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发表于 2003-10-7 00:29
Chinese Journal of Digestive Diseases
Published on behalf of the Chinese Society of Gastroenterology and the
Chinese Medical Association Shanghai Branch
Print ISSN: 1443-9611
Online ISSN: 1443-9573
Frequency: Quarterly
Current Volume: 4
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Volume 4: Issue 3
Analysis of serum a-fetoprotein concentration in patients with viral hepatitis
Wei Min SHE
De Chang HU
He Jun YUAN
Wei Rong ZHAI
Yi LIANG
Hou Yu LIU
Abstract
OBJECTIVE:
To investigate serum a-fetoprotein (AFP) concentrations in patients with
viral hepatitis.
METHODS:
Serum concentrations of total bilirubin (TB), alanine aminotransferase
(ALT), aspartate amino­transferase (AST), albumin, globulin, AFP and viral
markers were determined in 310 patients with pathologically proven viral
hepatitis. The relation between the concentration of AFP and clinical
manifestation, pathology, family history of liver malignant disease and
virus type was studied.
RESULTS:
Serum AFP concentrations were elevated in 115 of the 310 patients
(37.1%). According to the pathological diagnosis, the lowest positive rate
of AFP was in acute hepatitis (11.7%), the highest was in chronic severe
hepatitis (66.7%), the second highest in liver cirrhosis (57.5%), and
chronic hepatitis was intermediate (34.2%). If the diagnosis was based on
the clinical manifestation, the highest positive rate was found in chronic
severe hepatitis, the lowest in chronic hepatitis, and acute hepatitis was
intermediate. The positive rate of serum AFP by virus type was 35.5% for
hepatitis B (HBV), superinfected with HAV or with HEV was 62.8%, and with
HCV was 27.3%. Only one in six patients with HCV infection and none with
simple HAV or HEV infection were positive for AFP. In patients with a family
history of liver cancer, the positive rate of AFP was higher than in those
without such a history (57.9%vs 38.2%; P = 0.75).
CONCLUSIONS:
The results indicate that AFP positivity is not uncommon in patients
with viral hepatitis and if the patient has an elevated concentration, it is
highly likely to be HBV infection or HBV super­infected with HAV or HEV.
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