Introduction and Aim of the Work: The identification of cirrhotic patients with esophageal varices or other portosystemic collateral by non-invasive means is appealing in that it could decrease the necessity of endosc...Introduction and Aim of the Work: The identification of cirrhotic patients with esophageal varices or other portosystemic collateral by non-invasive means is appealing in that it could decrease the necessity of endoscopic screening. This study was to evaluate the diagnostic utility of venous ammonia level with other ultrasonographic parameters as non-invasive markers for the presence of portosystemic shunts. Patients and methods: The study included 3 groups of Child Pugh class A and early B patients. Group (A): 25 patients with evidence of both esophageal varices and portosystemic collaterals;group (B) 25 patients with neither evidence of varices nor portosystemic collaterals and group (C): 25 patients with evidence of varices but no collaterals. Measurement of venous ammonia level was done for all patients. Results: serum ammonia level was significantly higher in group A (222.8 ± 54 μg/dL) than that in group B (85 ± 21.1 μg/dL) and group C (148.2 ± 19.6 μg/dL). The cut-off value of serum ammonia level 113 μg/dL was a good predictor for the presence of esophageal varices, while the cut-off value of serum ammonia level at 133 μg/dL was a good predictor for the presence of both esophageal varices and abdominal collaterals. Combination of portal vein diameter > 13mm + splenic vein diameter > 8.9mm + ammonia level > 133 μg/dL gives 100% of sensitivity and 96% of specificity for the prediction of the presence of portosystemic shunts. Conclusion: Determination of serum ammonia level, splenic, portal vein and splenic vein diameters are considered as good predictors for the presence of portosystemic shunts in patients with liver cirrhosis.展开更多
目的 探讨 u PA、u PAR基因表达和肝癌转移、肝细胞癌门静脉主干癌栓 (Tum or thrombosid of the m ain trunkof the portal vein,PVTT)形成的关系。方法 采用原位杂交等技术检测 u PA、u PAR表达。结果 癌栓 (A1组 )和其原发癌(A2组...目的 探讨 u PA、u PAR基因表达和肝癌转移、肝细胞癌门静脉主干癌栓 (Tum or thrombosid of the m ain trunkof the portal vein,PVTT)形成的关系。方法 采用原位杂交等技术检测 u PA、u PAR表达。结果 癌栓 (A1组 )和其原发癌(A2组 ) u PA、u PAR m RNA阳性表达率均高于无转移肝癌 (B组 ) (P均 <0 .0 1) ;A 1组表达强度均高于 A2组 (P<0 .0 1)。 A 2组小血管内可见癌细胞群落 ,A 1组多见 ,B组无此现象。 A1组、A 2组 u PAR和 u PA蛋白质阳性表达率均高于 B组 (P均 <0 .0 1) ,A1组表达强度均高于 A2组 (P<0 .0 1)。 u PA、u PAR m RNA和其蛋白质表达存在良好相关性 (P均 <0 .0 1)。结论 u PA、u PAR在肝癌的侵袭和转移中起重要作用 ,其过度表达是展开更多
文摘Introduction and Aim of the Work: The identification of cirrhotic patients with esophageal varices or other portosystemic collateral by non-invasive means is appealing in that it could decrease the necessity of endoscopic screening. This study was to evaluate the diagnostic utility of venous ammonia level with other ultrasonographic parameters as non-invasive markers for the presence of portosystemic shunts. Patients and methods: The study included 3 groups of Child Pugh class A and early B patients. Group (A): 25 patients with evidence of both esophageal varices and portosystemic collaterals;group (B) 25 patients with neither evidence of varices nor portosystemic collaterals and group (C): 25 patients with evidence of varices but no collaterals. Measurement of venous ammonia level was done for all patients. Results: serum ammonia level was significantly higher in group A (222.8 ± 54 μg/dL) than that in group B (85 ± 21.1 μg/dL) and group C (148.2 ± 19.6 μg/dL). The cut-off value of serum ammonia level 113 μg/dL was a good predictor for the presence of esophageal varices, while the cut-off value of serum ammonia level at 133 μg/dL was a good predictor for the presence of both esophageal varices and abdominal collaterals. Combination of portal vein diameter > 13mm + splenic vein diameter > 8.9mm + ammonia level > 133 μg/dL gives 100% of sensitivity and 96% of specificity for the prediction of the presence of portosystemic shunts. Conclusion: Determination of serum ammonia level, splenic, portal vein and splenic vein diameters are considered as good predictors for the presence of portosystemic shunts in patients with liver cirrhosis.
文摘目的 探讨 u PA、u PAR基因表达和肝癌转移、肝细胞癌门静脉主干癌栓 (Tum or thrombosid of the m ain trunkof the portal vein,PVTT)形成的关系。方法 采用原位杂交等技术检测 u PA、u PAR表达。结果 癌栓 (A1组 )和其原发癌(A2组 ) u PA、u PAR m RNA阳性表达率均高于无转移肝癌 (B组 ) (P均 <0 .0 1) ;A 1组表达强度均高于 A2组 (P<0 .0 1)。 A 2组小血管内可见癌细胞群落 ,A 1组多见 ,B组无此现象。 A1组、A 2组 u PAR和 u PA蛋白质阳性表达率均高于 B组 (P均 <0 .0 1) ,A1组表达强度均高于 A2组 (P<0 .0 1)。 u PA、u PAR m RNA和其蛋白质表达存在良好相关性 (P均 <0 .0 1)。结论 u PA、u PAR在肝癌的侵袭和转移中起重要作用 ,其过度表达是
