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1.
肝病患者511例血清铁蛋白检测对原发性肝癌的诊断价值   总被引:2,自引:0,他引:2  
用RIA法检测111例原发性肝癌(PHC)(AFP>20ng/L86例、AFP≤20ng/L25例),342例急慢性肝炎及58例其它恶性肿瘤共计511例患者血清铁蛋白(SF),并与102例健康人群对照,结果显示:PHC组SF水平明显高于其它恶性肿瘤(P<0.001)和各种肝炎(P<0.05),尤其是血清SF检测对AFP≤20ng/L的25例PHC诊断敏感性高达92%,且10例PHC手术前后SF对比有显著差异(P<0.001)。故认为SF测定可能对早期诊断PHC,尤其AFP含量低的PHC是一个比较灵敏的指标。  相似文献   

2.
目的探讨血清甲胎蛋白(AFP)、表皮生长因子样结构域(Egfl7)联合检测在原发性肝癌(PHC)中的诊断价值。方法选择2015年10月至2017年2月期间我院经病理证实的PHC患者53例,肝硬化结节增生23例,另外选取20名健康志愿者作为对照组。检测3组的血清AFP、Egfl7水平,并进行比较。结果 PHC组AFP、Egfl7水平明显高于肝硬化结节增生组和对照组(均P0.05)。Pearson相关分析发现血清Egfl7与PHC的病灶体积呈明显正相关(r=0.874,P0.001)。联合检查诊断PHC要优于单独检测,灵敏度、特异度分别为88.64%、78.26%,漏诊率仅为11.32%。联合检测对小肝癌诊断显示较好诊断效能,敏感度及特异度分别为86.36%、69.56%。结论患者血清AFP、Egfl7的联合检测可提高PHC诊断率,降低漏诊率,对早期PHC诊断、治疗具有重要的临床意义。  相似文献   

3.
目的 探讨联合检测血清甲胎蛋白(AFP)、γ-谷氨酰基转移酶(GGT)、铁蛋白(SF)在原发性肝癌诊断中的价值.方法 检测61例原发性肝癌患者、64例肝炎/肝硬化患者和55例健康对照组血清AFP、GGT、SF的含量.结果 AFP和SF检测的阳性率在原发性肝癌组与肝炎/肝硬化组比较差异具有统计学显著意义(P<0.05),肝癌组的阳性率高于肝炎/肝硬化组,GGT检测的阳性率在两组比较差异无统计学意义(P>0.05);AFP、GGT和SF三项联合检测原发性肝癌的阳性率可提高到96.7%,与单项检测比较差异均具有统计学显著意义(P<0.05).结论 血清AFP、GGT、SF联合检测可明显提高对原发性肝癌的阳性检出率.  相似文献   

4.
目的评价甲胎蛋白异质体(AFP-L3)对于原发性肝癌(PHC)的诊断价值。方法收集本院2013年1月至2013年7月住院及门诊患者185例,包括PHC患者61例(PHC组)、肝硬化患者66例(肝硬化组)、慢性活动性肝炎患者58例(慢性肝炎组)。选择同期健康体检者60例为对照组。AFP-L3采用亲和吸附离心管分离血清,AFP和AFP-L3水平采用化学发光法检测,以AFP-L3≥10%为阳性诊断标准,计算AFP-L3的百分含量。结果 PHC组、肝硬化组、慢性肝炎组、对照组患者血清AFP-L3阳性率分别为78.02%、69.8%、78.26%、0%。PHC组患者AFP-L3水平与肝硬化组比较,差异无统计学意义(P=0.062)。PHC组患者AFP-L3水平与对照组比较,差异有统计学意义(P=0.031)。结论AFP-L3是国际公认的对PHC鉴别诊断的有用指标,但本研究显示其在良性肝病特别是肝硬化与PHC差别不明显,因此仍应与AFP及影像学联合检测更有利于PHC的诊断。  相似文献   

