Kashihara T, Ohki A, Kobayashi T, Sato T, Nishizawa H, Ogawa K, Tako H, Kawakami F, Tsuji M, Tamaoka K
Department of Internal Medicine, Itami City Hospital, Japan.
J Gastroenterol. 1998 Jun;33(3):447-53. doi: 10.1007/s005350050112.
CYFRA 21-1 is a fragment of cytokeratin 19 (CK 19). Four patients with large intrahepatic (or peripheral) cholangiocarcinoma (CC) and high serum levels of CYFRA 21-1 (normal, < or = 2 ng/ml) are reported. CYFRA 21-1 levels exceeded 9 ng/ml in all 4 patients. Carcinoembryonic antigen (CEA), was high in 1 (CEA; normal range, < or = 5.0 ng/ml) and carbohydrate antigen 19-9 (CA 19-9) was high in 3 (CA19-9; normal range, < or = 36 U/ml). We also measured serum levels of CYFRA 21-1 in 13 patients with hepatocellular carcinoma (HCC) more than 5 cm in diameter. Levels of CYFRA 21-1 exceeded 2 ng/ml in 9 of the HCC patients and were higher than 9 ng/ml in 2 of the HCC patients. Levels of alpha fetoprotein (AFP) and/or protein induced by vitamin K absence or antagonist II (PIVKA II) were elevated in all HCC patients (AFP, PIVKA II, respectively; normal range, < or = 10.0 ng/ml and < or = 0.1 AU/ml) CYFRA 21-1 levels were measured twice or three times during the clinical course in 2 CC patients and in 6 HCC patients, and increased gradually with tumor growth in the 2 CC patients and in 3 of the 6 HCC patients. Marked increases in serum CYFRA 21-1 levels in patients with large liver cancers, particularly in those with normal levels of AFP and PIVKA II, would suggest the existence of intrahepatic CC rather than HCC.
细胞角蛋白19片段（CYFRA 21-1）是细胞角蛋白19（CK 19）的一个片段。本文报告了4例肝内（或周边）胆管癌（CC）患者，其血清CYFRA 21-1水平较高（正常范围，≤2 ng/ml）。所有4例患者的CYFRA 21-1水平均超过9 ng/ml。癌胚抗原（CEA），1例升高（CEA；正常范围，≤5.0 ng/ml），糖类抗原19-9（CA 19-9）3例升高（CA19-9；正常范围，≤36 U/ml）。我们还检测了13例直径超过5 cm的肝细胞癌（HCC）患者的血清CYFRA 21-1水平。9例HCC患者的CYFRA 21-1水平超过2 ng/ml，2例HCC患者的CYFRA 21-1水平高于9 ng/ml。所有HCC患者的甲胎蛋白（AFP）和/或维生素K缺乏或拮抗剂II诱导蛋白（PIVKA II）水平均升高（AFP、PIVKA II的正常范围分别为≤10.0 ng/ml和≤0.1 AU/ml）。在2例CC患者和6例HCC患者的临床病程中，对CYFRA 21-1水平进行了2次或3次检测，2例CC患者和6例HCC患者中的3例患者的CYFRA 21-1水平随肿瘤生长而逐渐升高。肝癌患者，尤其是AFP和PIVKA II水平正常的患者，血清CYFRA 21-1水平显著升高，提示存在肝内CC而非HCC。
