AFP在肠道肝样腺癌诊断与监测中的临床意义

Clinical significance of AFP in diagnosis and monitoring of intestinal hepatic adenocarcinoma

目的 :探讨甲胎蛋白(AFP)在肠道肝样腺癌诊断和术后监测中的临床意义。方法 :收集并回顾分析7例肠道肝样腺癌的组织学形态、术前和术后血清AFP值的变化和癌组织AFP蛋白表达,并复习相关文献,评价AFP在诊断和监测肠道肝样腺癌时的临床价值。结果 :肠道肝样腺癌中肝样分化区与肝细胞癌形态结构相似,呈梁状或巢状,间质血窦丰富。7例患者术前血清AFP浓度为900~20000μg/L,术后7天5例患者血清AFP浓度逐渐下降并恢复至正常水平;2例患者切缘癌细胞累及,血清浓度未下降,提示复发和转移。结论 :术前血清AFP浓度升高、术后癌组织AFP免疫标记阳性是HAC的临床特征,在除外肝等脏器原发性病变外,血清AFP浓度明显升高时,应考虑HAC的诊断,术后或化疗后患者血清AFP值是监控是否复发的重要指标。

Objective To investigate the clinical significance of AFP in the diagnosis and postoperative monitoring of intestinal hepatoid adenocarcinpma. Methods To collecte and retrospectively analyze of the histology manifestation, the preoperative and postoperative changes of serum AFP and cancer tissue AFP protein expression in seven cases of intestinal hepatoid adenocarcinoma, review the related literature, evaluate the clinical value of AFP in the diagnosis and monitoring of intestinal hepatoid adenocarcinoma. Results Its had similar morphology and structure in the area of hepatoid differentiation in the intestinal hepatoid adenocarcinoma and in the hepatocellular carcinom, it were the shape of beam or nest and the rich interstitial blood.The 900 to 20000μg/L serum AFP concentration in 7 preoperative patients, there were 5 patients decreased gradually and restore to normal levels and 2 patients resection margin involvement, serum concentrations did not decrease, suggesting recurrence and metastasis. Conclusion It were the clinical features of hepatoid adenocarcinoma to elevated preoperative serum AFP concentration and positive postoperative cancer AFP immune markers positive. If the serum AFP concentration markedly elevated should be consider the diagnosis of hepatoid adenocarcinoma except liver and other organs of the primary lesions. It was important indicators to monitor hepatoid adenocarcinoma whether recurrence after surgery or chemotherapy.