PROSPECTIVE-STUDY OF ALPHA-FETOPROTEIN IN CIRRHOTIC-PATIENTS MONITORED FOR DEVELOPMENT OF HEPATOCELLULAR-CARCINOMA
PROSPECTIVE-STUDY OF ALPHA-FETOPROTEIN IN CIRRHOTIC-PATIENTS MONITORED FOR DEVELOPMENT OF HEPATOCELLULAR-CARCINOMA
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DOI：
10.1002/hep.1840190111
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发表时间：
1994-01-01
期刊：
影响因子：
13.5
通讯作者：
YAMAMOTO, S
中科院分区：
文献类型：
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作者：
OKA, H;TAMORI, A;YAMAMOTO, S
通过对260例肝硬化患者的前瞻性研究，评价了血清甲胎蛋白升高对诊断肝细胞癌发展的有用性。在5年的随访中，55例患者发现肝细胞癌，排除7例在前6个月发现肝细胞癌。在入组时甲胎蛋白水平低于20 ng/ml的185例患者中，肝细胞癌的累积发病率为26%，在甲胎蛋白水平为20 ng/ml或更高但低于200 ng/ml的68例患者中，肝细胞癌的累积发病率为46%。在169例患者中，定期检测血清甲胎蛋白水平至少2年。在36例甲胎蛋白反复一过性升高至100 ng/ml以上的患者中，肝细胞癌的发生率为36%。这显著高于甲胎蛋白水平始终低于20 ng/ml的99例患者的发生率。因此，甲胎蛋白水平20 ng/ml或更高的患者，甲胎蛋白一过性升高的患者或两者都有的患者应被视为肝细胞癌的超高风险组。建议对此类患者进行频繁和仔细的超声检查。
The usefulness of measurements of serum alpha-fetoprotein elevation for diagnosis of the development of hepatocellular carcinoma was evaluated by a prospective study of 260 patients with cirrhosis. Hepatocellular carcinoma was found in 55 patients during the 5-yr follow-up, excluding 7 found to have hepatocellular carcinoma in the first 6 mo. The cumulative incidence of hepatocellular carcinoma was 26% in the 185 patients who had alpha-fetoprotein levels below 20 ng/ml at the time of entry and 46% in the 68 patients who had alpha-fetoprotein levels of 20 ng/ml or more but below 200 ng/ml. In 169 of the patients, serum levels of alpha-fetoprotein were assayed regularly for at least 2 yr. The incidence of hepatocellular carcinoma development in the 36 patients who had repeated transient increases in alpha-fetoprotein to above 100 ng/ml was 36%. This was significantly higher than the incidence in the 99 patients who had alpha-fetoprotein levels consistently below 20 ng/ml. Thus patients who had alpha-fetoprotein levels of 20 ng/ml or more, who had transient increases in alpha-fetoprotein or who had both should be treated as being in a super-high-risk group for hepatocellular carcinoma. Frequent and careful examination by ultrasonography of such patients is recommended.