Kuwahara T, Sakai T, Majima Y, Hirai K, Tanikawa K
Second Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan.
Hepatogastroenterology. 1993 Aug;40(4):347-51.
In 49 liver cirrhosis patients with hepatocellular carcinoma in which the hepatocellular carcinoma nodule was smaller than 30 mm in size, serial changes in serum alpha-fetoprotein levels prior to the detection of the hepatocellular carcinoma were studied retrospectively, and compared with those of 70 cirrhotic patients with no hepatocellular carcinoma. The changes in alpha-fetoprotein levels were classified into the 4 types normal, low plateau, high plateau and spiky type. The spiky type (spiky elevation during a short period) was more frequently noted in the patients with hepatocellular carcinoma than in those with liver cirrhosis. In a prospective analysis of 39 patients with liver cirrhosis, hepatocellular carcinoma was detected in 6, and was also more frequently noted in the spiky type than the other types. Moreover, in the hepatocellular carcinoma patients with the spiky type of alpha-fetoprotein, hepatocellular carcinoma was suspected, on the basis of the tumor doubling time, to exist at the time of the first elevation of alpha-fetoprotein. These results suggest that the liver cirrhotics with the spiky type of alpha-fetoprotein may be considered to be a high-risk group of hepatocellular carcinoma.
在49例肝细胞癌结节大小小于30mm的肝硬化合并肝细胞癌患者中，回顾性研究了肝细胞癌检测前血清甲胎蛋白水平的系列变化，并与70例无肝细胞癌的肝硬化患者进行了比较。甲胎蛋白水平的变化分为正常、低平台、高平台和尖峰型4种类型。尖峰型（短期内急剧升高）在肝细胞癌患者中比在肝硬化患者中更常见。在对39例肝硬化患者的前瞻性分析中，6例检测出肝细胞癌，且尖峰型比其他类型更常见。此外，在甲胎蛋白呈尖峰型的肝细胞癌患者中，根据肿瘤倍增时间推测，在甲胎蛋白首次升高时肝细胞癌可能已经存在。这些结果表明，甲胎蛋白呈尖峰型的肝硬化患者可能被视为肝细胞癌的高危人群。
