Piva M T, Sieso V, Lumbroso S, Perney P, Mion H
Service de médecine interne E, CHU Saint-Eloi, Montpellier, France.
Ann Biol Clin (Paris). 1997 May-Jun;55(3):209-14.
In order to improve the non aggressive diagnosis of hepatic metastasis from digestive neoplasm, the authors analyzed the following biological parameters: aminotransferases, alkaline phosphatase and lacticodehydrogenase isoenzymes, gammaglutamyl-transpeptidase, conjugated and total bilirubin, C-reactive protein, type A, G, M immunoglobulins, C3 complement factor, alpha-1 acidic glycoprotein (orosomucoid), haptoglobin, ceruloplasmin, transferrin, albumin, prealbumin, ferritin. This work included 54 patients with digestive tract cancer (esophageal, gastric, colic, rectal, anal localizations), divided in two groups: M- (n = 27), without hepatic metastasis), and M+ (n = 27, with histological confirmed hepatic metastasis). The Mann-Whitney test showed significant differences for 12 parameters between the 2 groups. With more than 60% sensitivity (Se) and specificity (Sp), according to the ROC curves, the following parameters can be selected: Total alkaline phosphatase (Se 89%, Sp 70%) and their macromolecular H2 fraction, lacticodehydrogenase fraction 4 (Se 63%, Sp 63%), gammaglutamyl-transpeptidase (Se 85%, Sp 82%), ceruloplasmin (Se 64%, Sp 65%), aspartate-aminotransferase determination (Se 63%, Sp 65%).
为了改善消化系统肿瘤肝转移的非侵袭性诊断，作者分析了以下生物学参数：转氨酶、碱性磷酸酶和乳酸脱氢酶同工酶、γ-谷氨酰转肽酶、结合胆红素和总胆红素、C反应蛋白、A、G、M型免疫球蛋白、C3补体因子、α-1酸性糖蛋白（类粘蛋白）、触珠蛋白、铜蓝蛋白、转铁蛋白、白蛋白、前白蛋白、铁蛋白。这项研究纳入了54例消化道癌患者（食管癌、胃癌、结肠癌、直肠癌、肛门癌），分为两组：M-组（n = 27，无肝转移）和M+组（n = 27，经组织学证实有肝转移）。曼-惠特尼检验显示两组之间12项参数存在显著差异。根据ROC曲线，灵敏度（Se）和特异度（Sp）均超过60%的参数如下：总碱性磷酸酶（Se 89%，Sp 70%）及其大分子H2组分、乳酸脱氢酶4组分（Se 63%，Sp 63%）、γ-谷氨酰转肽酶（Se 85%，Sp 82%）、铜蓝蛋白（Se 64%，Sp 65%）、天冬氨酸转氨酶测定值（Se 63%，Sp 65%）。