5.
探讨血清α-L-岩藻糖苷酶(AFU)和甲胎蛋白(AFP)的联合检测对原发性肝癌(PHC)诊断的临床意义.应用自动生化分析仪测定正常人,非PHC的其它恶性肿瘤组,PHC组患者血清AFU的含量,应用时间分辨荧光免疫分析测定血清AFP含量.PHC、肝转移癌、胰腺癌均高于正常对照组(P<0.01或P<0.05),PHC阳性率高90.9%.AFU与AFP之间无相关性(P>0.5).血清AFU在PHC中敏感性较高.联合检测AFU、AFP对明显提高PHC的诊断具有实用价值.  相似文献   

6.
血清标志物在肝炎肝硬化患者中诊断肝癌的价值   总被引:2,自引:0,他引:2  
目的寻找有效的适合用于肝炎肝硬化患者肝癌诊断的血清肿瘤标志物.方法AFP测定应用竞争性放射免疫技术(RIA),岩藻糖苷酶(AFU)测定应用酶化学技术,唾液酶(SA)测定应用化学法,可溶性白介素2受体(sIL-2R)和肝细胞生长因子(HGF)的测定应用单克隆抗体双夹心酶联免疫吸附试验(ELISA).结果AFU、AFP和SA三项指标肝癌患者显著高于肝硬化患者,P值分别为P=0.027,P<0.001和P<0.001.分别以AFU值440nmol/ml·h-1、AFP测定值400 ng/ml、SA测定值590 μg/ml为阳性参考值,测定肝癌组患者阳性率分别为57.57%、68.09%和35.7%.三者假阳性率分别为48%、20%和0,以AFP和SA对41例肝癌进行联合检测,其肝癌患者阳性检出率为80.49%.肝癌患者血清sIL-2R水平与肝硬化患者及肝炎患者比较无显著差异,P>0.05.肝癌患者血清HGF水平低于肝硬化患者以及重症肝炎患者.结论肝癌患者HGF、sIL-2R和AFU显著高于正常人血清,但其升高的水平受肝脏炎症影响较大,对肝癌的特异性较差,因而不适合应用于肝炎肝硬化患者肝癌的诊断.AFP仍然是最敏感的肝癌血清指标,SA具有肿瘤特异性高和不受肝脏炎症干扰的特点,适合肝炎肝硬化患者肝癌的诊断,联合AFP可以使阳性检出率达80.49%,使肝癌的诊断灵敏性大大提高.  相似文献   

7.
目的通过联合检测磷脂酰肌醇蛋白聚糖-3(GPC3)、甲胎蛋白(AFP)在原发性肝癌患者血清及组织中的表达情况,探讨对原发性肝癌的诊断价值。方法分别采用ELISA和免疫组织化学法检测57例肝癌、74例肝炎后肝硬化患者和47例正常血清和肝组织GPC3、AFP表达水平,根据不同临床病理指标进行分组比较。结果 (1)肝癌患者、肝炎后肝硬化及正常对照者血清中GPC3水平分别为(212.6±137.5)、(60.9±27.8)、(39.5±18.7)ng/ml;肝癌患者血清GPC3浓度显著高于正常及肝炎后肝硬化患者(t=4.503,P〈0.05;t=6.045,P〈0.05);血清GPC3、AFP联合检测原发性肝癌的敏感性和特异性为84.2%和95.7%,均显著高于任一单项检测(t=4.132,P〈0.05;t=6.514,P〈0.05);(2)GPC3在肝癌组织表达高于癌旁和正常肝组织(t=3.724,P〈0.05;t=15.799,P〈0.05);GPC3与肿瘤大小、肿瘤数目、HBsAg及AFP水平无明显相关,而与病理分级和临床分期有关;(3)AFP阳性肝癌血清GPC3阳性率为91.4%,而在AFP阴性肝癌中GPC3阳性率为59.1%。结论 GPC3联合AFP检测有助于提高原发性肝癌的确诊率,检测GPC3有助于提高AFP阴性患者肝癌的确诊率。  相似文献   

