肝炎后肝硬化患者唾液酸水平的测定及在肝癌诊断中的意义

Detection of sialic acid in hepatitis involved liver cirrhosis and its significance for HCC diagnosis

探讨唾液酸在各种肝病患者血清中变化的情况,研究其在肝炎肝硬化患者中诊断肝癌的价值。收集患者血清包括肝癌4 2例,肝硬化6 6例,慢性肝炎2 4例,重型肝炎12例及健康人对照血清5 3例,应用化学比色方法测定血清中的唾液酸水平,同时以竞争性放射免疫方法测定甲胎蛋白的含量。4 2例肝癌患者中,唾液酸阳性15例,阳性检出率为35 7% ,而4 3例肝硬化患者和4 5例正常人血清对照无一例显示阳性。以唾液酸和甲胎蛋白对4 1例肝癌患者进行联合检测,肝癌阳性检出率达80 . 4 9% (33/ 4 1) ,显著高于单独应用甲胎球蛋白(6 8 .2 9% )和唾液酸(36 . 5 9% ) ,二者一致性为4 3. 9% (18/ 4 1) ,相关性检验P =0 . 0 76 ,无显著相关。上述结果显示,唾液酸具有肿瘤特异性高和不受肝脏炎症干扰的特点,与甲胎蛋白具有很好的互补性,配合AFP可以明显的提高肝癌的阳性检出率,适合应用于肝炎后肝硬化人群肝癌的诊断。

To evaluate the value of sialic acid in HCC diagnosis among patients with hepati tis involved liver cirrhosis (LC).The sera were collected from 42 patients with HCC,66 patients with liver cirrhosis accompanying chronic hepatitis,24 patients with severe chronic hepatitis without liver cirrhosis,12 patients with chronic o r subacute hepatic failure and 53 healthy people.Salic acid (SA) was detected by the method of chemical colorimetric analysis.AFP was detected by method of radi o immunoassay.When the cut-off value of SA is set at 590μg/ml,15 of 42 HCC pati ents show SA positive,while no one of 43 LC patients and 45 healthy controls sho ws positive result.The sensitivity of SA in HCC diagnosis among LC patients was 35.7%.When combined AFP with SA,33 among 41 HCC patients showed positive results ,the sensitivity was 80.4% which was higher than that of AFP (68.29%) and SA(36. 59%) separately.SA has characteristics of tumor-specific and less interfered wit h liver inflammation.The level of SA is totally independent of that of AFP, w hich greatly enhanced HCC diagnostic value of AFP among patients with hepatitis involved liv er cirrhosis.