AFP-IgM复合物在肝癌中的表达与临床关系
AFP-IgM복합물재간암중적표체여림상관계
Expression of AFP-IgM immune complexes in hepatocellular carcinoma and its clinical significance
  • 万方数据
    中华肝胆外科杂志 중화간담외과잡지
    CHINESE JOURNAL OF HEPATOBILIARY SURGERY
    2009年 8期 578-581 ,共4页

    蒋敬庭%吴昌平%吴骏%秦锡虎%孙达成%季枚%邓海峰%陆明洋%周国平%李敏%徐斌%郑晓%刘检%石亮荣%Ning Xu%Peter Nilsson-Ehle

    장경정%오창평%오준%진석호%손체성%계매%산해봉%륙명양%주국평%리민%서빈%정효%류검%석량영%Ning Xu%Peter Nilsson-Ehle

    癌,肝细胞%肿瘤标志物%甲胎蛋白-免疫球蛋白M复合物(AFP-IgM)%甲胎蛋白(AFP) 癌,肝細胞%腫瘤標誌物%甲胎蛋白-免疫毬蛋白M複閤物(AFP-IgM)%甲胎蛋白(AFP)
    암,간세포%종류표지물%갑태단백-면역구단백M복합물(AFP-IgM)%갑태단백(AFP)
    Carcinoma,hepatocellular%AFP-IgM immune complexes%AFP
    目的 分析甲胎蛋白-IgM免疫复合物(AFP-IgM)在肝细胞癌(HCC)中的含量,探讨AFP-IgM对诊断肝癌的临床意义.方法 采用酶联免疫吸附法与电化学发光法,对103名正常人、74例肝癌、43例肝硬化和58例脂肪肝病人血清AFP-IgM与甲胎蛋白(AFP)含量检测,并分析其与临床病理特点之间的关系.结果 应用ROC曲线确定AFP-IgM和AFP的最佳切割值分别为300 Au/ml和10μg/L作为诊断学意义的临界值.在此切割值下,肝癌组AFP-IgM和AFP血清水平均高于脂肪肝组和健康体检组(P<0.05).对早期(Ⅰ与Ⅱ期)肝癌诊断时,AFP-IgM的ROC曲线下面积大于AFP(0.91 vs 0.82);当肿瘤直径≤3 cm时,AFP-IgM为(1090.4±571.8)Au/ml,而当直径>3 cm时,AFP-IgM为(604.9±749.9)Au/ml,两者比较P<0.05.且AFP-IgM在诊断小肝癌时ROC曲线下面积大于AFP(0.92 vs 0.78);AFP-IgM对性别、年龄、乙型肝炎表面抗原、肿瘤数量、包膜的相关性无统计学意义(P>0.05),而与肿块大小和分期密切相关.结论 AFP-IgM对早期(Ⅰ与Ⅱ期)肝癌和小肝癌(≤3 cm)诊断具有重要作用,且对判断肝癌的肿瘤大小与分期等具有一定的临床意义.
    목적 분석갑태단백-IgM면역복합물(AFP-IgM)재간세포암(HCC)중적함량,탐토AFP-IgM대진단간암적림상의의.방법 채용매련면역흡부법여전화학발광법,대103명정상인、74례간암、43례간경화화58례지방간병인혈청AFP-IgM여갑태단백(AFP)함량검측,병분석기여림상병리특점지간적관계.결과 응용ROC곡선학정AFP-IgM화AFP적최가절할치분별위300 Au/ml화10μg/L작위진단학의의적림계치.재차절할치하,간암조AFP-IgM화AFP혈청수평균고우지방간조화건강체검조(P<0.05).대조기(Ⅰ여Ⅱ기)간암진단시,AFP-IgM적ROC곡선하면적대우AFP(0.91 vs 0.82);당종류직경≤3 cm시,AFP-IgM위(1090.4±571.8)Au/ml,이당직경>3 cm시,AFP-IgM위(604.9±749.9)Au/ml,량자비교P<0.05.차AFP-IgM재진단소간암시ROC곡선하면적대우AFP(0.92 vs 0.78);AFP-IgM대성별、년령、을형간염표면항원、종류수량、포막적상관성무통계학의의(P>0.05),이여종괴대소화분기밀절상관.결론 AFP-IgM대조기(Ⅰ여Ⅱ기)간암화소간암(≤3 cm)진단구유중요작용,차대판단간암적종류대소여분기등구유일정적림상의의.
    Objective To determine the contents of the new tumor marker alpha fetoprotein immunoglobulin M immunocomplex (AFP-IgM) in hepatocellular carcinoma (HCC) and evaluate the correlation between the level of AFP-IgM and clinical feature of HCC.Methods The contents of AFP-IgM and AFP in serum of 103 healthy subjects,74 patients with HCC,43,patients with hepatic cirrhosis and 58 patients with adiposis hepatica were detected by enzyme linked immunosorbent assay and electrochemiluminescence.Results As the critical value of diagnostic significance,the best cutoff value of AFP-IgM and AFP was 300 Au/ml and 10 ug/L,respectively.Under the cutoff value,the mean serum concentrations of AFP-IgM and AFP were significantly higher in the HCC group than in the adiposis hepatica and health examination groups (P<0.05).However,for early diagnosis of liver cancer (stage Ⅰ andⅡ),the area under ROC curve of AFP-IgM was larger than that of AFP (0.91 vs 0.82).The differences of AFP-IgM and AFP for early diagnosis of liver cancer were statistically significant.When the tumor was less than and over 3cm in diameter,the contents of AFP-IgM was (1090.4±571.8)Au/ml,and (604.9±749.9)Au/ml,respectilvely (P<0.05).Furthermore,the area under ROC curve of AFP-IgM was larger than that of AFP (0.92 vs 0.78) in diagnosis of small hepatocellular carcinoma.The dependability between the level of AFP-IgM and sex,age,HBsAg,the quantity of the tumor and capsule was not significant (P>0.05),but the level of AFP-IgM was closely correlated to the tumor size and stages.Conclusion AFP-IgM is of great significance for early diagnosis of liver cancer.Meanwhile,AFP-IgM has an effect in clinical judgment of the tumor size,differentiation and so on in liver cancer.
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