Izuno K, Fujiyama S, Yamasaki K, Sato M, Sato T
Third Development of Internal Medicine, Kumamoto University School of Medicine, Japan.
Hepatogastroenterology. 1995 Jul-Aug;42(4):387-93.
BACKGROUND/AIMS: To evaluate the usefulness of des-gamma-carboxy prothrombin (DCP) assay in a group of high risk for hepatocellular carcinoma (HCC).
Plasma DCP and serum-alpha-fetoprotein (AFP) concentrations were prospectively measured in 137 patients with liver cirrhosis (LC).
During the mean observation period of 3.4 years, HCC developed in 35 patients (25.5%; yearly rate 7.5%), of whom 16 (45.7%) had a small tumor < or = 2 cm in diameter. Eight patients (22.9%) had significantly elevated DCP at the time of HCC detection. However, all these tumors measured > 2 cm and were multiple or diffuse type. In cases with a tumor diameter < or = 2 cm HCC was diagnosed by imaging and elevated AFP concentrations. In contrast, elevated DCP frequently leads to the detection of tumors > 2 cm or those of diffuse type, which are difficult to recognize with imaging.
Thus, although DCP alone is not sensitive enough to detect early small liver cancers, the use of both markers and imaging in the follow-up of patients with LC might be beneficial.
背景/目的：评估去γ-羧基凝血酶原（DCP）检测在一组肝细胞癌（HCC）高危人群中的应用价值。
前瞻性检测137例肝硬化（LC）患者的血浆DCP和血清甲胎蛋白（AFP）浓度。
在平均3.4年的观察期内，35例患者（25.5%；年发病率7.5%）发生了HCC，其中16例（45.7%）肿瘤直径≤2 cm。8例患者（22.9%）在HCC检测时DCP显著升高。然而，所有这些肿瘤直径均>2 cm，且为多发或弥漫型。在肿瘤直径≤2 cm的病例中，HCC通过影像学检查和AFP浓度升高得以诊断。相比之下，DCP升高常导致直径>2 cm或弥漫型肿瘤的检出，而这些肿瘤通过影像学检查难以识别。
因此，尽管单独使用DCP检测早期小肝癌的敏感性不足，但在LC患者的随访中联合使用这两种标志物和影像学检查可能有益。
