纤维蛋白原在HBV相关性肝细胞癌中的临床意义  

Clinical significance of serum fibrinogen level in patients with HBV-related hepatocellular carcinoma

作　　者：张敏娜[1,2] 苏淑慧[2] 吴煜[2] 常秀娟[2] 陈艳[2] 周霖[2] 王春平[2] 杨永平[2] 

机构地区：[1]解放军军医进修学院,北京100853 [2]解放军第三0二医院,北京100039

出　　处：《传染病信息》2009年第2期86-88,共3页Infectious Disease Information

基　　金：国家重大专项基金资助项目(2008ZX10002-018);军队医学杰出人才基金资助项目(04J020)

摘　　要：目的探讨血浆纤维蛋白原(fibrinogen,Fib)水平在HBV相关性肝细胞癌(hepatocellular carcinoma,HCC)中的临床意义。方法87例未经治疗的HBV相关性HCC患者,按巴塞罗那分期标准分为:早期23例、中期20例、进展期23例和终末期21例。检测HCC患者Fib血浆含量和甲胎蛋白(alpha-fetoprotein,AFP)水平。结果Fib血浆含量分别为早期(3.12±0.80)g/L、中期(4.65±1.38)g/L、进展期(5.90±2.85)g/L和终末期(3.60±1.87)g/L。66例患者AFP>20μg/L,占75.86%。AFP阴性HCC患者Fib值在进展期患者中明显升高。结论Fib水平与HCC的形成、发展、恶化、转移呈正相关,对HCC没有早期诊断价值,晚期HCC患者出现Fib水平明显低下时,提示预后差。肝功能正常的HBeAg阴性慢性乙型肝炎患者出现AFP低水平异常时,应关注成像技术检查而排除HCC。Objective To investigate the clinical signifcance of fibrinogen （Fib） in patients with HBV-related hepatocellular carcinoma（HCC）. Methods Totally 87 untreated patients with HBV-related HCC were divided into 4 groups according to BCLC staging classification, 23 patients in early stage group, 20 in middle stage group, 23 in advanced stage group and 21 in terminal stage group. Serum levels of Fib and alpha-fetoprotein （AFP） were detected. Results The mean levels of serum Fib in patients in early, middle, advanced and terminal stage groups were（3.12±0.80） g/L, （4.65±1.38） g/L, （5.90±2.85） g/L, and （3.60±1.87） g/L, respectively. AFP positive （〉20 μg/L） was found in 66 patients（75.86%）. The levels of Fib increased significantly in AFP negative patients in advanced stage group. Conclusions The levels of Fib are positively related to the formation, progression, deterioration and metastasis of HCC, have no value in the early diagnosis of HCC, and suggest poor prognosis when they decrease significantly in patients in terminal stage. When a slightly elevated AFP level is found in HBeAg-negative chronic hepatits B patients with normal liver function, imaging techniques should be applied to exclude HCC.

关 键 词：肝细胞癌 纤维蛋白原 甲胎蛋白 巴塞罗纳分期 

分 类 号：R735.7[医药卫生—肿瘤] R512.62[医药卫生—临床医学]