8.
目的研究血清甘氨酰脯氨酸二肽氨基肽酶(grycylprolinedipeptidylaminopeptidase,GPDA)同工酶对PHC的诊断价值,提高早期PHC和AFP阴性PHC诊断水平。方法采用阶段梯度垂直平板聚丙烯酰胺凝胶电泳法进行血清GPDA同工酶分离检测,同步测定比较PHC患者血清GPDA同工酶与GPDA总活性(TGPDA)、AFP、肿瘤大小及ALT的关系。结果血清GPDA按其泳动速度可分为快带(GPDA-F)与慢带(GPDA-S)两种同工酶。PHC患者血清GPDA-F的阳性率为85.3%,而肝外肿瘤、转移性肝癌、肝炎后肝硬化、慢性肝炎中阳性率均较低,正常对照组以及良性肝占位全部阴性。GPDA-F阳性率在TGPDA活性增高组明显高于正常组(94.4%对75.0%),GPDA-F与AFP及肿瘤大小无关系。良性肝病ALT升高组GPDA-F阳性率高于ALT正常组,而PHC患者GPDA-F与ALT无关。PHC患者GPDA-F呈持续阳性,良性肝病患者GPDA-F常为一过性阳性。结论GPDA-F为一新的PHC血清标志物,有助于PHC的定性诊断,尤其对早期PHC及AFP阴性PHC的诊断具有重要价值。  相似文献   

9.
血清肿瘤标志物DR-70^TM对原发性肝癌的诊断价值   总被引:1,自引:0,他引:1  
目的评价血清肿瘤标志物DR-70^TM在原发性肝癌中的诊断价值,提高原发性肝癌(PHC)的检出率。方法应用美国AMDL公司的DR-70^TMELISA试剂盒,对20例正常人和60例AFP阳性原发性肝癌、43例AFP阴性原发性肝癌及30例肝硬化病人血清进行检测DR-70含量。结果原发性肝癌组血清DR-70^TM含量明显高于肝硬化组和正常对照组(P均〈0.001),AFP阳性原发性肝癌DR-70的阳性率为81.67%,AFP阴性原发性肝癌为93.02%,差异有显著性(P〈0.05)。DR-70^TM诊断肝癌敏感性为86.4%,特异性为94%;肝硬化组阳性率10%,特异性90%。肝硬化组与正常组比较差异无显著性(P〉0.05);DR-70^TM与癌肿(直径)大小无明显关系(P〉0.05)。结论血清DR-70和AFP联合检测可大大提高原发性肝癌的阳性率,有利于原发性肝癌的早期诊断,特别是AFP阴性的肝癌的有价值的标志物。也有利于PHC与肝硬化(LC)的鉴别诊断。对非恶性肿瘤病人特异性较高,对人群筛选将有较高的参考价值。  相似文献   

10.
对原发性肝癌(PHC)58例,良性肝病62例(包括肝硬化31例,肝血管瘤10例,慢活肝15例,急性肝炎,6例),转移性肝癌10例,正常对照30例。检测血清γ-谷氨硫胺转换酶同功酶Ⅱ(γ-GTⅡ),并且与甲胎蛋白(AFP)及AFP异质体对照。结果显示γ-GTⅡ对PHC有较高的敏感性和特异性,与AFP联合检测可以提高AFP阴性的PHC患者的诊断率,同时还可用以小肝癌的诊断及观察PHC的治疗效果。  相似文献   

11.
Forty-nine liver disease patients (7 chronic persistent hepatitis, CPH; 10 chronic active hepatitis, CAH; 13 liver cirrhosis, LC; 9 primary hepatocellular carcinoma, PHC, without LC; and 10 PHC with associated LC) and 20 controls were assessed for their serum alpha-L-fucosidase (ALF) and alpha-fetoprotein (AFP) levels and several routine liver injury parameters. Tumor diameter in those with hepatic cancer was assessed by angio-CT. Only ALF and AFP were significantly greater in patients with PHC and PHC + LC patients as compared to patients with LC alone. At an accepted cutoff level of 500 ng/ml, the AFP level provided 43% false negative tests. On the other hand, an ALF level exceeding 740 mumol/hr/ml provided a sensitivity of 84% with a specificity of 94%. No relationship between the ALF level and Child's criteria or with any liver injury parameter was evident. Considering all individual values, the ALF, rather than the AFP, correlated with tumor size. This finding suggests the ALF level may be of value in the early detection of PHC as well as in the follow-up of patients treated for PHC.  相似文献   

