Forones N M, Queiroz L A, Ferraz M L, Parise E R
Disciplina de Gastroenterologia, Universidade Federal de São Paulo-Escola Paulista de Medicina.
Rev Assoc Med Bras (1992). 1995 Mar-Apr;41(2):91-3.
AFP is an oncofetal protein found in increased levels in hepatocellular carcinoma, liver metastasis and other benign liver diseases. PURPOSE--To know the behaviour of this protein in each of these clinical situations would undoubtedly help us to discriminate between hepatocellular carcinoma and benign diseases. PATIENTS--A hundred forty nine patients were divided into 4 groups: 1. acute hepatitis (AH) n = 24, 2. chronic liver disease, viral or alcoholic (CLD) n = 81, 3. hepatic metastasis (HM) n = 29, 4. hepatocellular carcinoma (HCC) n = 15. AFP assays were done by ELISA (Abbott Diagnostica, ref. value: 15ng/mL). RESULTS--The results observed were as follows: AFP < 15ng/mL: AH 75%, CLD 86.4%, HM 79.3%, HCC 6.6%, AFP > 15 e < 100ng/mL: AH 25%, CLD 8.6%, HM 20.6%, HCC 20%, AFP > 100ng/mL: AH zero, CLD 4.9%, HM zero, HCC 49%. It is clear that depending on the cut off level, there is a decrease of sensibility which is paralleled by an increase in specificity. CONCLUSIONS--AFP levels are increased in benign liver diseases (AH, CLD) and HM, how ever levels above 100ng/mL occur much more frequently in HCC. In our sample, 93.3% of the HCC showed high levels of AFP, probably because most of the patients had advanced clinical stages of the disease.
甲胎蛋白是一种癌胚蛋白,在肝细胞癌、肝转移瘤及其他良性肝病中水平升高。目的——了解该蛋白在上述每种临床情况下的表现无疑将有助于我们鉴别肝细胞癌与良性疾病。患者——149例患者分为4组:1. 急性肝炎(AH),n = 24;2. 慢性肝病,病毒性或酒精性(CLD),n = 81;3. 肝转移瘤(HM),n = 29;4. 肝细胞癌(HCC),n = 15。采用酶联免疫吸附测定法(ELISA)(雅培诊断,参考值:15ng/mL)检测甲胎蛋白。结果——观察到的结果如下:甲胎蛋白<15ng/mL:急性肝炎组占75%,慢性肝病组占86.4%,肝转移瘤组占79.3%,肝细胞癌组占6.6%;甲胎蛋白>15且<100ng/mL:急性肝炎组占25%,慢性肝病组占8.6%,肝转移瘤组占20.6%,肝细胞癌组占20%;甲胎蛋白>100ng/mL:急性肝炎组为零,慢性肝病组占4.9%,肝转移瘤组为零,肝细胞癌组占49%。显然,根据临界值水平,敏感性降低,特异性升高。结论——良性肝病(急性肝炎、慢性肝病)和肝转移瘤中甲胎蛋白水平升高,但甲胎蛋白>100ng/mL在肝细胞癌中更为常见。在我们的样本中,93.3%的肝细胞癌显示甲胎蛋白水平高,可能是因为大多数患者处于疾病的晚期临床阶段。