SERUM ALPHA-FETOPROTEIN ESTIMATIONS AND DOUBLING TIME IN HEPATOCELLULAR-CARCINOMA - INFLUENCE OF THERAPY AND POSSIBLE VALUE IN EARLY DETECTION
SERUM ALPHA-FETOPROTEIN ESTIMATIONS AND DOUBLING TIME IN HEPATOCELLULAR-CARCINOMA - INFLUENCE OF THERAPY AND POSSIBLE VALUE IN EARLY DETECTION
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DOI：
10.1093/jnci/64.6.1329
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发表时间：
1980-01-01
影响因子：
10.3
通讯作者：
WILLIAMS, R
中科院分区：
文献类型：
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作者：
JOHNSON, PJ;WILLIAMS, R
在 40 名肝细胞癌患者中测量 32 至 500 多天的连续甲胎蛋白 (AFP) 水平，准确地反映了对化疗 [阿霉素] 或手术的反应。在对化疗没有反应的患者中以及在最初成功的化疗或手术后复发的患者中，AFP 浓度随着时间呈指数级上升。以倍增时间为特征的上升率在 6.5-112 天（平均 41 天）范围内，与生存时间呈正相关，并被证明对预后有帮助。 AFP 浓度的下降与肿瘤质量的减少有关；达到正常水平并不一定意味着肿瘤完全清除，正如两名接受移植治疗但肿瘤复发的患者所显示的那样。基于临床表现时 AFP 浓度和 AFP 倍增时间的数据表明，放射免疫测定可检测到的 AFP 浓度增加可能持续长达 18 个月。在出现症状之前。通过这种方式，对高危人群（即患有肝硬化的男性）进行筛查可以显着提早诊断。
Serial .alpha.-fetoprotein (AFP) levels, measured from 32 to more than 500 days in 40 patients with hepatocellular carcinoma, accurately reflected a response to chemotherapy [adriamycin] or surgery. In patients who failed to respond to chemotherapy and in those who relapsed after initially successful chemotherapy or surgery, AFP concentration rose exponentially with time. The rate of rise, as characterized by the doubling time ranged 6.5-112 days (mean, 41 days), correlated positively with survival time and proved a useful guide to prognosis. Falls in AFP concentrations were associated with a decrease in tumor mass; the achievement of a normal level did not necessarily imply complete tumor clearance as shown in 2 patients who had been treated by transplantation and in whom the tumor recurred. Data based on AFP concentrations at the time of clinical presentation and AFP doubling time suggest that increasing concentrations of AFP detectable by radioimmunoassay may be present up to 18 mo. before appearance of symptoms. In this way screening of high-risk groups, i.e., men with cirrhosis, could lead to significantly earlier diagnosis.