Castaldo G, Oriani G, Cimino L, Topa M, Budillon G, Salvatore F, Sacchetti L
Dipartimento di Biochimica e Biotecnologie Mediche, Facoltà di Medicina e Chirurgia, Università di Napoli Federico II, Italy.
Clin Chem. 1995 Mar;41(3):439-43.
Hepatocellular carcinoma (HC) is often difficult to distinguish from secondary liver neoplasia (SLN) by physical and imaging diagnostic procedures alone. To this aim we have extended and improved a laboratory approach based on a serum lactate dehydrogenase isoenzyme ratio (LD4:LD5) by adding the carcinoembryonic antigen: alpha-fetoprotein ratio, alkaline phosphatase, and serum iron concentrations to obtain a highly efficient discriminant function. In two successive cohorts, for a total of 102 patients, all histologically diagnosed, with a prevalence of HC vs SLN of 3:1, we correctly classified 96% of cases (100% of SLN cases). Subsequent verification with the jackknife reallocation statistical algorithm confirmed these results. In conclusion, this discriminant function based on simple laboratory assays of a few analytes is an important tool in solving a diagnostic dilemma in cases of liver neoplasia.
仅通过体格检查和影像学诊断程序，肝细胞癌（HC）往往很难与继发性肝肿瘤（SLN）区分开来。为此，我们扩展并改进了一种基于血清乳酸脱氢酶同工酶比率（LD4:LD5）的实验室方法，加入癌胚抗原与甲胎蛋白的比率、碱性磷酸酶和血清铁浓度，以获得一种高效的判别函数。在两个连续队列中，共有102例经组织学确诊的患者，HC与SLN的患病率为3:1，我们正确分类了96%的病例（100%的SLN病例）。随后用留一法重新分配统计算法进行验证，证实了这些结果。总之，这种基于对几种分析物进行简单实验室检测的判别函数，是解决肝肿瘤病例诊断难题的重要工具。
