甲胎蛋白测定优势肝癌的监测肝硬化患者

StephenW

Liver

Subject Category: Liver

Am J Gastroenterol 2015; 110:836–844; doi:10.1038/ajg.2015.100; published online 14 April 2015

        Alpha-Fetoprotein Measurement Benefits Hepatocellular Carcinoma Surveillance in Patients with Cirrhosis

Te-Sheng Chang MD, PhD1,2,3, Yu-Chih Wu PhD3, Shui-Yi Tung MD1,4, Kuo-Liang Wei MD1, Yung-Yu Hsieh MD1, Hao-Chun Huang MD1, Wei-Ming Chen MD1,2, Chien-Heng Shen MD1,2, Chang-Hsien Lu MD2,5, Cheng-Shyong Wu MD1,4, Ying-Huang Tsai MD4,6 and Yen-Hua Huang PhD3,7,8,9,10

• 1Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Chiayi, Taiwan
• 2Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
• 3Department of Biochemistry and Molecular Cell Biology, College of Medicine, Taipei Medical University, Taipei, Taiwan
• 4College of Medicine, Chang Gung University, Taoyuan, Taiwan
• 5Department of Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
• 6Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
• 7Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
• 8Center for Reproductive Medicine, Taipei Medical University Hospital, Taipei, Taiwan
• 9Comprehensive Cancer Center of Taipei Medical University, Taipei, Taiwan
• 10Ph.D. Program for Translational Medicine, Taipei Medical University, Taipei, Taiwan
  

Correspondence: Yen-Hua Huang, PhD, Department of Biochemistry and Molecular Cell Biology, Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, No. 250, Wuxing Street, Taipei 110, Taiwan E-mail: [email protected]; Ying-Huang Tsai, MD, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, No. 6, Section West, Chiapu Road, Puzih, Chiayi 613, Taiwan. E-mail: [email protected]

Received 5 November 2014; Accepted 9 February 2015
Advance online publication 14 April 2015

Take the CME quiz here

Top of pageAbstractOBJECTIVES:

Liver cirrhosis is a major risk factor for hepatocellular carcinoma (HCC), and all liver study societies recommend HCC surveillance in patients with cirrhosis. However, no ideal modality for HCC surveillance has been determined. The aim of this study is to assess the effectiveness of α-fetoprotein (AFP) measurement in HCC surveillance.

METHODS:

In this retrospective analysis, all patients with cirrhosis, who received HCC surveillance through ultrasound (US) and AFP measurement between January 2002 and July 2010, were followed up until June 2013. The performance effectiveness of surveillance using AFP, US, or both in HCC detection was compared.

RESULTS:

Overall, 1,597 patients were followed for a median duration of 4.75 (range 1.42–12) years. Over the 8563.25-person-year follow-up period, 363 patients (22.7%) developed HCCs. For HCC detection, the area under the receiver operator characteristic curve of surveillance AFP was 0.844 (95% confidence interval: 0.820−0.868, P<0.001). When the traditional cutoff value of 20
ng/ml was used, the sensitivity and specificity of AFP were 52.9% and 93.3%, respectively. US exhibited a sensitivity and specificity of 92.0% and 74.2%, respectively. A combination of US and AFP exhibited a sensitivity and specificity of 99.2% and 68.3%, respectively. By using cut-off at 20
ng/ml and AFP level increase ≥2 × from its nadir during the previous 1 year, the combination of US and AFP yielded a sensitivity of 99.2% and an improved specificity of 71.5%.

CONCLUSIONS:

The complementary use of AFP and US improved the effectiveness of HCC surveillance in patients with cirrhosis.

StephenW

肝

主题分类：肝脏

继续医学教育牛J Gastroenterol 2015年; 110：836-844; DOI：10.1038 / ajg.2015.100;网上公布的14月到2015年
甲胎蛋白测定优势肝癌的监测肝硬化患者

张德胜博士，PhD1,2,3，玉芷吴PHD3，水易秃嗯MD1,4，郭台梁伟MD1，容宇谢MD1，郝淳黄MD1，威名臣MD1， 2，建恒申MD1,2，昌县鲁MD2,5，成武Shyong MD1,4，映黄文仔MD4,6和颜华黄PhD3,7,8,9,10

    胃肠病学和肝病，长庚医院，嘉义，台湾教研室
    临床医学科学院长庚大学2Graduate研究所，台湾桃园
    生物化学与分子细胞生物学，医学院，台北医学大学，台北，台湾3Department
    医药，长庚大学，桃园，台湾4College
    肿瘤学，长庚医院，嘉义，台湾5Department
    肺部和重症医学，长庚医院，嘉义，台湾6Department
    医学科学台北医学大学7Graduate学院，医学院，台北，台湾
    8Center生殖医学，台北医学大学附设医院，台北，台湾
    台北医学大学9Comprehensive癌症中心，台北，台湾
    10Ph.D.程序转化医学，台北医学大学，台湾台北

函授：颜华黄，博士，生物化学与分子细胞生物学，医学科学研究所，医学院，台北医学大学，250号，五星街，台北110部，台湾电子邮箱：rita1204 @ TMU。 edu.tw;英黄文仔，MD，肺及危重病急救医学，长庚医院，6号，西节，Chiapu路，朴子，嘉义613，台湾系。电子信箱：[email protected]

收到的2014年11月5日;接受2015年2月9日
提前在网上公布2015年4月14日

就拿CME竞猜这里
返回页首
抽象
目的：

肝硬化是肝细胞癌（HCC）的主要危险因素，而所有肝脏研究协会建议肝硬化患者肝癌的监控。然而，没有理想的方式肝癌监控已经确定。本研究的目的是评估α甲胎蛋白（AFP）的测定在肝癌监视的有效性。
方法：

在这项回顾性分析中，所有肝硬化患者，谁收到HCC监视通过超声（美国）和AFP测定2002年1月和2010年7月，随访至2013年6月的监视使用法新社，美国的表现效果，或两者在肝癌检测进行比较。
结果：

总体而言，1597例患者随访的4.75（范围1.42-12）年时间中位数。在8563.25-人年随访期间，363例（22.7％），肝癌发展。肝癌的检测，监控AFP的受试者工作特征曲线下面积为0.844（95％置信区间：0.820-0.868，P <0.001）。当使用20纳克/毫升的传统的截止值，AFP的灵敏度和特异性分别为52.9％和93.3％。美国表现出92.0％和74.2％的灵敏度和特异性分别。美国和AFP的组合显示出99.2％和68.3％的灵敏度和特异性分别。通过使用截止在20纳克/毫升和AFP水平增加≥2从它的最低点在以前1年×，美国的组合和AFP产生了99.2％的灵敏度和71.5％的改进的特异性。
结论：

互补使用AFP和美国改善肝硬化患者肝癌监督的有效性。

打虎上山

什么东西,没有一点可读性.

君看一叶舟

结论:甲胎蛋白和超声波检测配合使用可以有效监测肝硬化患者患有肝癌的程度。

君看一叶舟

台湾研究者的文章，关于甲胎蛋白对肝癌检测的重要性研究。不算很新的成果，以前好像听过。