12.
目的探讨甲胎蛋白(AFP)在原发性肝癌首诊中的诊断价值。方法回顾性分析177例临床资料相对完善的最终确诊为原发性肝癌(PHC)患者首诊时的AFP及影像学结果,以2011年收治的98例慢性乙型肝炎、82例乙型肝炎肝硬化患者为对照组。计数资料采用χ2检验。结果177例PHC患者首诊时AFP≥400 ng/ml 93例,20 ng/ml <AFP<400 ng/ml 38例,正常46例,分别占5254%、21.47%、25.99%,异常率占74.01%,显著高于慢性乙型肝炎组(χ2=106.07,P<0.001)和乙型肝炎肝硬化组(χ2=67.82,P<0.001);177例患者中63例病程中AFP<400 ng/ml,占35.59%;肿瘤直径≤3 cm患者的AFP水平低于直径>5 cm患者(χ2=862,P<0.005);首诊时AFP确诊率低于B超 (χ2=30.39,P<0.000)和CT (χ2=84.83,P<0.000)。结论PHC患者首诊时AFP异常率较高,且AFP水平越高,其诊断价值越大,AFP水平与肿瘤大小有一定关系;也要警惕AFP阴性的PHC;动态监测AFP并结合影像学检查有利于早期诊断,以减少漏诊误诊。  相似文献   

13.
转化生长因子β1对原发性肝癌诊断价值的初步探讨   总被引:3,自引:0,他引:3  
为了解转化生长因子β1(TGFβ1)在原发性肝癌中的诊断意义,用酶联免疫吸附试验法(ELISA)测定了47例原发性肝癌(PHC)、77例其他各种肝病和消化道恶性肿瘤及20例正常对照者的血清TGFβ1水平。结果:PHC血清TGFβ1水平明显高于正常对照及其他各病组(P值分别<0.05或0.01)。血清TGFβ1诊断PHC的敏感性和特异性分别为72.3%和77.9%,甲胎蛋白(AFP)阴性PHC诊断阳性率为78.6%,其中7例小肝癌有5例(71.4%)血清TGFβ1阳性,与AFP联合检测可提高PHC诊断阳性率,达93.6%。血清TGFβ1作为一种新的PHC血清标志物应用于PHC的诊断、监测和疗效判断,尤其是对AFP阴性或早期肝癌的诊断,有重要临床意义。  相似文献   

14.
BACKGROUND AND AIM: Patients with liver disease are prone to develop peptic ulceration and often receive H(2)-receptor antagonists. Therefore, it is important to clarify whether the pharmacokinetics of H(2)-receptor antagonists is affected by hepatic function. However, pharmacokinetics of a new H(2)-receptor antagonist, roxatidine acetate, in chronic liver disease has not been well known. In this study, we analyzed the pharmacokinetics of roxatidine in patients with liver disease. METHODS: Blood samples were obtained from 11 patients with chronic hepatitis, 11 patients with cirrhosis and six healthy subjects. Under fasting conditions, 75 mg of roxatidine acetate was administered orally, and plasma roxatidine levels were determined sequentially from 3 to 12 h. Relationships between pharmacokinetic variables and each parameter related to hepatic functions were also investigated. RESULTS: There was no difference in the pharmacokinetic variables and serum levels of roxatidine between chronic hepatitis and healthy controls. In contrast, in cirrhosis, serum roxatidine levels were significantly higher than those in chronic hepatitis and normal control. Half-life, the area under the plasma concentration-time curve and clearance in cirrhosis were also significantly longer, bigger and smaller than those in chronic hepatitis and healthy controls, respectively. The half-life became longer and the clearance became smaller in parallel with the progression of liver disease. Serum levels of hyaluronate and gamma-glutamyl transpeptidase showed a good correlation with half-life, clearance and elimination rate. A good correlation between creatinine clearance and elimination rate was found. CONCLUSION: Pharmacokinetics of roxatidine acetate is affected by hepatic function, and the dosage of roxatidine acetate for patients with liver disease, especially cirrhosis, should be modified.  相似文献   

