CAJ | 학술논문

目的：探讨原发性肝癌( PHC)行经导管动脉化疗栓塞术( TACE)前后血清异常凝血酶原( DCP)和甲胎蛋白( AFP)变化的临床意义。方法：利用ELISA分别检测PHC患者TACE术前及术后第1、2、4个月血清DCP和AFP值；将95例行TACE术治疗的PHC患者根据治疗效果分为好转组和进展组，分析观察术前和术后DCP、AFP动态变化与TACE治疗效果的关系。结果：好转组术后第2、4个月血清DCP和术后第4个月AFP水平均较术前降低(P<0.01)；进展组术后第2、4个月血清DCP和术后第4个月AFP水平均较术前升高(P<0.05)。 AFP<400 ng/ml的PHC患者中进展组术后第1、2、4个月血清DCP水平均较术前升高(P<0.05)，术前、术后AFP水平变化差异均无统计学意义(P>0.05)。结论：DCP和AFP都可以作为PHC患者TACE术疗效判断的指标，在AFP较低时DCP在判断TACE术治疗效果方面比AFP更具优势。
목적：탐토원발성간암( PHC)행경도관동맥화료전새술( TACE)전후혈청이상응혈매원( DCP)화갑태단백( AFP)변화적림상의의。방법：이용ELISA분별검측PHC환자TACE술전급술후제1、2、4개월혈청DCP화AFP치；장95례행TACE술치료적PHC환자근거치료효과분위호전조화진전조，분석관찰술전화술후DCP、AFP동태변화여TACE치료효과적관계。결과：호전조술후제2、4개월혈청DCP화술후제4개월AFP수평균교술전강저(P<0.01)；진전조술후제2、4개월혈청DCP화술후제4개월AFP수평균교술전승고(P<0.05)。 AFP<400 ng/ml적PHC환자중진전조술후제1、2、4개월혈청DCP수평균교술전승고(P<0.05)，술전、술후AFP수평변화차이균무통계학의의(P>0.05)。결론：DCP화AFP도가이작위PHC환자TACE술료효판단적지표，재AFP교저시DCP재판단TACE술치료효과방면비AFP경구우세。
Objective:To explore the clinical significance of the level changes of serum Des-γ-carboxy-prothrombin(DCP) and α-fetoprotein( AFP) before and after transcatheter arterial chemoembolization( TACE) in patients with primary hepatic carcinoma( PHC) . Methods:The serum levels of DCP and AFP in patients with HPC before TACE,and in 1,2 and 4 months after TACE were detected by ELISA. Ninety-five PHC patients treated with TACE were divided into the improvement group and progression group according to their clinical effects. The relationships between DCP and AFP dynamic changes before and after TACE and TACE treatment effect were analysed. Results:Compared with the preoperation,the serum DCP levels in 2 and 4 months after operation and AFP level in 4 months after operation in improvement group decreased(P<0. 01),but in progression group,their levels increased(P<0. 05). Compared with the preoperation,the serum DCP levels in PHC patients of progression group with less than 400 ng/ml of AFP incrased in 1,2 and 4 months after operation(P<0. 05),and the difference of AFP level was not statistical significance(P>0. 05). Conclusions:The serum DCP and AFP level in PHC patients can be acted as the index in judging the curative effect of TACE. The DCP has more advantage than AFP in judging the curative effect of TACE while the serum AFP level is low.