原発性肝細胞癌診断における血清BFP測定の意義

概要

論文の詳細を見る
We attempted to discover how useful measurements of serum basic fetoprotein (BFP) are in diagnosing hepatocellular carcinoma (HCC). We measured BFP and alpha-fetoprotein (AFP) in the sera of 60 HCC patients and 60 others with liver cirrhosis (LC). Serum BFP was determined by sandwich enzyme linked immunoassay using two monoclonal antibodies that react to different epitopes on the BFP molecule. The lowest measurable levels of BFP and AFP were 75ng/ml and 400ng/ml respectively. Patients with HCC averaged 106.3ng/ml BFP and 656.6ng/ml AFP while cirrhotic patients averaged 46.1 and 19.7ng/ml respectively. Serum BFP was positive in 39 cancerous patients (65%) and 12 cirrhotic patients (20%) ; serum AFP was positive in 33 (55%) and 1 (1.7%) respectively. In diagnosing HCC, BFP was more sensitive and less specific than AFP. BFP was more common in the blood of those with HCC without LC than in those with both diseases, and more common in advanced HCC than in the early stages. AFP, however, was more likely to be found in HCC with LC and was independent of the stage of HCC. In none of our subjects was there any correlation between BFP and AFP levels, so we thought that a combined assay would be more effective in diagnosing HCC. Accordingly, we found that such a combined assay revealed to us 48 (80%) of the HCC patients and 7 (63.6%) of the 11 HCC patients who were in an early stage. To see if BFP could function as a monitor for HCC patients after treatment, we measured BFP in the sera of 15 such patients before and after treatment, we measured BFP in the sera of 15 such patients before and after effective transcatheter arterial embolization (TAE). Serum BFP levels rose transiently and then fell significantly in 10 cases after TAE. In the five cases in which BFP rose after treatment, death followed within 5 months of TAE. We stained cells from 27 dead HCC victims with immunohistochemical agents containing two kinds of monoclonal anti-BFP antibody and one of polyclonal anti-BFP. In general, the monoclonal agent had lesser immunoreactivity than that of polyclonal anti-BFP. The cytoplasm and nucleus were stained homogeneously. These results indicate that serum BFP determination is useful in the diagnosis of HCC, and that combining BFP with AFP improves diagnostic efficiency particularly in the early stages of HCC. Further, using quantification analysis, these proteins together with other liver-function tests will greatly improve the detection of early-stage HCC developing concurrently with LC.
神戸大学の論文

原発性肝細胞癌診断における血清BFP測定の意義

スポンサーリンク

概要

著者

関連論文

スポンサーリンク