γ-谷氨酰移换酶同功酶Ⅱ对原发性肝癌疗效与预后判断价值的探讨

THE STUDY OF γ-GLUTAMYL TRANSPEPTIDASE Ⅱ FOR CURATIVE EFFECT AND PROGNOSIS OF HEPATOCELLULAR CARCINOM

目的：了解γ－谷氨酰移换酶同功酶Ⅱ（γ－ＧＴⅡ）对原发性肝癌（ＰＨＣ）疗效和预后的判断价值。方法：动态观察８０例ＰＨＣ治疗前后γ－ＧＴⅡ的变化，以ＡＦＰ作对照。结果：治疗后γ－ＧＴⅡ可转阴，手术组转阴率显著高于化疗栓塞组（８６．９％ｖｓ．１１．１％），根治切除组显著高于姑息切除组（１００．０％ｖｓ．５７．１％）。８例肝癌术后复发，γ－ＧＴⅡ均转阳性，２例再切除后又转阴性。结论：手术前后动态监测γ－ＧＴⅡ可了解肝癌切除是否彻底，能及时发现肝癌复发，对ＡＦＰ阴性患者意义更大。γ－ＧＴⅡ和ＡＦＰ联用对ＰＨＣ疗效和预后的判断有重要价值。

Objective:To investigate the diagnotic value of γ-glutamyl transpeptidase Ⅱ(γ-GTⅡ) for curative effect and prognosis of HCC.Methods:Serum γ-GTⅡ were determined consecutively in 80 cases,which divided into surgical resection group (30 cases) and transhepatic artery chemotherapy embolism (TACE) group (50cases).Results:The positive of γ-GTⅡ could be transferred to negative after treatment.The transfer negative rate of operating group was much higher than that of TACE(86.9% vs.11.1%) and the radical resection much higher than palliative resection (100.0% vs.57.0%).The γ-GTⅡ transferred from negative to positive in 8 cases of postoperative recurrent HCC.Conclusion:The serum γ-GTⅡ assay has a significant diagnostic value for curative effect and prognosis of HCC after surgical resection and more valuable in AFP negative cases.