Tsai J F, Jeng J E, Chuang L Y, Yang M L, Ho M S, Chang W Y, Hsieh M Y, Lin Z Y, Tsai J H
Department of Internal Medicine, Kaohsiung Medical College, Taiwan, Republic of China.
Br J Cancer. 1997;75(10):1460-6. doi: 10.1038/bjc.1997.250.
To evaluate the diagnostic application of urinary transforming growth factor-beta1 (TGF-beta1) and serum alpha-fetoprotein (AFP) levels in hepatocellular carcinoma (HCC), TGF-beta1 and AFP were determined in 94 patients with cirrhotic HCC and in 94 sex- and age-matched patients with cirrhosis alone. TGF-beta1 and AFP levels in HCC were higher than in cirrhosis alone (P = 0.0001). There is an inverse correlation between TGF-beta1 and log AFP (r = -0.292, P = 0.004). Multivariate analysis indicated that TGF-beta1 and AFP were closely associated, in a dose-related fashion, with the development of HCC. Receiver-operating characteristic (ROC) curves were used to determine the optimal cut-off values of TGF-beta1 (50 microg g(-1) creatinine) and AFP (100 ng ml(-1)). Both TGF-beta1 and AFP showed a high specificity (99%) and positive likelihood ratio. The sensitivity was 53.1% for TGF-beta1 and 55.3% for AFP. The determination of both markers in parallel significantly increased the diagnostic accuracy (90.1%) and sensitivity (84%), with a high specificity (98%) and positive likelihood ratio (40.0). In conclusion, TGF-beta1 and AFP are independent tumour markers of HCC and may be used as complementary tumour markers to discriminate HCC from cirrhosis.
为评估尿转化生长因子-β1（TGF-β1）和血清甲胎蛋白（AFP）水平在肝细胞癌（HCC）中的诊断应用，对94例肝硬化合并HCC患者及94例年龄和性别匹配的单纯肝硬化患者测定了TGF-β1和AFP。HCC患者的TGF-β1和AFP水平高于单纯肝硬化患者（P = 0.0001）。TGF-β1与log AFP呈负相关（r = -0.292，P = 0.004）。多变量分析表明，TGF-β1和AFP与HCC的发生密切相关，且呈剂量相关。采用受试者操作特征（ROC）曲线确定TGF-β1（50μg g⁻¹肌酐）和AFP（100 ng ml⁻¹）的最佳临界值。TGF-β1和AFP均显示出高特异性（99%）和阳性似然比。TGF-β1的敏感性为53.1%，AFP的敏感性为55.3%。同时检测这两种标志物可显著提高诊断准确性（90.1%）和敏感性（84%），具有高特异性（98%）和阳性似然比（40.0）。总之，TGF-β1和AFP是HCC的独立肿瘤标志物，可作为互补的肿瘤标志物用于鉴别HCC与肝硬化。
