血浆异常凝血酶原对原发性肝癌诊断的评价

Plasma des-r- Carboxyprothrombin and Hepatocellular Carcinoma: Study of Normal Range and Clinical Significance

应用RIA法测定血浆异常凝血酶原(DOP)531例,其中肝癌(HOG)285例、肝硬化88例、慢迁肝20例,健康成人138例。结果:(1)从累计分布可见91.4％的非癌者DGP含量在200ng/ml以下,61.75％HCC在此值以上。HGO的DOP水平显著高于其它各组(P均<0.01),(2)以DCP的四种界值计算出拟诊HCC较合理的标准,即DCP≥200ng/ml为阳性,<163ng/ml为阴性,163-199ng/ml为可疑;(3)DCP≥200ng/ml的诊断指数、敏感性、特异性、假阳性率、阳性结果价值分别为0.5389±0.0336、62.11％,91.87％、8.13％,89.85％。说明DCP≥200ng/ml是一可靠而有诊断意义的界值;(4)HOC≤5cm的DOP阳性率为57.41％,≥10cm为84％,DCP含量为瘤体大小、病变进展有一致关系;(5)DOP与αFP互相补充可使总阳性率提高达80.35％。

Plasma des-r-carboxyprothrombin (DCP) was analyzed in 531 subjects, using RIA kit. Two groups consisted 285 cases of HCCs and 246 non-HCCs (138 healthy controls, 88 cirrhosis, 20 chronic persistent hepatitis). The results were: (1)upon cumulative distribution, DCP value less than 200ng/ml was found in 91.4％ non-HCCs, of them including 95.7％ healthy controls and 100％ chronic persistent hepatitis. While DCP values above 200ng/ml was found in 61.75％ HGCs. Mean value of DCP in HCCs was significantly higher than those three groups of non-HCCs(p<0.01), and strongly suggested that DCP was valuable for screening of HCCs from other non-malignant hepatic leasions; (2) analysis of four DCP levels, obtained from the above four groups, suggested that DCP 200ng/ml is a rational and reliable value in the diagnosis of HCC, DGP<163ng/ml(-) is negative and 163—199ng/ml(±) is a suspectable value; (3) when DCP≥200ng/ml, the diagnostic exponent, sensitivity, specificity, fulse positive rate., value in positive result were 0.5898±0.0336, 62.11％, 91.87％, 8.13％, 89.85％ respectively; (4) DCP levels in HCGs≤5cm and≥10cm/with metastasis were elevated in 57.14％ and 84％ respectively. When using DCP>163ng/ml as (+) value, the diagnostic rate of HCC≤5cm increased to 73.8％; The mean value of DCP also corresponded well with the tumor size and grade; (5) the sensitivity of DCP in the diagnosis of HCC was increased to 80.35％ by simultaneous measurement of AFP.