15.
Endoglin, a transforming growth factor (TGF)-beta1 co-receptor, has been associated with renal and cutaneous fibrosis, as overexpression of this protein has been observed in biopsies from patients with glomerulosclerosis and scleroderma, respectively. Our aim was to evaluate whether endoglin may be associated with hepatic fibrosis featuring chronic hepatitis C virus (HCV) infection. Fifty-two anti-HCV+ patients, five anti-HCV- patients and 27 healthy subjects were studied. Western blot and immunohistochemistry were used to quantify the expression levels of endoglin and TGF-beta1 in liver biopsy samples, and serum concentrations of endoglin and hyaluronic acid were determined by enzyme-linked immunosorbent assays (ELISAs). In patients with advanced fibrosis, intrahepatic expression levels of endoglin and TGF-beta1 were significantly higher than those in patients with early fibrosis (mean: 3- and 5.8-fold, respectively) and normal liver (mean: 3.9- and 12-fold, respectively). Interestingly, activated hepatic stellate cells as well as portal and septal myofibroblasts expressed endoglin. Serum levels of endoglin were also significantly higher in patients with advanced fibrosis than in those with early fibrosis (55.5 +/- 1.6 vs 47.5 +/- 0.9 ng/mL, P < 0.001), showing a positive correlation with serum hyaluronic acid concentrations (r = 0.57, P = 0.01). In conclusion, increased intrahepatic endoglin and TGF-beta1 expression is significantly associated with progressive hepatic fibrosis in chronic HCV infection. Circulating endoglin levels are elevated in HCV patients showing a significant correlation with histological and serum markers of hepatic fibrosis. These data suggest an active role for endoglin in the fibrotic process featuring chronic HCV infection.  相似文献   

16.
目的 应用滚环扩增(RCA)技术检测HBV共价闭合环状DNA(cccDNA),观察该方法的特异性和敏感性.方法 以HBV全基因质粒为模板,经酶切、连接、浓缩、胶回收纯化等步骤,构建和制备HBV cccDNA标准品.抽提7例慢性乙型肝炎患者肝组织总DNA,进行滚环扩增.用HBV cccDNA标准品、3.2 kb线性HBV DNA、健康肝组织总DNA及15例慢性乙型肝炎患者血清总DNA作为对照,验证此方法的特异性.将HBV cccDNA标准品进行系列稀释,了解该方法的敏感性.结果 成功构建了HBV cccDNA,并可用RCA方法进行扩增.RCA方法可从2 mg的慢性乙型肝炎患者肝组织中检测到HBV cccDNA,并可检测低至1×102拷贝/μL的HBV cccDNA.RCA方法不能检测3.2 kb线性HBV DNA,在健康肝组织及15例慢性乙型肝炎患者血清中亦检测不到HBV cccDNA.结论 RCA方法操作较方便,具有很高的特异性和敏感性.  相似文献   

17.
BACKGROUND AND AIM: Parvovirus B19 has been reported to be detected in the sera of patients with acute or chronic hepatitis. The prevalence and clinical significance of B19 DNA in serum samples from patients with chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection were investigated. METHODS: Serum samples from 54 patients with HBV infection, 51 with HCV infection and 53 normal controls were examined for anti-B19 antibodies and B19 DNA by enzyme-linked immunosorbent assay (ELISA), the nested polymerase chain reaction (PCR), Southern blotting and direct nucleotide sequencing, respectively. RESULTS: Anti-B19 IgM and IgG antibodies were detected in 19 (35.2%) and 46 (85.2%) of 54 serum samples from patients with HBV infection, and eight (15.7%) and 36 (70.6%) of 51 serum samples from patients with HCV infection. B19 DNA was detected in serum samples of 20 (37%) of 54 patients with HBV infection and 12 (23.5%) of 51 patients with HCV infection, but not in 53 serum samples from normal controls. The occurrence of liver dysfunction was not affected by B19 infection in patients with HBV and HCV infection (P > 0.05). All of the 20 serum samples with B19 DNA from patients with chronic HBV infection and all of the 12 serum samples with B19 DNA from patients with chronic HCV infection exhibited TW-3 subtype and TW-9 subtype, respectively. The variant subtypes of B19 were found to be distinctive in patients with HBV or HCV infection. CONCLUSIONS: These data revealed that human parvovirus B19 infection was frequently found in patients with chronic HBV or HCV infection. The variant genotypes were present in patients with different chronic hepatitis. The coinfection of B19 with HBV or HCV did not increase the frequency of liver dysfunction in patients with chronic hepatitis. Long-term longitudinal studies are required to determine the natural course of parvovirus B19 infection and whether its coinfection affects the natural history of chronic hepatitis B or hepatitis C.  相似文献   

