常凝血酶原水平较低，而在正常受试者中检测不到。5例接受维生素K治疗的患者，其异常凝血酶原水平没有降低，这表明其存在并非由于维生素K缺乏。2例患者的肿瘤手术切除和1例患者的化疗显著降低了异常凝血酶原浓度，但随后随着疾病复发又升高。血清甲胎蛋白水平与异常凝血酶原水平相关性较差。异常凝血酶原检测和甲胎蛋白检测共同识别出了76例肝癌患者中的64例（84%）。异常凝血酶原可能在原发性肝细胞癌的实验室诊断中有用。