18.
目的探讨原发性肝癌患者血清血管内皮生长因子(VEGF)及转化生长因子-β1(TGF-β1)的表达水平与肝癌浸润和转移的相关性。方法采集98例原发性肝癌患者和4O例健康志愿者的血清。应用ELISA法检测受检者血清VEGF、TGF-β1的表达水平,并分析其与临床病理因素之间的关系。结果原发性肝癌患者血清VEGF与TGF-β1水平显著高于正常对照组(P〈0.01),患者血清VEGF、TGF-β1的表达水平与患者与肿瘤的组织学分级、浸润深度、转移密切相关(P〈0.01)。血清VEGF与TGF-β1水平呈显著正相关(r=0.418,P〈0.01)。结论VEGF和TGF-β1与原发性肝癌的病情发展、浸润和转移有密切相关性,临床上,血清VEGF、TGF-β1的表达水平可作为了解原发性肝癌生物学行为和判断预后的指标。  相似文献   

19.
AIM: To investigate the role of glycylproline dipeptidyl aminopeptidase (GPDA) isoenzyme in the diagnosis of primary hepatocellular carcinoma (PHC), especially in patients with negative alpha-fetoprotein (AFP). METHODS: A stage gradient polyacrylamide gel discontinuous electrophoresis system was developed to separate serum GPDA isoenzymes, which were determined in 102 patients with PHC, 45 cases with liver cirrhosis, 24 cases with chronic hepatitis, 35 cases with benign liver space-occupying lesions, 20 cases with metastatic liver cancer and 50 cases with extra-hepatic cancer, as well as 80 healthy subjects. The relationships between GPDA isoenzymes and AFP, the sizes of tumors, as well as alanine aminotransferase (ALT) were also analyzed. RESULTS: Serum GPDA was separated into two isoenzymes, GPDA-S and GPDA-F. The former was positive in all subjects, while the latter was found mainly in majority of PHC (85.3 %) and a few cases with liver cirrhosis (11.1 %), chronic hepatitis (33.3 %), metastatic liver cancer (15.0 %) and non-hepatic cancer (16.0 %). GPDA-F was negative in all healthy subjects and patients with benign liver space-occupying lesions, including abscess, cysts and angioma. There was no correlation between GPDA-F and AFP concentration or tumor size. GPDA-F was consistently positive and not correlated with ALT in PHC, but GPDA-F often converted to negative as decline of ALT in benign liver diseases. The electrophoretic migration of GPDA-F became sluggish after the treatment of neuraminidase. CONCLUSION: GPDA-F is a new useful serum marker for PHC. Measurement of serum GPDA-F is helpful in diagnosis of PHC, especially in patients with negative AFP. GPDA-F is one kind of glycoproteins rich in sialic acid.  相似文献   

20.
目的通过对血清反应蛋白(CRP)与甲胎蛋白(AFP)联合检测,探讨其在原发性肝癌诊断与鉴别诊断中的价值。方法抽取52例临床确诊的原发性肝癌患者、68例肝硬化患者及50例健康体检者血液,化学发光免疫分析法检测CRP,放射免疫法检测AFP的浓度,以同期50例健康体检者作对照。结果原发性肝癌CRP、AFP水平与肝硬化及正常对照组比较差异均有统计学意义(P〈0.05)。原发性肝癌组单项CRP、AFP阳性检出率分别为76.9%、73.1%;两项联合检测敏感度达94.2%,与AFP单项检测比较,差异有统计学意义(P〈0.01)。结论联合检测CRP与AFP可提高原发性肝癌的检出率,对肝癌的诊断及鉴别诊断具有实用价值。  相似文献   

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